Fibromyalgia is a condition that is mainly characterized by generalized chronic musculoskeletal pain. Yes, this is a broad statement and that is why so many of us don’t know much about it and when or how it is diagnosed.
So, what do we need to know?
Firstly, fibromyalgia is a female prevalent condition with a staggering 5:1 female-to-male ratio. Fibromyalgia affects approximately 2% of the population worldwide but in New Zealand, it is estimated that about 6% of the population suffers from it. As with many conditions like this (that take longer to diagnose), it is simply diagnosed more often in developed countries as there is better access to healthcare.
Fibromyalgia has an increasing incidence with aging and is often associated with other inflammatory (and autoimmune) conditions such as irritable bowel syndrome (IBS), chronic fatigue syndrome and migraines, rheumatoid arthritis (RA), or systemic lupus erythematosus (SLE).
What are the symptoms?
- Chronic and generalized musculoskeletal pain.
- Fatigue.
- Stiffness, aching, and fatigue in multiple muscle groups.
- Persistent morning stiffness.
- Pin and needles.
- Headaches.
- Difficulty sleeping.
- All the above are made worse in cold and damp weather, sitting for prolonged periods, mental stress, overexertion, or when fatigued.
What is the cause?
Unfortunately, even in the twenty-first century, there are still conditions where the cause is unknown. Fibromyalgia is one of them. It never used to be considered a medical condition – believing that it was more a psychological condition, but this has changed in recent years. So, what could be causing inflammation and pain in the fibrous tissues and muscles?
There are various theories. The first theory is that there is some form of malfunction or misfiring of the processing of pain signals in the brain or spinal cord where what would normally be perceived as uncomfortable is misinterpreted by the nervous system as pain.
Other theories explain that fibromyalgia is associated with low levels of serotonin or possibly altered alpha rhythms due to interrupted non-rapid eye movement sleep (the stage of deep sleep).
It is suggested that fibromyalgia is commonly triggered by severe emotional events, sickness, or physical injuries and it is suspected that there is a genetic link.
The big question is – how is it diagnosed?
Fibromyalgia is one of those conditions where most of us know someone who has it but most of us do not fully understand what it is. This is most likely because there is no exact known cause, exact symptoms, or specific one-dimensional treatment for it. From start to finish – it is a vague condition.
It is often a condition or term that is incorrectly used as an umbrella term for patients who suffer from chronic pain when the cause is difficult to determine. The reality is that fibromyalgia is a condition that needs to fit into very specific criteria to be diagnosed properly which we will discuss below.
Unfortunately, due to the variability of the symptoms, it is often not a straightforward diagnosis and is rarely diagnosed straight away but usually after a long-time of suffering. Many patients will approach practitioners with a specific area where they are experiencing pain and it takes time for the practitioner to build a full understanding of the clinical picture at hand – the patient responds positively to treatment but they tend to come back explaining that they are suffering with differing areas of pain.
Fibromyalgia is not diagnosed with specific blood tests or x-rays and ultrasounds. These tools are used to exclude other conditions.
So, the clinical picture needs to be pieced together and examined by looking at the greater picture at hand. Fibromyalgia is most often diagnosed by deduction.
There is a specific criterion that needs to be met for fibromyalgia to be diagnosed according to the American College of Rheumatology
- Persistent generalized musculoskeletal pain.
- Bilateral and above and below the waistline.
- For at least 3 months.
- Tenderness at 11/18 of the following sites:
- 9 of which must be bilateral.
- Suboccipital, lower cervical spine (C5-C7), upper trapezius, supraspinatus, second rib at costochondral junction, later epicondyle (2cm distal), gluteal muscles, greater trochanter of the femur and medial fat pad of the knee (proximal to joint line).
What is the treatment approach?
There is little consistent evidence available for a definite treatment or cure for fibromyalgia, but we encourage patients to not be disheartened.
Treatment requires a holistic approach and we have seen the results time and time again.
Moving is almost always the answer! No matter what condition we are dealing with. The body does not like to be in stagnation for too long, but this is of particular importance with fibromyalgia. Exercise is a non-negotiable BUT this is done at a fine balance. It needs to be mild to moderate exercise as too much or too intense exercise may create inflammation and fibromyalgia flair-ups.
As with exercise, movement is the medicine – so it is with Chiropractic. With the correct adjustment, movement, and normality are restored within the body. Getting the right Chiropractic care will give the body’s nervous system the ability to balance, adapt and build resilience, and with regular, maintenance care we see the greatest results.
Rest and stress management are just as important. Stress and inflammation go hand in hand and so the better we manage our stress, the less likely there will be pain and inflammation. A calm mind gives space for a calm body. How do we do this? Getting out into nature, exercising, eating well, engaging in the community, having fun, and keeping a mindset of self-compassion. If you look at our previous blog post about Applied Kinesiology, you’ll note a bunch of techniques you can use to stimulate the vagus nerve (a way to get the body out of stress mode). Dr Mac recommends singing, whistling and humming.
Food is medicine at our very fingertips. An anti-inflammatory diet is recommended. This means reducing the number of foods that are processed, high in sugar or fat (fried), and refined grains as well as reducing alcohol intake. Anti-inflammatory foods are encouraged such as fruits and vegetables, whole grains, lean proteins, and healthy fats (such as almonds or salmon)
Supplementing with magnesium and vitamin D as well as activated B6 is always a go-to for any patient that suffers from acute or chronic pain. Both supplements allow the muscles, nerves, and bones to function at their optimal level. Any form of deficiency (which both of these often are) is simply an added stress to the body.
Getting the diagnosis of fibromyalgia is both scary and relieving. It’s not a diagnosis anyone wants to hear but it also gives patients the peace of mind knowing that what they are going through is real.
We are here to tell you that yes, it is real – but so is the treatment approach. These are all excellent tools to have to give your body the best chance possible at living a full, happy, and pain free life. We have seen it so many times. At Chirolink, we love to see that our patients are educated and that they are given the best tools possible.
If you’d like to know more about fibromyalgia, contact us at Chirolink and book an appointment. We are here to help.