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What is Fibromyalgia?

Fibromyalgia is a long-term (chronic) condition that can cause widespread pain and tenderness over much of the body.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), around 5 million adults aged 18 years or over in the United States experience fibromyalgia, and 80 to 90 percent of fibromyalgia patients are women.

 

Symptoms

Fibromyalgia has many symptoms that tend to vary from person to person. The main symptom is widespread pain.

Patients with fibromyalgia often find themselves on a merry-go-round of symptoms with prolonged, chronic, widespread pain leading to sleep deprivation, which leads to fatigue.

Fatigue consequently makes it difficult for patients to accommodate exercise, a key component of fibromyalgia management. Tired, in pain, and often unable to function in day-to-day life, they are at risk for depression and anxiety, which leads to more sleepless nights, and the cycle begins again.

 

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Common symptoms include:

  • Widespread pain
  • Jaw pain and stiffness
  • Pain and tiredness in the face muscles and adjacent fibrous tissues
  • Stiff joints and muscles in the morning
  • Headache
  • Irregular sleep patterns
  • Irritable bowel syndrome (IBS)
  • Painful menstrual periods
  • Tingling and numbness in the hands and feet
  • Restless leg syndrome (RLS)
  • Sensitivity to cold or heat
  • Difficulties with memory and concentration, known as “fibro-fog”
  • Fatigue

 

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Causes

The cause is unknown, but risk factors include:

  • Traumatic injury
  • Rheumatoid arthritis
  • Autoimmune disorders, such as lupus
  • Genetic factors
  • Abnormal pain messages
  • Chemical imbalances
  • Sleep problems

 

A Comparison of Fibromyalgia & Myofascial Pain Syndrome

The muscle pain present in both fibromyalgia (FM) and myofascial pain syndrome (MPS) is why these two conditions are sometimes mistaken for one another or erroneously lumped together as one condition.

 

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What is Trigger Points in MPS ?

 

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Myofascial pain syndrome is diagnosed by the presence of trigger points—small, hard knots that you can sometimes feel under your skin. A trigger point represents a taut band of muscle. The knot itself is not generally painful when poked, but it causes pain in another area of the body (known as referred pain).

Trigger points typically form after the tissue is injured and, for some reason, don’t heal properly. Experts don’t know why damage that heals normally in most people causes trigger points in others. However, studies suggest that muscle injury in some people leads to abnormalities where the nerve cells connect to muscle cells.

While trigger points are usually found by an experienced doctor simply by touch (palpation), other tests such as magnetic resonance elastography (MRE) or tissue biopsy may be ordered. That said, the role of imaging in diagnosing MPS has not been fully teased out.

 

What is Tender Points in Fibromyalgia ?

FM is diagnosed primarily on a person’s report of widespread pain, along with a finding of multiple tender points on a physical exam.

The tender points of FM are different from the trigger points of MPS in that they represent exquisitely tender areas of muscles that hurt with simple manual pressure. In addition, the tender points of FM do not refer pain like the trigger points of MPS do.

 

Acupuncture for fibromyalgia

Affecting more women than men, fibromyalgia syndrome (FMS) is a rheumatic disorder characterized by chronic, diffuse and widespread musculoskeletal pain, and its pathogenesis is still unknown. Among the recommended treatments, acupuncture (for its analgesic effects) is an effective option for reducing the pain sensitivity and improving quality of life.

Acupuncture involves the stimulation of the specific acupuncture points (acupoints) on the skin, usually by the insertion of needles ranging in length from 1 cm to 10 cm. Between 5 and 15 needles are used in a typical treatment, with the point combinations varying during a course of sessions. The acupoints can be chosen based on a standardized “formulary” involving a fixed menu of consistent points for each disease or condition or selected for each patient individually based on a patient’s specific symptoms and Qi balance. Depth of puncture can be up to 5 cm.

 

 

According towww.acupuncturetoday.com,TCM divide fibromyalgia into four common typical TCM patterns.

