Fibromyalgia (F.M.)

Fibro = Fibrous tissue

my = muscle

algia = pain

Fibromyalgia is a chronic condition of widespread pain and profound fatigue.  The pain tends to be felt as diffuse aching or burning, often described as head to toe.  It may be worse at some times than at others.  It may also change location, usually becoming more severe in parts of the body that are used most.  The fatigue ranges from feeling tired, to the exhaustion of a flu-like illness.  It may come and go and people can suddenly feel drained of all energy – as if someone just “pulled the plug”.

Symptoms vary from sufferer to sufferer, and besides pain and fatigue, can include:

Poor quality sleep: Fibromyalgia can affect your sleep.  You may find you often wake up tired even when you have had plenty of sleep.  This is because Fibromyalgia can sometimes prevent you from sleeping deeply enough to refresh you properly.  You may hear this described as ‘non-restorative sleep’. 

Cognitive problems ('Fibro-fog'): are problems with mental processes, such as thinking and learning.  If you have Fibromyalgia, you may have:

• trouble remembering and learning new things

• problems with attention and concentration

• slowed or confused speech

Headaches: If you have pain and stiffness in your neck and shoulders from Fibromyalgia, you may also have frequent headaches.  These can vary from being mild headaches to severe migraines, which may also involve other symptoms, such as nausea.

Other symptoms of Fibromyalgia can include:

• not being able to regulate your body temperature (feeling too hot or too cold)

• restless legs syndrome

• tingling, numbness, prickling, or burning sensations in your hands and feet

• tinnitus

• unusually painful periods

• anxiety

• depression

• irritable bowel

• clumsiness and dizziness

• sensitivity to changes in the weather and to noise, bright lights, smoke and other environmental factors allergies

It is believed that Fibromyalgia often develops after some sort of trauma that seems to act as a trigger, such as a fall or car accident, a viral infection, childbirth, an operation or an emotional event.  Sometimes the condition begins without any obvious trigger.

The actual cause of Fibromyalgia has not yet been found.  Over the past several years, however, research has produced some insights into this puzzling condition.  For instance, it has been known that most people with Fibromyalgia are deprived of deep restorative sleep.  Current studies may find out how to improve the quality of sleep and some of the prescribed medicine is specifically aimed at addressing the lack of restorative sleep.

Research has identified a deficiency in Serotonin in the central nervous system coupled with a threefold increase in the neurotransmitter substance P, found in spinal fluid and which transmits pain signals.  The effect is disordered sensory processing.  The brain registers pain when others might experience a slight ache or stiffness.  It is hoped that more research will discover the cause and result in more effective treatment.

The best way to cope with Fibromyalgia is to use a number of techniques that ease the symptoms as much as possible:

• Pacing.  Taking your time doing every day tasks.  Sitting down and having a coffee whilst vacuuming/cleaning for instance.  Listen to your body when it tells you to slow down.

• Relaxation is one technique that works really well for almost everybody with Fibromyalgia.  It reduces tension in the mind and body right away.  The results are calming for all the symptoms, especially for the pain.  Relaxation can be learned from books, tapes, videos or special courses.

• Heat is important.  A hot water bottle and hot baths or showers will help reduce pain and banish morning stiffness.  Soaking hands and feet in hot water for a few minutes can ease their aching.  Alternatively some sufferers use a cold peppermint foot spray which can help ease aching feet.

• Exercise is the most common prescription for Fibromyalgia, even just light stretching.

• Massage, light, relaxing type, (not sports massage which would leave a sufferer unable to move after, even if they could take the pain of one)

• Diet.  Although no particular diet has been shown to help Fibromyalgia, a healthy, balanced diet is important to provide protein, vitamins and minerals.  It is best to avoid or at least cut down on coffee, tea and alcohol.

Myofascial Pain

Myo = refers to muscle

fascia = the layers of connective tissue that surround the muscles

Myofascial pain syndrome is a chronic pain disorder.  In this condition, pressure on sensitive points in your muscles (trigger points) causes pain in the muscle and sometimes in seemingly unrelated parts of your body.  A trigger point in the back, for example, may produce referral pain in the neck.  The neck, now acting as a satellite trigger point, may then cause pain in the head.  The pain may be sharp and intense or a dull ache.

Our muscles comprise a very large part of our bodies, and are a very potent source of pain.  This pain can be a very effective mimic of many other pain contacts - a very large number of what are described as "trapped nerves" are in fact muscle pains.  Sadly, this area of pain is not well understood by many health professionals. 

We all get pain in our muscles from time to time, with "cricked necks", the symptoms of 'flu and so on.  Muscle pain is also a component of the symptoms associated with many other painful contacts such as back pain and neck pain.

In some people muscle pain can become persistent and can cause considerable problems.  In the past this was given names like Fibrositis, but now these pains are classed as Myofascial pain.

Muscle adhesions, (you might've heard them called knots), are places where the muscle has become chronically contracted.  It can be an entire muscle, but more than likely it is a small band within the greater muscle.  When you run your hand over the area, you can actually feel the muscle's contraction in the form of a lump.  Things that cause adhesions are dehydration, over-use/over-stretching and injury.

Patients with Myofascial pain usually report regionalized aching and poorly localized pain in the muscles and joints.  They also may report sensory disturbances, such as numbness in a characteristic distribution.  Patients often report disturbed or unrefreshing sleep.

Self management techniques are extremely important.  Sedentary individuals are more prone to develop active TrPs than are individuals who exercise vigorously on a daily basis.

There are a number of things that you can do which can help to reduce the symptoms of Myofascial pain:

·         Exercise regularly.  Aerobic fitness of the muscles is a very important factor in helping Myofascial pain. 

·         Improve your posture.

·         Reduce your body weight.

·         Eat a healthy, well-balanced diet.

·         Learn stress-management techniques and relaxation techniques.

·         Use proper techniques at work, and during exercise and sports

Treatment for Myofascial pain syndrome typically includes:

·         medications

·         trigger point injections (or acupuncture treatments directly to the muscles)

·         massage, physical therapy.

Difference between Myofascial Pain and Fibromyalgia

Although Myofascial pain and Fibromyalgia have some overlapping features, they are separate entities; Fibromyalgia is a widespread chronic pain problem, not a regional condition caused by specific Trigger Points.