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What is Fibromyalgia... 
and Why is Chiropractic Care So Important?


Fibromyalgia includes widespread muscle pain, fatigue, and multiple tender points. 

In addition to pain and fatigue, people who have fibromyalgia may experience:

  • sleep disturbances
  • morning stiffness
  • headaches
  • irritable bowel syndrome
  • painful menstrual periods
  • numbness or tingling of the extremities
  • restless legs syndrome
  • temperature sensitivity
  • cognitive and memory problems (sometimes referred to as "fibro fog")

Unfortunately, fibromyalgia is a chronic condition, meaning it lasts a long time - possibly a lifetime. However, it won't cause damage to your joints, muscles, or internal organs.

Chiropractic Care Is Critical if You Have Fibromyalgia

Chiropractic care helps keep your spine and muscles from losing too much movement.

Because fibromyalgia causes the muscles to tighten up and lose some of their natural pliability, it can result in a loss of movement in the spine. This loss of movement in the spine results in a neurological reflex that causes the muscles to tighten even further. This vicious cycle will continue and over time it will lead to more pain, more muscle tightness, a loss of movement, and difficulty sleeping as well as development of more and more trigger points.

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You Must Continually Adjust the Spine and Keep it Moving

It is not uncommon for those with fibromyalgia to be adjusted three to four times per month to keep everything mobile and relaxed.

The biggest concern in treating people with fibromyalgia is that their muscles have a diminished healing ability. For this reason, chiropractic adjustments are usually modified slightly to be more gentle than normal. This helps to decrease the stress on all of the small supporting muscles of the spine, which can be easily injured.

It is important when seeking chiropractic care, to make sure that the doctor is familiar with the muscular changes that occur with fibromyalgia so that they can adjust their treatment accordingly.

The Basics of Fibromyalgia

One of the major physical abnormalities that occurs with fibromyalgia lies in the muscle itself, where there is a build up of a protein called "Ground Substance." Ground substance is normally found in muscle, bone and connective tissue all over the body and is responsible for making the tissues stronger and less susceptible to tearing. In a normal person, when a muscle is injured, the muscle tissue itself is able to regenerate and over time and completely heal itself.

In a person with fibromyalgia, the muscle is unable to completely heal itself. Instead, an abnormally large amount of ground substance builds up in the injured area. It is the ground substance, coupled with the local muscle spasm it creates that creates the muscle 'knots' associated with fibromyalgia.

A number of tests may be done to rule out other disorders and an examination can reveal whether a person has the characteristic tender areas on the back of the neck, shoulders, sternum, lower back, hips, shins, elbows, or knees.

Unlike its cousin lupus, there are currently no diagnostic laboratory tests for fibromyalgia.

Because there are no clinical tests for fibromyalgia, some doctors, unfortunately, conclude that a patient's pain is not real, or they may tell them that there is little they can do. But a combination of chiropractic, trigger point therapy, and lifestyle changes has proven to be very effective in decreasing the severity and duration of the physical pain and disability of fibromyalgia.

Fibromyalgia can be difficult to treat. Not all doctors are familiar with fibromyalgia and its treatment, so it is important to find a doctor who is. Fibromyalgia treatment often requires a team approach, utilizing chiropractic care, trigger point therapy, massage, dietary changes, as well as exercises and stretching.

Dr. Eric Janowitz
Oviedo Family Chiropractic

Treating Fibromyalgia with Trigger Point Therapy

The overwhelming characteristic of fibromyalgia is long-standing, body-wide pain with defined tender points, and frequently, trigger points. Trigger points are often confused with "tender points." They are not the same. A trigger point needs firm pressure to elicit pain, while tender points are painful with even very light pressure. Trigger points will refer pain to other areas of the body, whereas tender points will not. Unlike tender points, trigger points can occur in isolation and represent a source of radiating pain, even in the absence of direct pressure. As discussed earlier, trigger points are purely comprised of spasmed muscle fibers, whereas tender points are knots filled with ground substance. Those with fibromyalgia almost always have a combination of the two - trigger points and tender points - and can improve dramatically with light trigger point therapy.

