Fibromyalgia/Myofascial Pain Syndrome Handout # 3 - A Guide for Relatives and Companions

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

Fibromyalgia/Myofascial Pain Syndrome Handout # 3

Devin Starlanyl MD

A GUIDE FOR RELATIVES AND COMPANIONS

What exactly is FMS and MPS?

FMS is a " chronic invisible illnesses " . It is NOT a form of

muscular rheumatism. It's a type of neurotransmitter dysfunction.

(Neurotransmitters are how the brain and body communicate.) It is

a systemic, non-inflammatory, non-progressive pain amplification

syndrome. If inappropriately treated, it may SEEM to progress.

MPS is a neuromuscular condition. It may SEEM to be

systemic and appear to progress if not appropriately treated. FMS

and MPS are not uncommon.

One major symptom of FMS is a type of dysfunctional

sleep--the alpha-delta sleep anomaly. As soon as people reach deep

level sleep, alpha brain waves intrude, bringing the patient to

shallow sleep or wakefulness. Not only are patients denied

refreshing sleep, but delta level is when the body does its repair

work and much of it's biochemical replenishment and regulation. If

people with FMS are immobile, such as during travel, or sitting in a

meeting, their muscles get rigid and painful. Morning stiffness can

be severe. Since neurotransmitters affect every part of the body,

symptoms can show up all over, yet the usual medical tests come back

negative. FM sympto}{\plain fluctuate from hour to hour and day to

day, and often worsen with changes in barometric pressure. It " s no

wonder that FMS is one of the most misdiagnosed illness. Doctors

often refer FMS psychologists or psychiatrists, and yet recent

studies show that psychologically, FMS patients have about the same

amount of abnormal psychology as Rheumatoid Arthritis patients. An

editorial in the Journal of the American Medical Association in 1987

stated " ...a disease which may have occupied five minutes of time

in medical school really exists and is a majoof...disability. "

People with FMS have a history of being unsupported and doubted.

Research is showing that people with FMS have low growth hormone,

which is involved with muscle repair. The FMS body is an engine

idling at 35% power, rather than a normal 5%. Most FMS patients

have significant cognitive impairments.

In FMS there is a dysregulation of neurotransmitters such as

serotonin, melatonin, norepinephrine, dopamine, and other chemicals

which help control pain, mood, sleep and the immune system. It

looks like there is a genetic predisposition to FMS. Often there

has been a trigger event, such as accident. An American College of

Rheumatology study in 1992 found that the impact on your life is as

bad, or worse, as that of Rheumatoid Arthritis. They listed one

major factor in this as " clinician bias " . FMS patients don " t look

sick, so they are often victimized by clinicians, family, and

friends, leaving them with self-doubt and low self-esteem.

People with FMS have more pain receptors than healthy

people--their receptors change the shape of their endings, causing

touch receptors, etc to become pain receptors.. They are

hypersensitive to everything, sort of like the " Princess and the

Pea " in the nursery stories. Little things that others take for

granted, like wringing out a wash cloth, or writing a letter, can

become pain endurance sessions.

How can someone know if they have FMS?

Suspect it if you have a history of diffuse, widespread pain, and

wake up every morning feeling like you " ve been run over by a truck.

You may have headaches and loss of balance. You can't find your car

in a parking lot. On your best days you feel as though you have the

flu. You usually develop esophageal reflux, and put on weight,

especially in a fat pad over your belly. Some objective signs are

ridges on the fingernails and mottling on the skin. Sometimes you

get muscle twitches. You are magnetically sensitive, and prone to

" sensory overload " .

Technically, you will have 11 of 18 specific " tender points "

When these spots are pressed, you will have pain. Traumatic FMS may

have the tender points clustered around the trauma. Fibromyalgia

patients often have chronic myofascial pain syndrome. That " s a

musculoskeletal dysfunction that has " Trigger Points " . These are

incredibly painful areas that often feel like knots or lumps in the

muscles. Taut bands of fibers form in the muscles. These TrPs refer

pain to other areas. They can trigger gastritis, or irritable bowel

syndrome, grinding of teeth at night, pain when you put your hands in

cold water, dizziness, chronic inversion sprains of the ankle, weak

knees, weak ankles, pelvic pain, dysmenorrh and painful intercourse

in women, impotence in men, etc. The tightened and spasming of the

muscles can entrap nerves, blood vessels, and ducts. You can have

blurring of the eyes or double vision. Leg cramps, reactive

hypoglycemia, problems with vision, immune dysfunction, allergies

and chemical sensitivities, sciatica, hives and rashes, numbness and

tingling, mood swings, confusional states, loss of balance sometimes

the list seems endless.

What can we do for someone who has FMS and/or MPS?

There is no cure for FMS/MPS. When the two conditions occur

together, it is more than the sum of the parts. The two conditions,

which I call FMS/MPS Complex, seem to feed on each other. The muscle

tightness causes more pain which causes more tightness. There are

medications that help some symptoms. Trigger points can be relieved

by some types of physical therapy. It takes a commitment on the part

of the patient to practice good nutrition, a program of gentle

stretching and moderate exercise, and a recognition from the patient

and her/his companions in life that there are real limitations with

FMS/MPS. It isn " t easy to find the right balance to optimize the

quality of life. Be kind. Be patient. Be compassionate. Listen.

And ask if there isn " t something you can to help.

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