Back Clinic Fibromyalgia Team. Fibromyalgia syndrome (FMS) is a disorder and syndrome that causes widespread musculoskeletal pain in the joints, muscles, tendons, and other soft tissues throughout the body. It is often combined with other symptoms like temporomandibular joint disorders (TMJ/TMD), irritable bowel syndrome, fatigue, depression, anxiety, cognitive issues, and sleep interruption. This painful and mysterious condition affects around three to five percent of the American population, predominantly women.
Diagnosis of FMS can be difficult, as there is no specific lab test to determine if the patient has the disorder. Current guidelines state that a diagnosis can be made if a person has widespread pain for more than three months, with no underlying medical condition. Dr. Jimenez discusses advances in the treatment and management of this painful disorder.
When muscle pains and aches present from health conditions, work, exercise, housework, etc., many individuals turn to topical sprays, creams, ointments, and gels to bring relief. Can magnesium spray be beneficial in the fight against neuromusculoskeletal pain?
Magnesium Spray
Magnesium spray is a liquid form of magnesium applied externally to the skin that has been marketed to promote muscle relaxation, improve sleep, and manage migraines. However, studies of its effectiveness have had mixed results. Some studies have shown that topical use can:
Improve chronic muscle and joint pain. Example: fibromyalgia.
Decrease the frequency and severity of nerve pain symptoms. Example: peripheral neuropathy.
Reduce the incidence and severity of an intubation-related sore throat after surgery.
Further studies of various groups are necessary to clarify the optimal dose for each condition and to determine how topical magnesium affects magnesium blood levels.
What is It?
Magnesium is a mineral that has an important role in many of the body’s processes and is essential for the following (Gröber U. et al., 2017)
Nerve transmission
Muscle contraction
Blood pressure regulation
Blood sugar regulation
Protein production
DNA and RNA production
Currently, there is no recommended dosage for topical magnesium use. However, some major health institutions have established a recommended daily amount taken by mouth. Listed are the recommended daily magnesium intake based on age and other factors. (National Institutes of Health Office of Dietary Supplements, 2022)
14 to 18 years old: 410 mg for males, 360 mg for females and when lactating, and 400 mg when pregnant.
19 to 30 years old: 400 mg for males, 310 mg for females and when lactating, and 350 mg when pregnant.
31 to 50 years old: 420 mg for males, 320 mg for females and when lactating, and 360 mg when pregnant.
51 years old and above: 420 mg for males and 320 mg for females.
Although self-care is appropriate for minor injuries or exercise, individuals are encouraged to see their healthcare provider for severe musculoskeletal pain symptoms.
Benefits
Though taking oral magnesium supplements is common, there is limited research on using magnesium on the skin to improve magnesium levels. Studies comparing the absorption of magnesium taken by mouth with the spray applied to the skin require further research. However, some studies look at the localized effect of magnesium spray on improving a sore throat after surgery and nerve, muscle, and joint pain.
Intubation-Related Sore Throat
Topical magnesium reduced the severity of sore throat after surgery in individuals undergoing tracheal intubation compared to a placebo. (Kuriyama, A. et al., 2019) However, further studies are necessary to clarify the optimal dose.
Nerve Pain
Peripheral neuropathy is nerve damage that causes a tingling and numbing sensation in the arms or legs. In a study of individuals with chronic kidney disease, the daily application of magnesium sprays to limbs affected by peripheral neuropathy for twelve weeks decreased the frequency and severity of nerve pain symptoms. However, one limitation was that it was performed mostly in females. (Athavale, A. et al., 2023)
Chronic Muscle and Joint Pain
A small study assessed whether applying magnesium to the skin could improve the quality of life of female participants with fibromyalgia – a chronic condition that causes muscle and joint pain, fatigue, and other symptoms. The study found that four sprays of magnesium chloride applied twice daily to the upper and lower limbs for four weeks could benefit those with fibromyalgia. However, further research with larger studies is needed to confirm the results. (Engen D. J. et al., 2015)
Does The Spray Increase Overall Magnesium Levels?
