If you ever seen the pharmaceutical commercials for fibromyalgia and seen the way the actors act so sullen, but at the end there is a smile on their faces with hope in their eyes and then the product name followed by its side effects. Fibromyalgia is just like that, but without the hope and smiles. Imagine for a moment that when someone touches you lightly, the thoughts that come to your mind aren’t love and happiness, but alienation, pain and despair.
Fibromyalgia is a specific disease with its own causes and symptoms, but further testing needs to be done to differentiate it from CRPS (Complex Regional Pain syndrome) , nerve damage (if the patient had a traumatic accident) rheumatiod arthritis, and other conditions. First off, the disease presents itself as such: Sharp unyielding pain when one touches, massages, or pain just from the fabric of clothes touching your skin. The pain symptoms are not relegated to any specific location on the body, but are all over and can be differentiated with the dull, but soothing pain of massage. Doctors usually use this fact to screen patients who do or do not have this by testing the whole body and finding 12 out of a possible 20 places with this kind of pain.
Now let me explain what fibriomyalgia is and how it works. When your spouse or significant other touches you, receptors in the skin respond to the pressure of the touch, or the hairs being moved. In normal individuals the signal is sent to the brain where it is interpreted as being touched by another person and the area it was, so within a milisecond the brain was given a message that is kind of like electric morse code ( or binary if you think about it, basically working with an on/off switch) the brain interprets what it means and tells you what to think about it through bio(electrical)chemical interactions (neurotransmitters – proteins produced in the body that control sensation, movement, emotion, memory and a discussion for another day) al this done in the moment it takes to involuntarily blink an eye. Amazing huh, but nature isn’t perfect and not for everyone.
Fibromyalgia patients get the sensation for pain when the brain should be telling them they are being touched lightly, or being lightly massaged. Skin contact with certain fabrics can be painful, and the patient feels this pain CONSTANTLY. Because there is nothing to quantify this pain, for instance chemical markers in the blood, or positive Rheumatiod factors, testing is usually not as effective as the doctor using his intuition and asking the right questions. Because their isn’t a test to say with good certainty that you have or don’t have this condition like there is for HIV, it isn’t unusual for patients with this condition to be told that it is all in their heads. Of course it’s all in their heads, perception of the universe is just a thought in my opinion, but these people did not choose to feel a lifetime of pain no more than a leper chooses to his disease.It really is there, even if we can’t fix it.
I always explain it like this, fibromyalgia is like screwing up the wiring system in the car, but instead of not running it functions in a devastating sort of way. Something in the morse code that makes up our nerves, brain and spinal cord is off kilter. Culprits (causes) are unknown, but interesting facts about the condition are that many of these patients don’t get the right amount of REM sleep for their bodies, have been overstraining, overtraining, or over-working themselves. Supplements may help, but the underlying mechanism of the disease is not nutritional and so usually is not fixed by dietary support of insufficient vitamins and minerals. Acupunture can be extremely helpful in reducing the symptoms if you can get past the needles (most do because the pain of the needle is nothing like the pain they feel all day) and some patients say that adjustments help.
As a chiropractor I will say that adjustments generally don’t help because it is a systemic cause rather than a regional joint pain or stiffness, but they don’t make the condition worse and can give the patient some relief. The adjustments probably don’t help as much as the fact that a professional is willing to listen and take the responsiblity to figure out the problem. Do not perform deep tissue massage on these patients and record everything that happens with these patients. I am not saying that doctors get sued more often with a condition like this, but what happens when the patient realize the doctor never had an answer and was just as clueless about the disease as yourself, many think they are cheated when really that doctor took the time and patience to try something… anything in the face of overwhelming odds. If a doctor can’t give you hope then he shouldn’t be your doctor, but that being said what is one to do when there is no standard answer to the solution.
For patients with this disease, please don’t be angry with a doctor who says there is nothing more he can do if he has tried everything he can, just ask him if there is someone who he can refer you to who might help. It isn’t our jobs to have all the answers, but it is our job to make sure people with complex problems see the right doctor or specialist.