• Siri DeMarche

A Few Words on Fibromyalgia

Updated: Feb 18

*As always, scroll to the end for a TLDR synopsis*


Because I have worked or rowed with a few gals with fibromyalgia and have also gotten multiple inquiries about myofascial pain, I thought amassing some easily accessible tips and tricks in one spot could be helpful to others. Disclaimer: I am not a medical professional. These tips & tricks are by no means an end-all, just some friendly research-based advice that proved particularly useful to those that I have worked with in the past :)


Firstly, a little background because I firmly believe that understanding the source and root of the pain is necessary to understanding how best to alleviate it. Although described in the 19th century, fibromyalgia was not conceptualized as a pain syndrome until 1950- identifying regions of extreme tenderness and "tender points" helpful to diagnosing the syndrome. Even now, it is a poorly understood condition. Fibromyalgia is characterized by chronic and widespread pain, with multiple tender points, joint stiffness, systemic symptoms (mood disorders, fatigue, cognitive dysfunction, insomnia...). It is associated with diseases like rheumatic pathologies, psychiatric & neurological disorders, infections, and diabetes. While symptoms of fibromyalgia are often confused with those of rheumatoid arthritis (joint inflammation), it does not cause joint or muscle inflammation and damage. Rheumatoid arthritis is a systemic inflammatory autoimmune disease where the immune system attacks the joints and causes joint damage, with the potential of organ damage. Fibromyalgia is a chronic pain condition that causes muscle, joint, bone pain & tenderness, fatigue..etc. but does not cause elevated inflammation levels in the blood stream. It does not cause joint damage and is not a threat to other organs. While folks with rheumatoid arthritis can also have fibromyalgia, having fibromyalgia does not increase the likelihood of developing rheumatoid arthritis.


While the characterization of fibromyalgia is fatigue with widespread pain and tenderness, other symptoms can include brain fog & memory issues, periodic tingling or numbness in the hands and feet, anxiety, depression, headaches, painful menstruation, morning stiffness, temperature sensitivity, restless leg syndrome, irritable bowel, myofascial pain, and sensitivity to loud noises or bright lights among others.


Let's break it down. Factors involved in the above symptoms are the central nervous system (brain & nerves of the spinal cord), the autonomic nervous system (parasympathetic nervous system, sympathetic nervous system, & enteric nervous system; responsible for internal organ and gland control), neurotransmitters, hormones, the immune system, the HPA axis (body's central stress-response system) external stressors, and psychiatric aspects.



Fibromyalgia is a classified as a Central Sensitivity syndrome."Central" refers to the central nervous system, the regulation of how the body responds to other signals throughout the body (via the brain and nerves of the spinal cord). "Sensitization" refers to a gradual change in how the body reacts to a particular stimulus. For example, in the immune system "sensitization" results in an allergy; it most likely developed over time and is not necessarily permanent i.e. a gradual change. Gradual change implies that first you were exposed to a stimulus (probably repeatedly) and then your body became increasingly irritated by that stimulus until the irritation became a problem. Central sensitization as it pertains to the central nervous system means that the entire system becomes sensitized to a particular stimulus, like an alarm that keeps your central nervous system on constant alert. Central sensitization is integral to understanding the symptoms of fibromyalgia because it is the reactions to particular stimuli that result in the condition. Central sensitization also helps to explain how the brain and body amplify and process pain signals.


Fibromyalgia is also characterized by a dysfunction of the autonomic nervous system. The equilibrium between the sympathetic nervous system (fight or flight) and the parasympathetic nervous system (rest or digest) is disrupted. This disruption further explains the symptoms experienced by those with fibromyalgia- ex. disturbed sleep patterns. Not only is disturbed sleep an issue because of the disrupted equilibrium between the sympathetic and parasympathetic nervous systems, but the results of a restful night's sleep are therefore also disrupted-i.e, fatigue, morning stiffness, depression, and reduced cognitive performance.



Because fibromyalgia does not cause joint or organ damage, there are many inexpensive home practices that can be helpful to alleviate some or much of the pain and address several factors associated with the discussed symptoms. The following have greatly helped those I know with the syndrome.


Helpful home practices:

-Develop a regular yoga, Tai chi and/or meditation practice

Reduce stress, gently loosen tight muscles and joints, reduce stiffness, great alternative when exercise can be a major stressor on symptom flares, mindful activity to focus & calm anxiety and emotional turmoil

-Acupunture & Massage Therapy

Help reduce chronic pain, headaches, fatigue, anxiety, reduce inflammation by stimulating the release of the body's own pain killer, increase blood flow

-Physical Therapy

Help relieve chronic pain & stiffness, build strength and range of motion, often specifically designed for those with fibromyalgia

-Exercise

Often causes pain to flare at first, but regular moderate exercise lessens pain and improves function

-Vitamin D

Essential for bone strength, cell growth, reproduction, immune function, neuromuscular health, cofactor for autoimmune disorders (can help in associated symptoms). Get it from: ample sun exposure, a good supplement (with minimal additional ingredients), foods (fatty fish, cage-free egg yolks, mushrooms...)