Magnesium is transported into cells through magnesium transporters. The outer layer of the skin does not contain these transporters, so absorption occurs in the small areas of the sweat glands and hair follicles. (Gröber U. et al., 2017) One study suggested that applying magnesium to the skin can help with magnesium deficiency within four to six weeks, compared to four to 12 months in the case of oral magnesium supplementation. However, there is minimal research on topical magnesium and its impact on magnesium levels. Another study suggested that 56 mg of magnesium cream applied daily on the skin for 14 days had no statistically significant effect on magnesium blood levels. Although the results were statistically insignificant, a clinically relevant increase in magnesium blood levels was observed. (Kass, L. et al., 2017) Because it remains unclear if magnesium absorption via the skin is more effective than by mouth, further studies are necessary to confirm the amount of magnesium absorbed into the skin.
Using The Spray
In one study, a magnesium chloride solution was poured into a spray bottle and applied as follows (Engen D. J. et al., 2015)
The solution was sprayed into the palm and applied evenly on the affected area.
There is a four-hour wait time between spray dose applications.
Individuals should wait at least one hour after application before showering or washing the product off.
Leave the product on the skin throughout the day and wash it off before bed.
Rinse the solution off with water if the skin becomes irritated.
Avoid applying to open wounds.
Precautions
Avoid magnesium chloride sprays if you are allergic to them or their components. If you have a severe allergic reaction, such as itching, hives, or shortness of breath, seek immediate medical attention. Topically applied magnesium solution has no known side effects other than skin irritation. (Engen D. J. et al., 2015)
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment plan through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Why Choose Chiropractic?
References
Gröber, U., Werner, T., Vormann, J., & Kisters, K. (2017). Myth or Reality-Transdermal Magnesium?. Nutrients, 9(8), 813. doi.org/10.3390/nu9080813
Kuriyama, A., Maeda, H., & Sun, R. (2019). Topical application of magnesium to prevent intubation-related sore throat in adult surgical patients: a systematic review and meta-analysis. Application topique de magnésium pour prévenir les maux de gorge liés à l’intubation chez les patients chirurgicaux adultes: revue systématique et méta-analyse. Canadian journal of anaesthesia = Journal canadien d’anesthesie, 66(9), 1082–1094. doi.org/10.1007/s12630-019-01396-7
Athavale, A., Miles, N., Pais, R., Snelling, P., & Chadban, S. J. (2023). Transdermal Magnesium for the Treatment of Peripheral Neuropathy in Chronic Kidney Disease: A Single-Arm, Open-Label Pilot Study. Journal of palliative medicine, 26(12), 1654–1661. doi.org/10.1089/jpm.2023.0229
Engen, D. J., McAllister, S. J., Whipple, M. O., Cha, S. S., Dion, L. J., Vincent, A., Bauer, B. A., & Wahner-Roedler, D. L. (2015). Effects of transdermal magnesium chloride on quality of life for patients with fibromyalgia: a feasibility study. Journal of integrative medicine, 13(5), 306–313. doi.org/10.1016/S2095-4964(15)60195-9
Kass, L., Rosanoff, A., Tanner, A., Sullivan, K., McAuley, W., & Plesset, M. (2017). Effect of transdermal magnesium cream on serum and urinary magnesium levels in humans: A pilot study. PloS one, 12(4), e0174817. doi.org/10.1371/journal.pone.0174817
For individuals dealing with fibromyalgia, can incorporating acupuncture as part of integrative treatment help with pain relief?
Introduction
The musculoskeletal system helps the various muscles, tendons, and ligaments be mobile while stabilizing the vertical pressure. The upper and lower extremities work together, enabling the host to be mobile without feeling pain and discomfort. However, many individuals have dealt with pain, whether it is acute or chronic, at one point in their lives. When the body is dealing with pain, the response signal from the brain will show where the pain is located, which causes muscle soreness. To that point, the immune system will start to heal the affected area naturally. However, when a person has an autoimmune disease, the body will be impacted for no reason, which then causes the immune system to release inflammatory cytokines to healthy cells and muscular structures. When this happens, it can affect their quality of life and cause painful sensations to the musculoskeletal system, forcing individuals to seek treatment. Today’s article focuses on the correlation between the musculoskeletal system and fibromyalgia and how treatments like acupuncture can help reduce the pain-like symptoms that are caused by fibromyalgia. We talk with certified medical providers who utilize our patients’ information to provide acupuncture treatments to lessen the overlapping risk profiles associated with fibromyalgia. We also inform and guide patients on how various treatments can help reduce the pain-like symptoms related to fibromyalgia. We encourage our patients to ask their associated medical providers intricated and important questions about the pain-like symptoms they are experiencing from fibromyalgia. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.