1. Liver Qi Stagnation
Anxiety, emotional upset, headaches (including migraine headache), being easily angered, muscle stiffness in neck and shoulders, insomnia, waking frequently and having difficulty falling back to sleep, irritable bowel syndrome. All symptoms may be triggered by emotional stress.

2. Qi and Blood Deficiency
Specifically spleen qi deficiency and heart blood/liver blood deficiency, with such symptoms as chronic fatigue, exhaustion, dull headache, muscle weakness and numbness, insomnia, dream-disturbed sleep and waking up tired, palpitations and depression.

3. Qi Stagnation and Blood Stasis
Aches and pains in the whole body, burning or gnawing pain with tingling sensations in extremities, headaches.

4. Kidney Deficiency (either Yin, Yang, Qi or Essence Deficiency)
There will be impotence or lack of libido for males and infertility issues for both males and females. Other symptoms: sore lower back with restless leg syndrome, irritable bladder, dysmenorrhea, amenorrhea, premenstrual syndrome, hot flashes and night sweats.

 

Special Acupuncture Points

Use any tender points that the patient has along with any of the following points listed below. There are a total of 18 tender point sites that may present in fibromyalgia.

 

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The results are not only the effectiveness of tender-point acupuncture treatment on the patients’ overall well-being,but also reducing the pain sensitivity of FMS lead to improve quality of life.

 

Fibromyalgia self care

According to NHS, there are some tips that may help relieve symptoms of fibromyalgia.

1. Exercise
As extreme tiredness (fatigue) and pain are 2 of the main symptoms of fibromyalgia, you may find that you’re not able to exercise as much as you’d like.
But an exercise programme specially suited to your condition can help you manage your symptoms and improve your overall health. Exercise is likely to involve a mixture of aerobic and strengthening exercises.

2. Aerobic exercise
Aerobic activities are any kind of rhythmic, moderate-intensity exercises that increase your heart rate and make you breathe harder.
Examples include:

  • walking
  • cycling
  • swimming

Research suggests that aerobic fitness exercises should be included in your personalised exercise plan, even if you cannot complete these at a high level of intensity. As aerobic exercises increase your endurance (how long you can keep going), these may also help you function better on a day-to-day basis.

3. Resistance and strengthening exercises
Resistance and strengthening exercises are those that focus on strength training, such as lifting weights.
These exercises need to be planned as part of a personalised exercise programme. If they’re not, muscle stiffness and soreness could be made worse.
A review of a number of studies concluded that strengthening exercises may improve:

  • muscle strength
  • physical disability
  • depression
  • quality of life

People with fibromyalgia who completed the strengthening exercises in these studies said they felt less tired, could function better and experienced a boost in mood.
Improving the strength of your major muscle groups can make it easier to do aerobic exercises.

4. Relaxation
If you have fibromyalgia, it’s important to regularly take time to relax or practise relaxation techniques.
Stress can make your symptoms worse or cause them to flare up more often. It could also increase your chances of developing depression.
There are many relaxation aids available, including books, tapes and courses, although deep-breathing techniques or meditation may be just as effective.
Try to find time each day to do something that relaxes you. Taking time to relax before bed may also help you sleep better at night.
Talking therapies, such as counseling, can also be helpful in combating stress and learning to deal with it effectively.
Your GP may recommend you try this as part of your treatment.

 

Better Sleeping Habits

Fibromyalgia can make it difficult to fall asleep or stay asleep, known as insomnia. If you have problems sleeping, it may help to:

  • get up at the same time every morning
  • try to relax before going to bed
  • try to create a bedtime routine, such as taking a bath and drinking a warm, milky drink every night
  • avoid caffeine, nicotine and alcohol before going to bed
  • avoid eating a heavy meal late at night
  • make sure your bedroom is a comfortable temperature and is quiet and dark
  • avoid checking the time throughout the night

 

Best (Thunyaluck Phongsasithron) CM.D.

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