A Functional Approach To Treating Fibromyalgia

By Dottie Evans

Called an “invisible” disorder, the painful muscular condition known as fibromyalgia confounds doctors and patients alike. There are no blood tests, no recognizable outward signs, and no signature markers on imaging tests offering clues leading to a definitive diagnosis.

Fibromyalgia is not considered a disease because there is no evidence of inflammation, and it is not degenerative or life threatening, like multiple sclerosis. Yet the person who suffers from it knows all too well that something is seriously wrong.

He or more likely she –– women are three times more prone to the disorder –– may be plagued by sleeplessness and recurring feelings of depression, irritable bowel syndrome, cognitive problems, numbness or tingling in the extremities, and skin sensitivity.

Chronic muscle pain accompanies most or all of these symptoms. It is felt in all four quadrants of the body, and it travels intermittently throughout the skeletal-muscular system. For a positive diagnosis of fibromyalgia, the pain must have been going on for a period of at least three to six months.

After hearing a patient’s history and suspecting fibromyalgia, a doctor initiates a series of probing tests at nine pairs (18 in total) of specific “tender points” on the patient’s body. A positive, or pain reaction, response at 11 or more of these points in all four quadrants usually leads to a diagnosis and treatment is begun.

“Whether the causes of fibromyalgia are structural or physiological, we want to treat the pain and, if possible, correct the problems,” said Richard J. Bailey, DC, a chiropractic doctor with the Brookfield Health and Injury Center during a presentation given June 9 at his practice at 304 Federal Road.

“It’s like a train going in the wrong direction. You’ve got to turn it around. It might take six weeks, and it might take longer. There’s no catchall diagnosis.

“You could say chronic fatigue and fibromyalgia are one in the same thing,” he added.

Although deconstructing the term does not make the syndrome any easier to deal with, Dr Bailey offered the following definition of fibromyalgia.

“Fibro mean soft tissues, such as muscles, ligaments, and tendons; myo means muscle; and algia means pain.”

Instruments Enhance Massage Therapy

“Typically, the first order of treatment is to give relief, then attempt a correction,” Dr Bailey said.

“We are all subject to gravity and our skeletal structure is the key to good health. There must be a physiologically efficient posture in order for us to stand in a relaxed manner,” he added.

Specialists at the Brookfield Health and Injury Center work as a team when treating patients who present with symptoms of fibromyalgia. Their areas of specialty include medical, chiropractic, physical therapy and exercise rehab, massage therapy, naturopathy, acupuncture, pain management, nutritional counseling, and exercise rehabilitation.

“To begin with, we assess posture and are able quite quickly to discover if there is a misalignment.

“Gravity is relentless, and over a period of a lifetime, muscle strength and the ability to resist gravity wanes.”

The aging progression as we lose the war with gravity is predictable, he explained. People must first use a cane, then a walker, then a wheelchair, and finally they are reduced to lying in bed. The goal is always slow the process down, to maintain physical health and strength for as long as possible.

“After assessing posture, we look for evidence of crisscrossing of tendons –– what are called myofascial, gristlelike knots. Physical therapists may attempt to correct posture with exercises, and massage therapists work out the knots using Graston Technique instruments to detect and treat scar tissue,” Dr Bailey said.

He demonstrated the use of Graston instruments, which are patented and have FDA clearance. The instruments are heavy and smooth and are made in varying shapes to assist a massage therapist in locating and treating scar tissue and adhesions.

These adhesions, which may have been formed suddenly through injury or over a long time as the result of bad posture or congenital skeletal deformity, are the cause of many kinds of pain: acute or chronic cervical (neck) or lumbar (back) pain; plantar fascitis (foot pain); tennis elbow and golfer’s elbow; rotator cuff tendonitis; ankle pain, and the general syndrome known as fibromyalgia.

“With these instruments, I can feel the knots with the tips of my fingers. They help me know exactly where the areas are that need deep, probing massage.”

Often the cool heavy pressure of the instrument wielded by skilled hands across neck and shoulder muscles is enough to give immediate relief, he added.

Depression: Side Effect Or Cause?

“Depression feeds into fibromyalgia,” Dr Bailey said, mentioning that the two syndromes go hand in hand. “Physicians believe, however, that the depression results from the disorder rather than being a cause of it.”

He explained that clinical depression interferes with sleep patterns and the body’s ability to heal itself. For this reason, antidepressants may be prescribed to alleviate symptoms and improve the quality if sleep.

In addition, depression may lead to the overconsumption of sugar, he said, because there is reduced libido, and this leads to the next two important areas needing attention: diet and exercise.

“We absolutely want to close the gate on certain behaviors that contribute to symptoms of fibromyalgia. For example, we recommend staying away from meat and saturated fats — which are anything you put on the table that will turn into a solid — and eating a lot of fish,” Dr Bailey advised.

“Get off caffeine after noontime, and take regular aerobic exercise.”

For many years, patients suffering from fibromyalgia were given painkillers, muscle relaxers, and mood-altering drugs, as well as sleeping pills. While these medications helped alleviate some of the symptoms, their effectiveness wore off over time.

More recently, fibromyalgia patients are taking control of their treatment and consulting a wide variety of specialists to help them cope. Meanwhile, doctors are turning more and more to a holistic approach as demonstrated by the multidisciplinary team at Physicians Health and Injury Center.

“For structural problems, we treat with exercise, physical adjustments, massage, and weights to improve flexibility, agility, and strength. It is not unusual now to have medical doctors working hand in hand with nutritionists, chiropractors, and a rheumatologist,” Dr Bailey said.

Among the possible causes of fibromyalgia now being looked at are the following: metabolic dysfunction, altered pain perception, immune system disorder, allergies, yeast infestation, parasites and viral or bacterial infections, sudden illness or injury such as the flu or a car accident, genetics or an inherited disposition, Lyme disease, prolonged physical or emotional stress, or malformation of a portion of the brain or neck vertebrae.

Faced with this daunting list of interacting disorders, it is no wonder that physicians are turning to multiple modes of treatment. With nearly five percent of the population suffering from fibromyalgia, the emphasis is on management of the condition while research toward a cure is ongoing.