The Musculoskeletal System & Fibromyalgia
Have you been experiencing tingling sensations in your arms, legs, feet, and hands? Do you feel your muscles and joints lock up and feel stiff constantly in the morning? Or have you been dealing with unquestionable pain in your body that is affecting your daily routine? Many of these pain-like symptoms are associated with an autoimmune disease known as fibromyalgia. Fibromyalgia is often characterized by widespread chronic musculoskeletal pain that is associated with neurosensory disorders. People with fibromyalgia will have musculoskeletal pain symptoms from muscle and joint stiffness to fatigue and myofascial pain. (Siracusa et al., 2021) This is because the vagus nerve in the parasympathetic autonomic nervous system is in constant “fight or flight” mode, which causes many individuals to become hypersensitive and experience amplified painful sensations. This forces the muscle fibers in the musculoskeletal system to develop tiny nodules known as trigger points in the soft tissues. This causes muscle pathophysiology as a primary mechanism that mediates the onset of symptoms that pertain to fibromyalgia. (Geel, 1994) Unfortunately, fibromyalgia is a challenge to diagnose when comorbidities factors start to overlap and can play a role in this autoimmune disease.
Fibromyalgia is an autoimmune condition that increases a person’s sensitivity to pain while including multiple tender points at specific areas of the body, causing widespread chronic musculoskeletal pain. Many individuals dealing with chronic musculoskeletal pain are unaware of the proper pathway to care as it generates a negative impact on pain, disability, and quality of life. (Lepri et al., 2023) Since fibromyalgia is associated with musculoskeletal pain, it can be combined with myofascial pain syndrome since both are characterized by muscle tenderness. (Gerwin, 1998) However, there are numerous treatments available to reduce the painful effects of fibromyalgia and help restore a person’s quality of life.
From Inflammation to Healing- Video
Do you feel muscle pain and tenderness in various areas of your body? Do you feel muscle and joint stiffness in your upper and lower extremities? Or do you feel numbing or tingling sensations in your arms, hands, legs, and feet? Many people dealing with these pain-like issues are experiencing an autoimmune disorder known as fibromyalgia. Fibromyalgia is a challenging autoimmune disorder to diagnose. However, the symptoms are often correlated with muscular pain. This can cause many individuals to reduce their quality of life. Fibromyalgia can cause the body to be hypersensitive to pain and can cause chronic inflammation of the joints. However, some treatments are non-surgical, cost-effective, and can help provide the pain relief many people deserve. The video above explains how various non-surgical treatments can help reduce inflammatory and pain effects on the body through various treatments that can be combined to minimize the pain-like symptoms of fibromyalgia.
Acupuncture Reducing Fibromyalgia Pain
When it comes to treating fibromyalgia and reducing pain-like symptoms, many people will seek out non-surgical treatments to manage and improve the symptoms correlating with fibromyalgia. Acupuncture can help ease the pain-like symptoms that are affecting the body and reduce the myofascial trigger points correlating with fibromyalgia. Since acupuncture originated in China, it is one of the most popular sensory stimulation therapies that are non-surgical; acupuncturists who are highly trained use various techniques to insert and manipulate fine needles to stimulate specific anatomic trigger points in the body to restore balance to the body. (Zhang & Wang, 2020) For individuals dealing with fibromyalgia pain, acupuncture can be combined with other therapies as part of the individual’s personalized treatment plan. Acupuncture helps improve muscle pain caused by fibromyalgia.
