Everyone knows someone in their social circle who suffers from Fibromyalgia, one of the most misunderstood conditions in the medical community. At Kent Chiro-Med Wellness Clinic, our practitioners treat an extensive number of Fibromyalgia patients. They all coming in with different medical profiles, age differences, various pain level, and diverse expectations. Many have tried everything and they come to us as last resort. These are emotionally and physically fatigued patients, who are tired hearing people and doctors telling them that their disease is “all in their head”. At our clinic, practitioners have great research knowledge and clinical experience in understanding and managing Fibromyalgia.
Until today, doctors and scientists do not know what causes Fibromyalgia. There is no cure for it yet. However, post-traumatic event(s), emotional shock, anxiety, chronic stress, certain chronic joint diseases such as lupus and rheumatoid arthritis, jaw disorders, unhealthy diet, and lack of sleep may predispose certain individuals to develop Fibromyalgia.
What’s The Latest Evidence to Explain Fibromyalgia?
Our review of the medical database concluded two interesting group of research studies that explain the cause of Fibromyalgia. In the first group, it has been shown that the brain and spinal cord of Fibromyalgia patients process pain signals differently. As a result, they react more strongly to touch and pressure, with a heightened sensitivity to pain. It’s like you are stuck in a loud party and there are no law enforcement authorities to come and tone the music down for you. You are forced to be in this loud party for days. Over the next few days, you get tired, irritated and hypersensitive to sounds and noises. Fatigue, exhaustion, and body aches finally kick in. Then, even when the party is over, anytime you hear a loud noise or you are forced to do a mentally challenging task, you start to feel body pain and hypersensitivity to everything. It becomes now a vicious chronic cycle pain. Essentially, that's how the brain and spinal cord behave in a person with Fibromyalgia; there is an increase in the volume setting in the pain processing such that they don’t have damage or inflammation in the muscles or joints or tissues in order to experience pain. It’s just that their volume control is turned up too loud. Many patients described Fibromyalgia like “as if they got hit by a Mack truck daily.” Fibromyalgia pain has no boundaries. Some people describe the pain as deep muscular aching, while others can feel throbbing, shooting, stabbing, or intense burning pain. Like any other disease, Fibromyalgia patients have their bad and good days.
However, on June 2013, Albrecht and his team from the Pain Medicine Journal discovered another observation in Fibromyalgia patients.(Albrecht et al., 2013) They sampled skin from the Fibromyalgia patients and were surprised to find an extremely excessive amount of a particular type of nerve fiber called arteriole-venule (AV) shunts. These researchers stipulated that Fibromyalgia patients contain an excessive presence of sensory nerve fibers around specialized blood vessel structures located in the palms of the hands. This mismanaged blood flow could be the source of muscular pain and achiness, and the sense of fatigue which are thought to be due to a build-up of lactic acid and low levels of inflammation. This, in turn, could contribute to the hyperactivity in the brain. AV shunts used to be thought that they were only involved in regulating blood flow and temperature of the skin at a subconscious level. However, more evidence starts to show that these blood vessel special endings could also contribute to our conscious sense of touch and pain.
Fibromyalgia Is a Form of Chronic Pain.
Whether it is the brain’s inability to “tone down” the volume of pain or the abnormally dense presence of AV shunts in Fibromyalgia patients' skin, central sensitization occurs either way. Central sensitization means that the nervous system goes through a process called “wind-up” and gets stuck in a state of constant high reactivity. It is well known that persistent or intense painful/unpleasant stimuli can lead to modulating negative changes in the spinal cord and brain, resulting in central sensitization and chronic pain.
How Can Chiropractic and Physiotherapy Help You?
Like any condition, Fibromyalgia pain varies from one patient to another. That’s why it’s important to investigate the patient’s expectations and previous experiences in managing this condition. Although chiropractors and physiotherapists cannot diagnose Fibromyalgia, many physicians and rheumatologists refer these patients to us because there’s nothing much left to try except manual intervention and wellness care. A lot of Fibromyalgia patients consult with us because they are looking for gentle yet effective non-pharmaceutical and non-surgical manual approaches to manage their pain. There are 4 main goals that need to be addressed:
- What are the patient’s expectations?
- Investigate previous triggers that caused Fibromyalgia
- Bring the excitation level of the nervous system to the lowest possible
- Empowering patients to regain control of their pain
At Kent Chiro-Med Wellness Clinic, we can manage Fibromyalgia patients though patient education, paced breathing technique, myofascial release therapy, acupuncture, advice in managing anxiety, post-traumatic stress disorder, behaviour modification), strength training, chiropractic adjustments, sleep hygiene and TENS stimulation. Fibromyalgia patients can tremendously benefit from a referral to a psychological counselling to benefit from cognitive behavioural therapy, biofeedback, and mind-body techniques. Exercise, excellent stress management, good sleep and good diet– till today – are the most effective combination of treatment to reduce Fibromyalgia pain.
- Albrecht PJ, Hou Q, Argoff CE, Storey JR, Wymer JP, Rice FL. Excessive peptidergic sensory innervation of cutaneous arteriole-venule shunts (AVS) in the palmar glabrous skin of fibromyalgia patients: implications for widespread deep tissue pain and fatigue. Pain Med. 2013 Jun;14(6):895-915.