By Dr. Greg Fors, DC, DIBCN
Board Certified Neurologist
Fibromyalgia Syndrome is not a disease, but actually a syndrome presenting with a common set of symptoms; individuals complain of being "sore all over" and generally more fatigued. It conservatively now affects more than 6 million Americans. Fibromyalgia Syndrome (FMS) is 10 to 20 times more likely to affect women of child-bearing age; however, it can occur in men and affect all age groups.
Besides widespread musculoskeletal pain, fibromyalgia suffers commonly complain of sleep disturbance, morning stiffness, headaches, irritable bowel syndrome (IBS), depression and anxiety. Nearly one-third of fibromyalgia syndrome patients claim they cannot hold down a steady job. Despite poor response to standard fibromyalgia treatment, healthcare costs have been documented at $2,274/year per fibromyalgia patient. It has been estimated that fibromyalgia puts a $20 billion drain on the U.S. economy, and a tremendous personal burden of those affected by fibromyalgia syndrome.
Criteria of a Fibromyalgia Syndrome Diagnosis:
Many individuals have been diagnosed as having fibromyalgia syndrome (FMS) or think they have fibromyalgia when in actuality they have regional myofascial pain syndrome (MPS), please see my article on MPS to understand difference.
To be diagnosed with fibromyalgia syndrome, according to the American College of Rheumatology 1990 classification, an individual must fulfill the following two criteria. Also there must be no other disease that would explain the individual's symptoms, for example rheumatic arthritis, systemic lupus, gout hypothyroidism, etc.
1. History of widespread pain for at least 3 months:
1. Pain is on both sides of the body
2. Pain is also above and below the waist
3. Pain is present in the axial skeleton (neck, mid-back, low back pain)
2. They must also have pain in at least 11 of 18 fibromyalgia tender point sites on digital pressure (see body diagram)
1. These points must have marked tenderness to palpation and possibly refer pain, and not just "tender"
2. Pain is elicited with approximately 4 kg of pressure
About 90% of fibromyalgia syndrome patients report symptoms of fatigue, unrestful sleep, and general morning stiffness. However, recent research is now showing that fibromyalgia syndrome in not simply a sleep disorder and sleep medications are not the complete answer. Because fibromyalgia syndrome can mimic other more dangerous diseases any individual must have a proper diagnostic work-up before accepting the diagnosis of fibromyalgia syndrome. You cannot use this article for self-diagnosis.
The Pain and Tenderness of Fibromyalgia:
Through complex changes in mechanisms involving the central nervous system (spinal cord and brain), fibromyalgia syndrome patients develop tenderness throughout their body. Fibromyalgia patients have enhanced pain perception at tender points in muscles, subcutaneous tissues, and even the skin itself.
This diffuse severe surface tenderness makes it difficult if not impossible to palpate deep muscle tissues for myofascial trigger points. However, research has found that tender points in muscles and tendons of fibromyalgia patients are many times myofascial trigger points. These myofascial trigger points under the severe surface tenderness of fibromyalgia syndrome patients’ accounts for a great of the deep aching pain they experience.
If fibromyalgia syndrome patients can work through their surface tenderness the myofascial trigger points deep in their muscles can be deactivated and they can experience a great deal of pain relief. If they are too extremely tender to apply trigger point therapy, fibromyalgia syndrome patients need to find a doctor to help them lower their surface pain hypersensitivity.
A comprehensive natural biomedical approach at the Pain And Brain Healing Center can help to reduce the severe ache, tenderness and fatigue of fibromyalgia syndrome. To achieve this we must improve the energy production of the mitochondria of your muscle cells and decrease the systemic inflammation and oxidative stress. For example, various studies have found improvement in fibromyalgia syndrome patients utilizing nutritional supplementation, such as: Omega-3 fatty acids, magnesium malate and proper anti-oxidants. Also, numerous studies have shown proper use of herbs, such as the standardized ginger and curcumin extracts that we use here in the office, can lower pain and inflammation in musculoskeletal disorders.
One study by Srivastava K.C. and Mytafa T. reported in Medical Hypothesis journal found ten out of ten patients with muscular discomfort experience pain relief with gingerroot extracts. A good place to start in understanding how do this is with my book “Why We Hurt”
Myofascial Trigger Points in Fibromyalgia Patients:
Once a fibromyalgia patient can utilize gentle myofascial trigger point therapy, daily home therapy with a device such as the FENIX Rehab System can allow them to begin release pain-causing trigger points themselves at home. However, instead of using direct deep pressure to deactivate this trigger points, there are special techniques to make it easier for fibromyalgia patients. All of this is part of our comprehensive program at the Pain and Brain Healing Center
The FENIX Rehab System is an ideal active home therapy program to assist us at the Pain and Brain Healing Center in keeping you as pain-free as possible.
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