Additionally, acupuncture can assist in regulating the somatosensory function of the body and reduce symptoms of muscle stiffness while enhancing a person’s quality of life. (Zheng & Zhou, 2022) Fibromyalgia is a chronic autoimmune disorder that can affect the musculoskeletal system and can cause unbearable pain to many people by disrupting a person’s quality of life. When combined with other therapies, acupuncture can provide a significant positive effect on managing fibromyalgia and enhancing a person’s quality of life. (Almutairi et al., 2022)
References
Almutairi, N. M., Hilal, F. M., Bashawyah, A., Dammas, F. A., Yamak Altinpulluk, E., Hou, J. D., Lin, J. A., Varrassi, G., Chang, K. V., & Allam, A. E. (2022). Efficacy of Acupuncture, Intravenous Lidocaine, and Diet in the Management of Patients with Fibromyalgia: A Systematic Review and Network Meta-Analysis. Healthcare (Basel), 10(7). doi.org/10.3390/healthcare10071176
Geel, S. E. (1994). The fibromyalgia syndrome: musculoskeletal pathophysiology. Semin Arthritis Rheum, 23(5), 347-353. doi.org/10.1016/0049-0172(94)90030-2
Gerwin, R. D. (1998). Myofascial pain and fibromyalgia: Diagnosis and treatment. J Back Musculoskelet Rehabil, 11(3), 175-181. doi.org/10.3233/BMR-1998-11304
Lepri, B., Romani, D., Storari, L., & Barbari, V. (2023). Effectiveness of Pain Neuroscience Education in Patients with Chronic Musculoskeletal Pain and Central Sensitization: A Systematic Review. Int J Environ Res Public Health, 20(5). doi.org/10.3390/ijerph20054098
Siracusa, R., Paola, R. D., Cuzzocrea, S., & Impellizzeri, D. (2021). Fibromyalgia: Pathogenesis, Mechanisms, Diagnosis and Treatment Options Update. Int J Mol Sci, 22(8). doi.org/10.3390/ijms22083891
Zhang, Y., & Wang, C. (2020). Acupuncture and Chronic Musculoskeletal Pain. Curr Rheumatol Rep, 22(11), 80. doi.org/10.1007/s11926-020-00954-z
Zheng, C., & Zhou, T. (2022). Effect of Acupuncture on Pain, Fatigue, Sleep, Physical Function, Stiffness, Well-Being, and Safety in Fibromyalgia: A Systematic Review and Meta-Analysis. J Pain Res, 15, 315-329. doi.org/10.2147/JPR.S351320
When issues like autoimmune disorders start to affect the body for no reason, it can lead to chronic problems and conditions that can affect the various muscles and vital organs that cause overlapping risk profiles to the host. The body is a complex machine that allows the immune system to release inflammatory cytokines to the affected area when a person has acute or chronic pain. So when a person has an autoimmune disorder like fibromyalgia, it can affect their quality of life while amplifying painful sensations in their musculoskeletal system. Today’s article focuses on fibromyalgia and its systems, how this autoimmune disorder correlates with myofascial pain syndrome, and how chiropractic care can help reduce fibromyalgia symptoms. We refer our patients to certified providers that incorporate techniques and various therapies for many individuals with fibromyalgia and its correlating symptoms, like myofascial pain syndrome. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a fantastic way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
What Is Fibromyalgia?