Trigger point therapy for fibromyalgia is much like trigger point therapy for low back pain, neck pain or headaches. The points are the same. The difference is just intensity. Since the muscles in patients with fibromyalgia are easily injured and take longer to heal, it is necessary to use less pressure on their trigger points.

Treating Fibromyalgia with Cold Laser Therapy

Since poor healing of muscle tissue and chronic pain are characteristic traits of fibromyalgia, laser therapy is an important part of any treatment plan. Two of the major benefits of cold laser therapy is stimulation of tissue healing and decreased sensations of pain.

A 1997 study of 846 people with fibromyalgia reported in the Journal of Clinical Laser Medicine and Surgery demonstrated that two-thirds of the patients experienced improved pain and mobility with cold laser therapy. Another study published in Rheumatology International in 2002, showed that those who received laser therapy had a significant improvement in pain, fatigue and morning stiffness.

Self-Care for Fibromyalgia

Your day to day lifestyle choices have a tremendous impact on how fibromyalgia will affect your life.

The Difference Between Those Who Take Care of

Themselves and Those Who Don't

... Is Tremendous.

Those who make lifestyle changes to help their fibromyalgia suffer much less pain, are able to remain more active and have a much higher quality of life than those who do not.

If you have fibromyalgia, here are some of the main things that you can do on a daily basis to help your body:

Getting enough good sleep

Getting enough sleep and the right kind of sleep can help ease the pain and fatigue of fibromyalgia. Unfortunately many people with fibromyalgia have problems such as pain, restless legs syndrome and brain-wave irregularities that interfere with restful sleep.

Insomnia is very common.

Although alcohol may help you to relax, it is not recommended before bed as it has been shown to interfere with restful sleep. Some of those with fibromyalgia have found 5-hydroxy tryptophan (5-HTP) very helpful, as well as the prescription anti-depressant amitriptyline. Typically, we don't recommend taking prescription drugs, but in this case, it is difficult to heal without enough sleep.

Exercising

 Improved fitness through exercise is recommended. Studies have shown that fibromyalgia symptoms can be relieved by aerobic exercise. Though pain and fatigue may make exercise and daily activities difficult, it's crucial to be as physically active as possible.

The best way to begin a fitness program is to start with low impact exercises, like walking and swimming. Starting slowly helps stretch and mobilize tight, sore muscles. High-impact aerobics and weight lifting could cause increased discomfort, so pay attention to your body. The more you can exercise, the better off you will be.

Making changes at work

Most people with fibromyalgia are able to continue working, but they may have to make big changes to do so. It may be necessary to reduce the number of hours at work, find a job that will allow you to have a flexible schedule, or switch to a less physically demanding job.

Many people with fibromyalgia require specially designed office chairs, adjustable desks or other adaptations in order to continue working. If you face obstacles at work, such as an uncomfortable desk chair that leaves your back aching or difficulty lifting heavy boxes or files, your employer may make adaptations that will enable you to keep your job.

Eating well

Foods, just like anything else, have the ability to either stress your body or to help your body heal. Foods that tend to be stressful on the body include: dairy, eggs, wheat, corn, as well as anything with monosodium glutamate (MSG), nitrates or nitrites (as are found in processed foods). Several environmental toxins may also contribute to the overall physical stress on your body, therefore fish should be avoided as well. It is important that you eat as much clean, organically grown fresh foods as possible. Base your diet around whole foods such as: brown rice, legumes, oats, spelt, rice milk, soy, hormone-free chicken or turkey, roots, nuts and berries.

Nutritional supplements

There are dozens of nutritional products that claim to be 'the answer' for fibromyalgia.

To date, none of them have proven to have long-term benefit. However, there are some people who have used magnesium malate with good results, some people who have used ginkgo biloba with good results and others with various herbals.

The bottom line with nutritional supplements is that, do date, there is nothing that works for everyone.

If you come across something that you would like to try, by all means do so, as long as you check it out with your chiropractor first to ensure that it won't interfere with any of your other treatments.



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