Tender points to diagnose fibromyalgia

Muscle and Joint


Dr. Owen Wiseman, ND
@@drowenwiseman


25 September 2018

What is fibromyalgia?

American Family Physician formally describes the condition as, “an idiopathic, chronic, nonarticular pain syndrome with generalized tender points”. Idiopathic means the condition has reared its ugly head without any apparent cause while nonarticular means it affects the soft tissues of the body rather than the joints. The condition is typically related to a diminished quality of life as those suffering experience a chronic sense of pain.

What symptoms are typical of the condition?

As mentioned, a key sign of the condition is pain in specific tender points, especially when pressure is applied to them. The constant sensation of overall muscle pain can also lead to poor sleep which quickly snowballs into other conditions. Imagine someone poking you awake every hour…you probably wouldn’t have the most restful sleep in the world. This is the same as fibromyalgia in the sense that tossing in your sleep has the potential to apply pressure to one of those trigger points and wake you up leading to fatigue, irritability, and potentially an inability to carry out your daily activities.

Aggravations of fibromyalgia itself can be triggered following an emotional or traumatic event

What causes the pain and how does it spread?

Unfortunately, the cause of the pain is poorly understood, but researchers are doing their best to try and understand the syndrome better. In one study, researchers showed that those with fibromyalgia have decreased levels of five microRNA’s which affect how genes express themselves in the human body. While the research might be promising, it is far from conclusive, so keep an eye on any developments that may help to have your syndrome diagnosed. Early detection is key to quality of life.

Who is most susceptible to this syndrome?

A recent literature review places the prevalence at approximately 0.2 to 6.6% in the general population while 2.4 to 6.8% of women experience the syndrome. Fibromyalgia is also most likely to show up between the ages of 40 to 60 as only 0.4% of those under 40 experience symptoms of the condition.

Are there any conditions associated with fibromyalgia?

Mood disorders such as anxiety and depression have been shown to be the most highly associated. This is interesting because it may suggest that the actual cause of fibromyalgia lies somewhere in the stress response or the neuroendocrine system. The endocrine system is responsible for creating all of the hormones circulating through your body as well as releasing them into the bloodstream through glands. The addition of neuro- simply refers to the function of such hormones in relation to the brain.

Psychiatric conditions such as depression are almost twice as common in Canadian women than men…and that is just those who have been formally diagnosed, so the real number could be higher. Among women aged 25 to 44 years of age, 8.9% reported a mood disorder in 2009. In one study on Veterans Health Administration in the United States, of those with fibromyalgia (77,087), upwards of 16.7% were also diagnosed with major depression as opposed to 8.7% in those without fibromyalgia.

How do physicians approach fibromyalgia?

The approach to diagnosing the syndrome can be long and arduous. It might be filled with frustration at individuals who are supposed to be there to help you as you’re shuffled from specialist to specialist. Canada achieved a consensus regarding how fibromyalgia is defined and diagnosed, which includes ruling out certain conditions like chronic fatigue syndrome. The individual must have general pain lasting more than three months and pain when pressure is applied to soft tissues.

What kind of treatment can I expect?

At this point in our understanding of the condition, it is far from being a mystery solved. The syndrome requires a multidisciplinary approach that includes stress management, diet, exercise, and potentially medication to manage psychiatric conditions if present.

Studies have shown that individuals diagnosed with fibromyalgia have elevated cortisol levels. Stress management techniques could include practices such as yoga to reduce the levels of the ‘stress hormone’ circulating in the body. Those practicing yoga for eight weeks experienced a clinically significant reduction in the severity of their depression, had a greater ability to cope with pain, and used fewer maladaptive strategies to control their pain.

How can I change my diet to lessen the pain?

Increasing the levels of antioxidants in your body has been shown to help reduce the pain of fibromyalgia in addition to adding magnesium to your diet. Foods high in both magnesium and antioxidants include something you probably won’t mind adding to your diet – dark chocolate. When we enter the realm of 70-85% cocoa and up, the levels are impressive. A single serving contains as much as 58% of your recommended daily intake of magnesium and more phenolic antioxidants than most foods.

What about exercise?

Women who performed a series of exercises twice a week for 15 weeks were shown to experience improvements in their current pain intensity and how disabled they felt by their pain to the acceptance of their pain.

I need pain relief in select areas...and quickly!

Never fear as your friend Absolüt Arnica Gel is here. This powerful herb contains compounds known as sesquiterpene lactones that have anti-inflammatory actions, reducing pain in areas of application. Products such as A.Vogel’s Absolüt Arnica gel is composed of a tincture containing 50% fresh Arnica and may help to temporarily relieve the general muscle ache experienced by those suffering from fibromyalgia.

References

https://www150.statcan.gc.ca/n1/pub/89-503-x/2010001/article/11543-eng.htm#a14
https://www.aafp.org/afp/2007/0715/p247.html
http://fmguidelines.ca/?page_id=19
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440795/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673928/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3768222/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4372601/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4575027/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4696435/
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