Have you been dealing with unquestionable pain that is affecting your daily life? Do you feel fatigued when you are barely getting out of bed? Or have you been dealing with brain fog and aches all over your body? Many of these symptoms overlap with an autoimmune disorder known as fibromyalgia. Studies reveal that fibromyalgia is an autoimmune condition characterized by widespread chronic musculoskeletal pain that can correlate with neurosensory disorders that affect the nervous system. Fibromyalgia can affect about 4 million adults in America and roughly 2% of the general adult population. When people with fibromyalgia go through a physical examination, the test results would appear to be normal. That is because fibromyalgia can include multiple tender points in specific body areas and manifest as a primary or secondary condition while extending far beyond the defining criteria. Additional studies reveal that the pathogenesis of fibromyalgia could potently be linked with other chronic factors that affect the following systems:
Inflammatory
Immune
Endocrine
Neurological
Intestinal
The Symptoms
Many individuals, especially women, have fibromyalgia, which causes symptoms of multiple somato-visceral issues. To that point, it can often overlap and accompany fibromyalgia. Unfortunately, fibromyalgia is challenging to diagnose since the pain can last for several months to years. Studies have shown that even though fibromyalgia is challenging to diagnose when many other factors like genetics, immunological, and hormonal factors potentially play a part in this autoimmune disorder. Also, additional symptoms and specific diseases like diabetes, lupus, rheumatic diseases, and musculoskeletal disorder can be associated with fibromyalgia. Some of the following symptoms that many fibromyalgia individuals deal with include:
Have you been having trouble getting a good night’s sleep? Do you feel pain in different areas of your body? Or have you been dealing with cognitive issues like brain fog? Many of these symptoms correlate with an autoimmune disorder known as fibromyalgia. Fibromyalgia is an autoimmune disorder that is challenging to diagnose and can cause immense pain to the body. The video above explains how to notice the signs and symptoms of fibromyalgia and what associated conditions correlate with this autoimmune disorder. Since fibromyalgia causes widespread musculoskeletal pain, it can even affect the peripheral and central nervous systems. This causes the brain to send out neuron signals to cause an increase in sensitivity to the brain and spinal cord, which then overlaps with the musculoskeletal system. Since fibromyalgia causes pain to the body, it can present unrecognized symptoms that can be difficult to recognize and can be arthritis-related.
How Fibromyalgia Is Correlated With Myofascial Pain Syndrome
Since fibromyalgia can correlate with different chronic conditions, one of the most chronic disorders can mask the effects of fibromyalgia in the body: myofascial pain syndrome. Myofascial pain syndrome, according to Dr. Travell, M.D.’s book, “Myofascial Pain Syndrome and Dysfunction,” mentions that when a person has fibromyalgia causes musculoskeletal pain, overtime if not treated, can develop trigger points in the affected muscles. This causes muscle stiffness and tenderness in the taut muscle band. Additional studies mentioned that since myofascial pain syndrome and fibromyalgia have common muscular pain symptoms, they can cause tenderness and refer pain to different body locations. Fortunately, available treatments can help reduce the muscular pain symptoms caused by fibromyalgia associated with myofascial pain syndrome.
Chiropractic Care & Fibromyalgia Associated With Myofascial Pain
One of the available treatments that can help relieve the muscular pain from fibromyalgia associated with myofascial pain syndrome is chiropractic therapy. Chiropractic therapy is a safe, non-invasive treatment option that can help alleviate symptoms of body pain and swelling from a spinal subluxation. Chiropractic care uses manual and mechanical manipulation to re-align the spine and improve nerve circulation while increasing blood flow back to the joints and muscles. Once the body has been re-balanced from chiropractic therapy, the body can manage symptoms better and reduce the effects of fibromyalgia. Chiropractic therapy also provides a customized treatment plan and works with associated medical professionals to achieve maximum results and ensure the highest quality of life for the individual.
Conclusion
Fibromyalgia is one of the most common autoimmune disorders that affect most of the population and can be challenging to diagnose. Fibromyalgia is characterized by widespread chronic musculoskeletal pain that can correlate with neurosensory disorders and cause pain symptoms in the body. People with fibromyalgia also deal with myofascial pain syndrome, as both disorders cause muscle and joint pain. Luckily, treatments like chiropractic therapy allow spinal manipulation of the body to be re-aligned and restore functionality to the host. This reduces the symptoms caused by fibromyalgia and causes the individual to be pain-free and function normally.
References
Bellato, Enrico, et al. “Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment.” Pain Research and Treatment, U.S. National Library of Medicine, 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3503476/.
Bhargava, Juhi, and John A Hurley. “Fibromyalgia – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 10 Oct. 2022, www.ncbi.nlm.nih.gov/books/NBK540974/.
Gerwin, R D. “Myofascial Pain and Fibromyalgia: Diagnosis and Treatment.” Journal of Back and Musculoskeletal Rehabilitation, U.S. National Library of Medicine, 1 Jan. 1998, pubmed.ncbi.nlm.nih.gov/24572598/.
Simons, D. G., and L. S. Simons. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.
