FIBROMYALGIA

1. FIBROMYALGIA Myths, Management, and Miracles

2. Your Presenter For Today Is:

3. Fibromyalgia Defined • “my” = Muscle • “algia” = Pain • “Fibro” = Outer covering of muscles and tendons • Fibromyalgia means pain in the outer coverings of muscles and tendons.

4. Pain is not new, but the term fibromyalgia is. In 1975, Canadian Rheumatologists Moldofsky & Smythe discovered that sleep deprivation in healthy subjects produced fibromyalgia-like symptoms. Sleep deficiencies resulted in: Oxygen deficit Growth hormone changes Deconditioning History

5. Diagnosis & Misdiagnosis • Many people are misdiagnosed with fibromyalgia. • In order to have Fibromyalgia you must exhibit: • Widespread pain in 11 out of 18 specific points on the body. • You must also have joint stiffness and insomnia.

6. Symptoms of Fibromyalgia • Widespread Muscle Pain • Weakness • Overwhelming Fatigue • Insomnia • Short-term Memory Loss/Confusion

7. If you have 3 or more of these symptoms… You may have Fibromyalgia.

8. No Fear • Do not be afraid of fibromyalgia. • At first the severity of pain is very scary and frustrating. • However, it is very important that calmness prevails because anxiety will only make the pain and your sleep patterns worse. • People do not usually die of fibromyalgia, they often only wish they did.

9. Fibromyalgia Devil’s Triangle • The triangle is - severe pain which causes sleep problems - which causes anxiety - which causes more muscle pain - which causes more sleep problems - which causes more anxiety and around and around it goes. • Anything that aggravates your sleep will also make the muscle shortening worse. • Goal for 7-10 uninterrupted hours per day. • Deep “REM” sleep vs. light sleep = healing, correction, growth

10. The Fibromyalgia Triangle Chronic Pain Sleep Disruption Anxiety/Depression

11. Not A New Condition • There are many names for this condition given all around the world. • There is a tremendous controversy over its existence, and even more over it’s criteria for diagnosis. • It can affect any person on the planet and is associated with many "Injury Factors" . • The complete condition is more common in women, but it is also common in men, and even in children and young people.

12. Increased Age Repetitive Work Types and Severity of Accidents Joint deformity Hormonal Effects (Growth Hormone, rapid cycling of periods, low estrogens and progestins, low testosterone) The Presence of Stress or Worry Inherent Anxiety Level Types of Work and Workload The Absence of Stretching Muscle Bulk and Strength Muscle Length Nerve function Inherent flexibility of muscle Types of Hobbies and Past-times Drug Effects upon muscles The Injury Factors

13. Nerve Compression • People with fibromyalgia are suffering from muscle and tendon shortening, caused in part by multiple nerve compressions throughout the spine and limbs. • Pain can be directly from the muscles crushing a joint, or from pain referring into the joint from the spine.  • Typically both exist at the same time. • Headaches can exist from referred pain from the neck but also from local muscle problems around the head.

14. How many people think PAIN is OK? Raise your hands!

15. Pain • The spine in the neck, mid back and low back figure prominently in the source of pain. • Deep spinal muscles cause deep nerve compressions and traction that cause further muscle problems in the spine, limbs and head. • Pain is nature’s (your body's) way of saying: “There is something wrong here that I can not fix by myself !”

16. How We Get Fibromyalgia? • The cause of most, if not all, fibromyalgia pain is a combination of nerve and muscle dysfunction. • The deep spinal muscles cause minor or even major nerve entrapment syndromes. • Those nerve injuries will cause pain that refers into our limbs, head and body.

17. The Physics of Fibromyalgia

18. Shortened Muscles • One of the most important principles that must be understood is that, once adulthood is reached, adult skeletal muscles shorten with exercise, injury or any movement of the muscle. • This is probably related, in part, to a decrease in growth hormone levels as we move into adulthood. • It appears that growth hormone has an affect upon the degree in which muscles sustain exercise and injury. 

19. Shortened Muscles • Another important principle is that muscles that are injured during work shorten from those injuries during rest, such as during sleep, sitting or standing. • This will cause joint compression of the spine and limbs and causes joint stiffness, joint pain, and eventually osteoarthritis of the joint.  • Much of this shortening is gradual,over months or years, but it does happen.

20. A Child-like Spine • The more your spine is like a child’s, the better. • This is why a child can run all day and not tire out or ache and then wake the next day and run all day yet again. • This is also why most adults over thirty have difficulty running a block or two without hobbling to their car.

21. Scar Tissue • Muscles that remain persistently spastic or short will eventually scar into a tight spastic position causing abnormal joint movement and compression. • This will lead to disk compression and herniation, arthritis and subluxations of the spine.  • It will also cause joint compression in the limbs and abnormal tracking,which will cause abnormal wear points and osteoarthritis. 

