What is it?
Fibromyalgia syndrome is characterised by widespread deep muscle pain, sleep disturbance, fatigue, depression and acute tenderness in particular areas of the body, called tender points. Women are 7 times more likely to have it than men and most cases are in the 30-50 age group. 

Fibromyalgia is fairly common now compared to the numbers of reported cases 20 years ago. This is not because more people have the condition but because it is recognised as a condition on it's own and not misdiagnosed as as other things such as Arthritis, sleep apnea, IBS, depression, psychosis, and unexplained pain. 

The condition is still not fully understood but new information about why some people have it and what is happening to the body is beginning to surface.
Here are some of the theories about what it is:

Neurotransmitters are the brain chemicals that communicate information throughout our brain and body. They relay signals between nerve cells, called “neurons.” The brain uses neurotransmitters to tell your heart to beat, your lungs to breathe, and your stomach to digest. They also communicate information back from the body, on how it is feeling, back to the brain.
One of the major characteristics of fibromyalgia is chemical imbalances. While both the role and significance of these imbalances is not yet fully explored or understood, research has indicated that these imbalances are the source of some fibromyalgia symptoms.
There are several important hormones that behave differently in a person with fibromyalgia. Serotonin, noradrenaline and dopamine have lower than average levels in the brain of a person with fibromyalgia. Since serotonin is responsible for such things as awareness of pain, digestion, sleep patterns, mental clarity and feelings of comfort, a reduction in serotonin will impact your mood, your tolerance and mental focus.

In fact, low levels of this hormone are linked to such things as depression, migraine and irritable bowel syndrome (IBS) which are commonly found health problems alongside fibromyalgia.
Research has shown that the walls of the capillaries feeding blood and oxygen to muscles become thickened in people with fibromyalgia. Thickened capillary walls makes them unable to deliver enough oxygen to fully supply the muscle tissue.

This lack of oxygen creates localised ischemia (dying of tissue) and drains energy in the affected muscle causing a cascade of physiological events leading to severe pain, muscle stiffness, soreness, and overwhelming physical and mental fatigue.
Stressful events such as death, divorce and poor health can change the health of your immune system. Stress can make your immune system behave unpredictably. It may not fight infection in a reasonable time frame or it may get over excited and actually cause inflammation in some fine membranes in the body. The membranes usually affected are those that surround joints or involve the connective tissue surrounding individual muscles. Connective tissue around muscles is called myofascial tissue, and it is found throughout the body as a white web of interconnected strands .

Stress causes the body to produce stress hormones called adrenaline and cortisol which can lead to a chronic state of muscle tension and thickening of the myofascial tissue in response. These hormones also cause general feelings of anxiety and disquiet leading to hormonal and chemical imbalances in the body, already described. As a result, stress causes multiple failures within finely tuned body systems.

People cope with stress in different ways, so not everyone who experiences a stressful event or sequence of events will develop fibromyalgia.
Some people, however, due to genetics and family history are at more risk than others of developing fibromyalgia following a stressful event.
What are the symptoms?
People with fibromyalgia may experience:
  • Localised tenderness just under the skin near joints , called tender points
  • Chronic fatigue and feeling tired even after sleeping
  • Trouble getting to sleep
  • Headaches lasting days at a time
  • Depression: mainly caused by poor sleep, coping with unending pain and feeling misunderstood
  • Anxiety and irritability
  • Inability to focus or difficulty paying attention, known as Fibro-fog
  • Pain or dull aching in the lower abdomen and a loss of appetite 
  • Painful movement in one or both hands, wrists and elbows
  • Other associated conditions such as stiff joints, arthritis and Raynauds (cold hands), weak wrists and carpal tunnel syndrome

As the location of tender points in the arm are almost identical to pain caused by other conditions, it is important not to accept pain in the arm or hand as normal for fibromyalgia. Instead have pain checked out in order distinguish it from other conditions, which if not treated separately, can become serious problems in their own right. These include Radial tunnel syndrome, Cubital tunnel syndrome and Tennis elbow
What are tender points?
Tender points are localised areas of tenderness around joints, but not in the joints themselves. Pressure on one of the tender points with a finger will cause pain that makes you flinch or pull back. Tender points are scattered close to joints over the neck, back, chest, elbows, hips, buttocks, and knees.

In the early stage of diagnosis when the cause for your pain is not yet identified, it is common practice for you to be referred to a Rheumatologist who specialises in joint conditions. The Rheumatologist may be able to diagnose chronic widespread pain as fibromyalgia if able to confirm the presence of at least 11 out of 18 known tender points. 
These tender points are about the size of a penny and are found in specific muscles near joints. Pain from tender points is local, that is, it goes no further than the tender point itself.

However, not everyone has tender points and they are not always tender. In fact, fibromyalgia can at times seem to flare up lasting for weeks at a time and at other times your body may feel like normal. Just because you don't have tender points on the day of your physical examination does not mean you don't have fibromyalgia. It is important to talk to your specialist about all other symptoms so they can spot the hidden signs of this condition.
What are trigger points?
Trigger points are not tender points.
Trigger points are associated with myofascial pain syndrome (the connective tissue around muscles) and are entirely different to tender points associated with fibromyalgia. You can have either condition independently or both at the same time.

Fibromyalgia is ratio 7:1 female to male and myofascial pain syndrome is 1:1. 

Trigger points can be felt along the length of a muscle as taut bands of long fibres in the connective or fascia tissue. 
The fascia tissue is like a spider web with every part interconnected with the next so it behaves as one very large organ which contains mostly water.
They are called trigger points because they can refer pain to other locations in the body when part of the web is pressed. This referred pain is usually confined to the same limb or half of the body.  

Like fibromyalgia, myofascial pain is be found in the shoulders, neck, arms, face, low back and/or legs which is why it can go undetected if a person has already been diagnosed with fibromyalgia. Trigger points are often as a result of misaligned posture, injury, or post-traumatic stress as opposed to hormonal or chemical imbalances found in fibromyalgia.

People with myofascial pain and trigger points tend to have tight muscles and limited flexibility. Myofascial pain syndrome can be treated in a number of ways including massage, stretching, acupuncture and myofascial release. Keeping hydrated and learning how to reduce stress and prevent the accumulation of tension in muscles is very important.
Treatment at Hand Kinetics
Fibromyalgia syndrome can really affect all aspects of your life. Not only can the illness cause chronic pain, fatigue, and other symptoms, but it can take a drastic toll on your working life, home life, and leisure pursuits. 

Occupational therapy can help fibromyalgia sufferers to restructure their lifestyles in order to make daily living easier and much more enjoyable. If you are finding it difficult to finish your work responsibilities, get on with tasks at home, or enjoy recreational activities, an occupational therapist might be just the thing to help increase your independence. Learning ways to manage fatigue and cope with pain can make all the difference to your quality of life.

Fibromyalgia can make the idea of exercise seem like an impossible task but research shows that the right kind of exercise can reduce pain and have a really positive impact on energy levels. Learning which exercise to do and at what time of day to do it is part of a self-management programme at Hand Kinetics.

At Hand Kinetics we can also look at your arm function and treat any of the difficulties you experience as a result of fibromyalgia or myofascial pain such as weak joints, pain and pins and needles in your arm. We also look at the whole body and perform trigger point release techniques to help to realign your whole body.

Hand Kinetics Telephone: 0044 28 417 72301

15 The Avenue, Burren, Warrenpoint. Co. Down. BT34 3XJ

0044 28 4176 7238
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