FibroMyalgia: A Different Perspective

Fibromylalgia (FM) is characterized by unexplained, long lasting all over pain. Currently there isn’t a known cause or cure. Diagnosis can be difficult because symptoms vary between people, and it is very similar to some other conditions like Chronic Fatigue Syndrome; there is usually a process of elimination to rule out everything it isn’t. Many times the onset of FM is triggered from an injury, meaning the person returns to their Doctor exclaiming that they should be healed but the pain has spread.

There are some characteristic symptoms that define FM: muscle aches, pain, sleeplessness, widespread pain, poor recovery from activity, specific tender spots, headaches, migraines, auras, fatigue, numbness and tingling. Unfortunately many of these can have other causes as well.

Because there is not a known cause or cure for FM, most treatments are based upon managing the symptoms. This can be done through various medications, aided by diet, exercise and other holistic and wellness additions including yoga and meditation. Massage Therapy, known for its pain and anxiety relieving benefits, is a popular strategy for treatment of FM.

Understanding some of the more current FM research, could help bring clarity and stress relief for some. Pain follows the same general concept as mail; a letter is written, sent to a recipient where it is read and interpreted. In the body, the ‘letter’ is a stimulus; a scratch, insect bite, muscle fatigue or tightness and inflammation are all examples. The message of “Hey! Something’s happening!” is transmitted through a nerve to the brain, similar to how a letter is transported to an address. Once the brain receives the message, it deals with the issue if it can; if it can’t then it brings the message to your attention. Many pain medications either prevent the brain from getting the message, or keep the message from being sent; this means that you’re not aware of the stimulus.

Originally, it was thought that the pain felt by people with FM was from the muscles, tendons or ligaments. Unfortunately, studies are not able to find any painful stimulus in those tissues. A 2009 study from Portland is suggesting that the stimulus isn’t in the muscle fibers, but is inflammation of the thin lining surrounding it. Muscles resemble a rope, in the sense that fibers are bundled, and then the bundles are bundled, etc. Around each fiber, and each bundle is a thin lining of connective tissue. This lining is also found underneath the skin, around organs, in between layers of muscles; essentially throughout the body. The researchers found an increased volume of collagen fibers and a greater than normal white blood cell count in the muscles of people with FM. This suggests that the lining is thicker and less mobile than normal and the extra friction is causing some inflammation. The study also suggests that the intense pain that the person feels is a result of Central Sensitization, or sensitization of the central nervous system. If that is true, then it means that the perceived pain is much greater than the stimulus, likely because the brain is essentially tired of constantly receiving the same messages.

The brain needs to interpret messages. Pain can be described many different ways depending on where it’s coming from and what tissue is involved. Communication within the brain is done through different chemicals. Changing the type and amount of chemicals will change how messages are interpreted. A 2011 Canadian study set out to track abnormalities in the neurotransmitters in FM patients. The results indicate that people with FM have altered hormonal stress responses and the type of dysfunction in the brain is likely related to symptoms. The authors recommend that subsequent studies begin to correlate specific neurotransmitter changes to symptoms. The relationship between the onset of FM and these changes are unclear.

So the symptoms of FM are related to inflammation and altered stress coping mechanisms within the brain. How are these things treated? Massage Therapists are able to target connective tissue, swelling from inflammation and stress directly. Myofascial Release Therapy is a style or type of massage that aims to stretch the connective tissue layers in the body. It has been documented to improve sleep and quality of life, and reduce pain and anxiety in people with FM. Part of the inflammation process is extra fluid in the area. This allows the white blood cells to move around. Manual Lymph Drainage is a modality that Massage Therapists are trained in, that re-circulates extra fluid into the blood. It can reduce pain, stiffness and sleepiness, and improve sleep and well-being.

Dan