22. Your Spine • The spine is lined with five layers of muscles. • The three top layers are designed to be the heavy work muscles for the spine and the two deepest layers are designed to be the structural integrity for the spine. • These deep muscles, primarily the multifidus and the rotator brevis and longus muscles are probably the most important muscles of the body. 

23. Spinal Muscles • These muscles allow our spines to move without falling apart. • They are very strong but also very small. • They are not designed for heavy work but unfortunately will be exposed to work and injury over time. • These muscles become very tight and scarred and can literally crush segments of your spine. 

24. Neuropathy • Neuropathy is a term to describe nerve disease or injury. • This includes diseases such as multiple sclerosis, but also includes myofascial compression/traction neuropathy, or "pinched nerves". • The most common neuropathy, or nerve "disease" is definitely a pinched nerve. • The deep spinal muscles cause directly, or indirectly, most of the pinched nerves we experience in our lives. 

25. The Neck and Lower Back • From a biophysical point of view, the base of the neck and low back are the weak links of the spine. • The base of the neck and low back are most susceptible to muscle injury and scarring. • The areas of note are between the fifth cervical, or neck vertebrae and the seventh cervical vertebrae. In the low back, the weak areas are between the fourth lumbar vertebrae and the first sacral vertebrae. 

26. Pain is not OK! • Pain could be considered a very important adaptation. • Many people would probably argue this point, but, nevertheless, pain can save your life, and in a world of natural selection, this is good. • Learning to live with it is not a good answer! • Covering it up with pain killers is not a good answer. • Ignoring it until it gets worse is not a good answer.

27. The Solution • There is no one definite solution for fibromyalgia for all people. • Most people with fibromyalgia respond gradually to a combination of chiropractic, physiotherapy, exercise and nutritional supplementation. • Some people can not be totally cured but may be helped by a combination of therapy and analgesics.  • Remember that physicians and therapists are not gods but are simply people trying to make a difference in a person’s life that is truly suffering. 

28. Chiropractic Adjustments • Learn as much as you can about stretching, physiotherapy and chiropractic. • Chiropractors use a procedure called an adjustment. • Chiropractic adjustments remove the interference from compressed nerves so that the muscles controlled by those nerves can relax and lengthen.

29. Physiotherapy • Physiotherapy can also be a helpful way to combat fibromyalgia, especially when combined with chiropractic adjustments and exercise. • Within the area of physiotherapy there are numerous tools such as ultrasound that can reduce muscle scarring. • Manipulation, stretching and traction can be helpful but are often a little too painful in the early stages of therapy. • Moist and dry heat can both be very helpful.

30. Exercise & Lifestyle Factors • A comprehensive stretching program will prove to be the single determining factor for prevention. • Career, lifestyle, depression and age are also important. • Exercise Increases Muscle Mass, Mobility, Circulation, and “Good” Hormones

31. Water requirement: 6-8 glasses/day Natural Sleep Aids like Valerian Root and Melatonin Proper eating is NOT enough: today’s food contains 70-80% less nutrition than it did 30 years ago. You need supplementation! All Natural High Potency Vitamin & Mineral supplement: Antioxidant Vitamins A,C, D,E, & K, Pycnoginols, Pine bark, Grape seed extracts, Co-Q10 Nutrition

32. Supplements • Glucosamine Sulfate, Chondroitin, and Cat’s Claw and Sharks Cartilage are aimed at cartilage supplementation and reducing inflammation. • Other supplements include Melatonin, a central brain hormone that can dramatically help sleep and pain in some. • It also stimulates growth hormone secretion but is not completely proven to be safe. L-Arginine is one of many amino acids that stimulates growth hormone naturally and may become a major player for pain and rehabilitation.

33. Other Considerations • Avoid prolonged postures at work and home. • Manage stress through meditation and, if needed, counseling. • Massage Therapy can be very effective as an adjunct to fibromyalgia treatment. Patients who suffer mild symptoms may benefit even more from massage therapy. • Timing: The longer the problem has existed, the more difficult it is to correct.

34. Learn more about the condition Seek support groups Find knowledgeable doctors and therapists willing to use a team approach You must become a Team Member and do your part Learn to manage stress Develop a positive attitude Develop a “Wellness Lifestyle” Take Charge!

35. 5 Most Dangerous Words • “Maybe it will go away!” • Don’t wait for your pain to go away on its own, because chances are it won’t! • Make appointment to get checked today. Make sure you sign up right now for the second part of this presentation • A complimentary examination to see if you have fibromyalgia or other condition that can be helped with chiropractic!

36. FIBROMYALGIA Myths, Management, and Miracles