Fibromyalgia

Definition:

Fibromyalgia - A chronic disorder characterized by widespread musculoskeletal pain, fatigue, and multiple tender points that occurs in precise, localized areas, particularly in the neck, spine, shoulders, and hips; also may cause sleep disturbances, morning stiffness, irritable bowel syndrome, anxiety, and other symptoms.

Mr Stefan Chmelik on Fibromyalgia (FMS – Fibromyalgia Syndrome)

FMS is better described as a number of potential symptoms, rather than a disease in itself. You could have several symptoms from the many that may be present, and it is the combination that leads to an FMS diagnosis. Muscle pain is always a feature, but digestive problems, sleep disturbance and emotional issues are all common. I have found that there are certain factors that are nearly always present with someone suffering from FMS, and that it is only through understanding and addressing these aspects that meaningful change can be made.

Someone with FMS may well feel depressed, but this can be a response to the condition rather than the cause of it. I also frequently find that people are likely to be hyperventilating or breathing badly, and it is essential to change this for improvements made through treatment to stick.

Although not usually a condition that is quick to respond to treatment, an appropriate combination of diet, acupuncture, herbs, supplements, breathing, relaxation and discussion can bring about lasting improvement.

David Peters on Muscle pain and trigger points (also called myofascial pain)

Acute muscle pain usually begins suddenly. So you can generally recall a definite time and place when it was briefly overloaded; perhaps in a road accident, a near fall, a sports activity, heavy lifting, twisting or over-reaching. The acute pain (particularly if it's your back that hurts) often takes a few hours or even a day or so to appear. There might be obvious signs that a joint has been strained at the same time (pain, redness, swelling). This kind of pain will usually respond well to RICE (rest, ice-packs, compression-bandaging and elevation) with or without some and pain-killers and later on anti-inflammatory medicines. I have found acupuncture helpful too.

But when your muscles have been sore for months or longer its less likely you will be so clear about when and how it began. The pain may by now have spread beyond its original source and, if its been dragging on for months the pain might have made you cut down on your physical and social activities. Perhaps it’s bad enough to have stopped you sleeping well. Its effects could even be making you feel a bit depressed; or that you aren’t relating as well to your family or your job; even that you may be losing control of your life. It can be confusing when the psychological side of things is predominant: which came first you might be wondering, the chicken (the pain) or the egg (the stress)?

'All in your head?' Perhaps you’ve already consulted a doctor, who was not able to locate a source of your pain. This may have left you feeling that your pain isn’t "real"; that its 'all in your head'. While its true that persistent muscle pain can be a sign of depression, and that stress can make it worse, it is also the case that well-meaning practitioners do not always understand enough about myofascial pain syndromes to have properly ruled them out; especially when the trigger point from which the pain arises is some distance from where you feel the pain.

A myofascial pain syndromes is more likely if the pain has lingered on after an injury (sometimes even quite a minor one); or if you have noticed very tender points in the muscles of one part of your body (tenderness all over the body goes against a myofascial cause). You may have found tender points that cause pain elsewhere when pressed. These ‘trigger points’ can be some way from the target area. For instance trigger points in the shoulder muscles cause a headache in the temples; certain trigger points in the buttocks can give you low back pain. If the muscles have tightened up, you might have noticed a reduced range of motion in the joint moved by the painful muscle(s).

The essential outcome of ant myofascial treatment is to desensitise the trigger points so that the muscle can stretch and relax. I usually treat myofascial pain syndromes with a combination of osteopathy and acupuncture. Sometimes I inject trigger points to reduce their sensitivity. Relaxation techniques are sometimes important, especially when long term pain has increased a person’s stress levels.

Muscle pain: all over the body, long term

Unlike the pain of a myofascial syndrome, which is typically provoked only by particular movements, and tends to be confined to one part of the body, fibromyalgia pain is far more widespread. People with fibromyalgia ache in many different places and may have noticed that several parts of their body are very tender when touched or pressed. The pain of fibromyalgia syndrome typically develops more gradually so its unlikely you can remember a particular time when your symptoms began. But In addition, people with this kind of pain often complain of poor sleep, and experience considerable fatigue.

Mr Leon Chaitow on Fibromyalgia

Although a complex and stubborn problem, there are a number of interventions that are beneficial for many people

• Acupuncture in general and electro-acupuncture in particular has an excellent track record in treatment of pain. The leading authority on pain and Fibromyalgia is categorical that only acupuncture has the ability to suppress the neural activity that causes FMS pain (1)
• Exercise, as guided by a therapist (2)
• Osteopathy (3, 4, 5)
• Herbal medicine

Refer to my book for more information: Fibromyalgia and Muscle Pain: Your Self-treatment Guide (Thorsons/Harper-Collins)
3 rd edition (2001)

References:
1. Dr. P. Baldry Acupuncture, Trigger Points and Musculoskeletal Pain (Churchill Livingstone, Edinburgh, 1993)
2. McCain G Role of physical fitness training in fibrositis/fibromyalgia syndrome American Journal of Medicine 1986 (supplement 3A)pp73-77
3. Fisher P et al Effect of homoeopathic treatment of fibrositis (primary fibromyalgia) British Medical Journal 32pp365-366 1989
4. Gemmell H et al Homoeopathic Rhus Toxicodendron in treatment of Fibromyalgia Chiropractic Journal of Australia Vol.21 No1 March 1991pp2-6
5. Stoltz A Effects of OMT on the tender points f Fibromyalgia Report in Journal of American Osteopathic Association 93(8)p866 August 1993