Siracusa, Rosalba, et al. “Fibromyalgia: Pathogenesis, Mechanisms, Diagnosis and Treatment Options Update.” International Journal of Molecular Sciences, U.S. National Library of Medicine, 9 Apr. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8068842/.
Everyone has dealt with acute or chronic pain at some point in their lives. The body’s response tells many of us where the pain is located and can leave the body sore as the immune system begins to heal the affected area. When disorders like autoimmune diseases start to attack the body for no reason, then that is when chronic issues and disorders begin to overlap in risk profiles on other various problems that affect both the muscles and organs. Autoimmune diseases like fibromyalgia can affect a person’s body; however, they could be associated with different issues affecting the body. Today’s article looks at fibromyalgia, how it affects the musculoskeletal system, and how chiropractic care helps manage fibromyalgia in the body. We refer patients to certified providers specializing in musculoskeletal treatments to help those with fibromyalgia. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer
What Is Fibromyalgia?
Have you experienced excruciating pain that is spread all over your body? Do you have trouble sleeping and feel exhausted every day? Do you experience brain fog or other cognitive disturbances? Many of these issues are signs and conditions of fibromyalgia. Fibromyalgia is defined as a chronic condition that is characterized by widespread musculoskeletal pain. Symptoms like fatigue, cognitive disturbances, and multiple somatic symptoms often overlap and accompany this disorder. Around two to eight percent of the world population suffers from fibromyalgia, and it affects women more than men. Sadly though, fibromyalgia is a challenge to diagnose, and the pain can last several months to years. Some of the main symptoms that fibromyalgia does to the body include:
Muscle and joint stiffness
General sensitivity
Insomnia
Cognitive dysfunction
Mood disorders
Fibromyalgia could also potentially be associated with specific diseases like diabetes, lupus, rheumatic diseases, and musculoskeletal disorders.
How Does It Affect The Musculoskeletal System?
The musculoskeletal system in the body has three muscle groups: skeletal, cardiac, and smooth muscles that provide different functions correlating how the body moves. Individuals with fibromyalgia will experience amplified painful sensations affecting their brain and spinal cord to process pain and nonpainful signals potentially associated with musculoskeletal disorders. The neural structures from the brain become hyper-reactive to any soft tissues close to the spine, known as segmental facilitation. These changes that occur to the soft tissues are called trigger points, and if situated in the muscles, they are referred to as “myofascial” trigger points. Studies reveal that the pathophysiology of musculoskeletal dysfunction can be considered secondary to central abnormalities of pain modulation associated with fibromyalgia.
An Overview Of Fibromyalgia-Video
Have you been experiencing excruciating pain in different areas of your body? Have you been constantly tired throughout the entire day? Or has your mood been dampened all of a sudden? These are the signs that you have fibromyalgia, and the video above gives an overview of what fibromyalgia is. Fibromyalgia is defined as a chronic disorder that is difficult to diagnose. Studies reveal that fibromyalgia is possible to be described as a cognitive disorder that triggers painful amplifications and sensory nociceptors that become hypersensitive. So what does this mean, and how is the nervous system affected by fibromyalgia? The nervous system has the central and peripheral systems. The peripheral system has a component known as the autonomic nervous system that regulates involuntary bodily functions. The autonomic system consists of two subsystems: the sympathetic and parasympathetic systems. For individuals with fibromyalgia, the sympathetic nervous system, which provides the “fight or flight” response, is constantly active, causing the parasympathetic nervous system, which provides the “rest and digest” response, to be inactive in the body. The good news is that individuals with fibromyalgia and its associated symptoms can find relief through treatment.
Chiropractic Care & Fibromyalgia
Even though there hasn’t been a cure for fibromyalgia yet, treatments are available to manage and improve the symptoms associated with fibromyalgia with chiropractic care. Chiropractic care can help relieve fibromyalgia pain by carefully correcting spinal misalignments or subluxations through spinal adjustments and manual manipulations of the body. Studies reveal that the effectiveness of chiropractic care for fibromyalgia patients helps improve their range of motion to the cervical and lumbar areas of the spine. Chiropractic care can help improve their flexibility, decrease their pain levels, and have better sleep quality. People diagnosed with fibromyalgia need to understand that many options for pain management don’t rely on medicines. Chiropractic care is gentle and non-invasive. It can be helpful for individuals that want to take control of their circumstances and have chiropractic therapy as a vital part of managing their well-being.
