Fibromyalgia/Myofascial Pain Syndrome Handout # 1

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http://www.pendulum.org/related/FMS/fm-pain.htm

Fibromyalgia/Myofascial Pain Syndrome Handout # 1

Devin Starlanyl MD

Pain is often the most prominent symptom of FMS, but there

are many others, especially when MPS gets in the picture. Trigger

Points (TrPs) cause muscle spasticity (tightness), which disrupts

the flow of liquids in the body. Your eyes may often be dry, yet

sometimes they water. Your thermal regulatory system is out of

whack. This is noticeable when you get out of bed (often--due to

bladder irritability) during the night. Spasticity can constrict

your peripheral blood vessels those close to the skin. Then, in the

winter, certain areas of your body, most often the buttocks and

thighs feel like cold slabs of raw meat. Perhaps you have a chronic

runny nose, which starts a " domino effect " . It's a " mechanical "

runny nose, caused by constriction of normal drainage passages, not

caused by an infectious agent. As you sleep, stuffiness in your nose

moves from side to side as you turn over in bed. Post-nasal drip

hits the back of your throat all night, causing you to wake up with

a sore throat. Throat and neck TrPs, especially in the

sternocleidomastoid (SCM) muscle, develop satellite and secondary

TrPs. Soon you have TrPs down your arms, and loss of motion in your

neck and shoulders. The constant back up from ever-more restricted

vessels can result in a sinus infection, because germs take

advantage of the situation.

Dr. Janet Travell, in her autobiography, " Office Hours Day

and Night " noted that dizziness, ringing of the ears, loss of

balance, and other symptoms can all be caused by SCM TrPs. Dr.

Travell was White House physician to JFK. She and her partner,

Simons, wrote the definitive texts on MPS. The tight SCM

complex transmits nerve impulses that inform the brain of the

position of the head and body in the surrounding space. It doesn't

match the input from your eyes. When head movement changes the SCM

messages to the brain, like when you turn or move fast, you get

dizzy. This, coupled with poor equilibrium, can make it seem that

the walls are tilting. When we take corners while driving, we get

the impression that we're " banking " the turn at a steep angle, as

if we're on a motorcycle. Cold drafts can bring on neck TrPs. Also,

be careful how you move in bed. When you turn, roll with your head

down and flat, and use your arms to help move. Don't lift your

head and " lead with it " as you roll over. That puts a great strain

on the neck area and electrically " loads " SCM TrPs, just as

climbing steps or walking uphill " loads " the muscles of the thighs.

A common symptom of SCM TrPs is a " drunken " walk, as we bump into

doorways and walls. Muscle weakness causes us grief. This is often

due to plain " latent " TrPs. They aren't " active " --they don't cause

pain unless we press them. But if we stress them, they " give

out " . You try to take a drink from a glass, and end up wearing

your drink. As you twist your wrist to bring the drink to your

mouth, a latent TrP stressed muscle is asked to support the drink.

Your body couldn't tell where the drink was in relation to your

mouth, nor how heavy it was, ie how many motor neurons should be

activated to complete the task. Learn to use two hands to carry

things, not to carry heavy things at all, and be prepared for lots

of spills. When your muscles frustrate you, don't dwell on it.

Move on. Don't berate yourself for something you can't help. Our

worst enemy isn't pain or muscle weakness, it's negativity.

Cultivate a sense of humor. Wear printed fabrics. Use straws.

Another distressing facet of TrP inspired muscle weakness is

the " weak ankle, weak knee " . You're walking across level ground and

bam! You're down. Or you " catch yourself " and avoid the fall,

stressing muscles even more. Be cautious on steps. Be especially

careful on uneven surfaces. Vary your tasks, use different muscle

groups. Slow your working pace. Listen to your body. Rest often.

Cultivate a rhythm of movement. Play music while you work, if you

can. Don't fight your body, work with it. If at all possible, lie

down for a few minutes at times during the day. Rest the muscles

working to hold your head up. Don't sit too long in any one

position. When you drive, pull of the road every hour and walk

around the car. Stretch. At home, use a rocker to prevent the

muscles from building up electrical activity. When you must

lift,keep the load close to your body, and look up just before you

lift. That tightens the long spinal muscles helps your back. Added

stress to the body will cause FM to flare. Any infection, or yeast

overload, is also stress. Disrupted carbohydrate metabolism of FM

patients causes intense craving for sweets, which feed yeast.

Carbohydrate-cravers snack not because they're hungry, but because

they need missing neurotransmitters, especially in the late

afternoon and early evening.

The alpha-delta sleep anomaly of FMS makes it just about

impossible to get rest. When morning comes, you're stiff, achy,

and your muscles are unresponsive. Your body/mind hasn't

received the proper quality nor quantity of sleep it needs. You

feel as though you've had a run-in with a truck the day before, and

the truck won. In delta sleep, deep sleep, immune chemicals and

rebuilding chemicals are created, and the body/mind is repaired.

When an FMS patient enters delta stage, sleep is interrupted

alpha (awake) wave intrusion. We're jolted up to light sleep or

totally awake. We never get the deep, refreshing sleep others

enjoy. Medications, such as amitriptyline, may increase the

quantity of our sleep, but they do nothing for the quality. FMS

patients can also get bruxism (teeth clenching and grinding),

muscle spasms in the arms and legs, twitches, sleep apnea and

shallow breathing (check out those chest TrPs). We also feel

sleepy at " inappropriate " times. If we push ourselves " over the

hump " , we slide into a wakefulness/insomnia pattern. It's important

for us to eat regularly (and not too close to bedtime), avoid

stimulants, avoid alcohol, and develop regular sleep patterns. Some

of us need waterbeds, and almost all of us need cervical pillows.