-5-HTP (5-Hydroxytryptophan)

Amino acid essential for serotonin production, low levels of serotonin are associated with depression, anxiety, sleep disorders, weight gain...has been shown to ease anxiety insomnia, morning stiffness & other symptoms associated with fibromyalgia. Get it from a quality supplement, as 5-HTP is not found in food-it is the intermediate metabolite of the essential amino acid L-tryptophan in the biosynthesis of serotonin.

-Magnesium & Melatonin

Low levels of both have been found in patients with fibromyalgia, can ease pain and improve sleep quality. Get it Magnesium from: foods (dark chocolate with minimal extra ingredients, avocados, nuts & seeds, some fish like salmon, mackerel, & halibut, bananas, leafy greens, a quality supplement. Get it Melatonin from: decreasing blue light exposure, food (beef, pork, salmon, basmati rice, tart cherries, grapes with skin intact, cranberries, arabica coffee beans), a quality supplement

-Medical Marijuana

Alleviate associated pain, used as a sleep aid, balance mood swings, relieve headaches, reduce anxiety

-EMG Biofeedback Therapy, Cognitive Behavior Therapy, Hypnotherapy

Measuring muscle tension, brain activity, heart rate, skin temperature...to ptovide helpful information about how your body reacts to physical or psychological stress. Once you are acutely aware of how your body reacts to symptoms you can work on changing them.

-Remove inflammatory foods & high glycemic carbohydrates, watch out for food additives

Excitotoxins (food additives found in MSG & aspartame) have been associated with increasing severity of symptoms. Removing typical inflammation triggers like dairy, corn, gluten, and soy has been shown to decrease the severity of fibromyalgia flareups. Fibromyalgia patients typically do not process high-glycemic carbohydrates normally and often crave them more as a result to keep up with demands of the body and brain's glucose usage to manage energy levels, but the inflammation from elevated blood sugar levels increases the severity of symptoms. By decreasing high sugar intake initially as a metabolic strategy can greatly alleviate pain and peripheral inflammation, thereby also decreasing the craving for high-glycemic foods in the first place


Read More Here:

Controversies and challenges in fibromyalgia: a review and a proposal

Sleep Disorders in Fibromyalgia Patients: The Role of the Autonomic Nervous System Dysfunction

Biology and therapy of fibromyalgia. New therapies in fibromyalgia

Acupuncture for treating fibromyalgia

Autonomic dysfunction in women with fibromyalgia

Patients with Fibromyalgia Have Significant Autonomic Symptoms but Modest Autonomic Dysfunction

Reduction in Parasympathetic Autonomic Nervous System Function in Fibromyalgia Patients

Vitamin D and fibromyalgia: a meta-analysis

5-HTP efficacy and contraindications

5-Hydroxytryptophan: a clinically-effective serotonin precursor

Dietary Sources and Bioactivities of Melatonin

Cannabis Use in Patients with Fibromyalgia: Effect on Symptoms Relief and Health-Related Quality of Life

Efficacy of EMG- and EEG-Biofeedback in fibromyalgia Syndrome: A Meta-Analysis and a Systematic Review of Randomized Controlled Trials

Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

The Effects of Sucrose Consumption on Left-Frontal Asymmetry and Anger in Persons with Fibromyalgia Syndrome


TLDR

Fibromyalgia is a chronic pain condition that causes muscle, joint, bone pain & tenderness, fatigue..etc. but does not cause elevated inflammation levels in the blood stream. It does not cause joint damage and is not a threat to other organs. Symptoms of fibromyalgia involve the central nervous system (brain & nerves of the spinal cord), the autonomic nervous system (parasympathetic nervous system, sympathetic nervous system, & enteric nervous system; responsible for internal organ and gland control), neurotransmitters, hormones, the immune system, the HPA axis (body's central stress-response system) external stressors, and psychiatric aspects. Because fibromyalgia does not cause joint or organ damage, there are many inexpensive home practices that can be helpful to alleviate some or much of the pain and address several factors associated with the discussed symptoms. These practices include;


-Developing a regular yoga, Tai chi and/or meditation practice

-Acupunture & Massage Therapy

-Physical Therapy

-Exercise

-Vitamin D

-5-HTP (5-Hydroxytryptophan)

-Magnesium & Melatonin

-Medical Marijuana

-EMG Biofeedback Therapy, Cognitive Behavior Therapy, Hypnotherapy

-Remove inflammatory foods & high glycemic carbohydrates, watch out for food additives



Statements made on this website have not been evaluated by the U.S. Food and Drug Administration or any other medical body. I do not aim to diagnose, treat, cure, or prevent any illness or disease. Information is shared for educational purposes only. You must consult your doctor before acting on any content on this website, especially if you are pregnant, nursing, taking medication, or have a medical condition.

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