Understanding Fibromyalgia

As a massage therapist, I have worked with a lot of clients over the years with fibromyalgia. Fibromyalgia is one of the most misunderstood and frustrating medical conditions out there today. Many people who suffer from this chronic disease have been misdiagnosed multiple times before someone figures out why they have so much pain.

Fibromyalgia is a disorder characterized by widespread body pain often accompanied by chronic fatigue that has no other underlying condition. Fibro = fibrous tissue, Myo = muscle, and Algia = pain. Widespread body pain means that pain is bilateral (on both sides of the body) and above and below the waist.

This disorder is so frustrating for fibromyalgia sufferers and physicians because there is no known cause of the disease and no test to confirm the diagnosis. There is also not one particular treatment that works for everyone. Sometimes fibromyalgia begins after some sort of accident, trauma, or infection. However, oftentimes it will show up after no apparent trigger or will develop over time. What IS known about fibromyalgia is that it is much more likely to affect women than men.

Doctors mostly diagnose fibromyalgia based on a predictable pattern of tender points:

• Back of the head
• Between shoulder blades
• Top of shoulders
• Front sides of neck
• Upper chest
• Outer elbows
• Upper hips
• Sides of hips
• Inner knees

Doctors will apply firm pressure to these points to check for pain and tenderness. If the patient has pain, with no other underlying cause, in at least 11 of these points, fibromyalgia is suspected. Doctors will also use the patient’s subjective reports of poor sleep habits (chronic fatigue syndrome), pain described as ‘all over’ and a ‘dull ache,’ depression/anxiety, headaches, endometriosis, and irritable bowel syndrome as clues.

Fibromyalgia pain is believed to be a result of something called ‘central sensitization.’ In layman’s terms this means that people with fibromyalgia have a lower pain tolerance because of increased sensitivity in their brain to pain. The brain remembers the pain, and the sufferer is more likely to notice the pain sensation. This does not imply that these people have a low pain tolerance or that they are ‘wimpy.’ Their condition makes them more sensitive to the pain.

Possible treatments
There is no ONE treatment for fibromyalgia. Sometimes it is a combination of treatments that is the most effective.

• Medication: Some medications have been shown to give relief to fibromyalgia sufferers. Some muscle relaxers, antidepressants, and anti-seziure medications have been effective. Cymbalta and Lyrica have been approved to treat fibromyalgia.
• Physical Therapy and Exercise Programs: Exercise along with some manual treatment (soft-tissue massage, stretching) can relieve pain and symptoms. Physical activity can also improve sleep patterns.
• Cognitive Behavioral Therapy and Support Groups: Oftentimes just talking to someone can help fibromyalgia patients feel better. Since fibromyalgia is so misunderstood by the general public, sufferers often feel isolated and depressed. Talking to people who understand what they are going through can be very helpful.
• Diet: Eating healthy and avoiding possible triggers like caffeine, nicotine, alcohol, high sodium, and highly processed foods can help prevent pain from getting worse.
• Massage Therapy and Acupuncture: Some alternative therapies like massage and acupuncture have been show to be very effective in relieving trigger point pain associated with fibromyalgia. Since a lot of the pain associated with fibromyalgia comes from these tender points, trigger point massage and the needling with acupuncture can help decrease the intensity of these points.

If you suffer from fibromyalgia, please talk to your doctor about what combination of these treatments may work for you. If you need more information on fibromyalgia or are looking for a support group, you can go to www.mayoclinic.com or www.fmaware.org.