Conclusion
Fibromyalgia is a chronic disorder that affects the musculoskeletal system by causing stiffness in the muscles and joints, general sensitivity, and other chronic issues associated with this disorder. Individuals with fibromyalgia will describe their pain as unbearable due to the nerves in the sympathetic system being hyperactive and tender to the touch. Fortunately, treatments like chiropractic care can help relieve fibromyalgia pain through spinal adjustments and manual manipulations. Chiropractic care for individuals with fibromyalgia can help improve their range of motion and flexibility and decrease their pain levels without using medicines. Incorporating chiropractic care as a treatment for fibromyalgia can be vital in managing a person’s well-being.
References
Bhargava, Juhi, and John A Hurley. “Fibromyalgia – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 1 May 2022, www.ncbi.nlm.nih.gov/books/NBK540974/.
Blunt, K L, et al. “The Effectiveness of Chiropractic Management of Fibromyalgia Patients: A Pilot Study.” Journal of Manipulative and Physiological Therapeutics, U.S. National Library of Medicine, 1997, pubmed.ncbi.nlm.nih.gov/9272472/.
Geel, S E. “The Fibromyalgia Syndrome: Musculoskeletal Pathophysiology.” Seminars in Arthritis and Rheumatism, U.S. National Library of Medicine, Apr. 1994, pubmed.ncbi.nlm.nih.gov/8036524/.
Maugars, Yves, et al. “Fibromyalgia and Associated Disorders: From Pain to Chronic Suffering, from Subjective Hypersensitivity to Hypersensitivity Syndrome.” Frontiers, Frontiers, 1 July 2021, www.frontiersin.org/articles/10.3389/fmed.2021.666914/full.
Siracusa, Rosalba, et al. “Fibromyalgia: Pathogenesis, Mechanisms, Diagnosis and Treatment Options Update.” International Journal of Molecular Sciences, MDPI, 9 Apr. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8068842/.
Fibromyalgia is a condition that causes pain throughout the whole body. It causes sleep problems, fatigue, and mental/emotional distress. It affects around four million adults in the United States. Individuals with Fibromyalgia tend to be more sensitive to pain. This is referred to as abnormal/altered pain perception processing. Research currently leans towards a hyperactive nervous system as one of the most plausible causes.
Symptoms and Related Conditions
Individuals with fibromyalgia/fibromyalgia syndrome/FMS may have:
Fatigue
Sleep issues
Headaches
Concentration, Memory issues, or Fibro Fog
Stiffness
Tender points
Pain
Numbness and tingling in hands, arms, legs, and feet
Central sensitization means that the central nervous system, made up of the brain and spinal cord, processes pain differently and more sensitively. For example, individuals with Fibromyalgia could interpret physiological stimuli, like heat, coldness, pressure, as pain sensations. Mechanisms that cause altered pain processing include:
Pain signal dysfunction
Modified opioid receptors
Substance P increase
Increased activity in the brain where pain signals are interpreted.
Pain Signal Dysfunction
When a painful stimulus is felt, the brain signals the release of endorphins, the body’s natural painkillers that block the transmission of pain signals. Individuals with Fibromyalgia could have a pain-blocking system that is altered and/or not functioning correctly. There is also the inability to block repetitive stimuli. This means that the individual keeps feeling and experiencing the stimuli even as they try to block them out, suggesting a failure in the brain to filter out irrelevant sensory information.
Modified Opioid Receptors
Research has found that individuals with fibromyalgia have a reduced number of opioid receptors in the brain. Opioid receptors are where endorphins bind so the body can use them when necessary. With fewer available receptors, the brain is less sensitive to endorphins, as well as opioid pain medication like:
Hydrocodone
Acetaminophen
Oxycodone
Acetaminophen
Substance P Increase
Individuals with fibromyalgia have been found to have elevated levels of substance P in their cerebrospinal fluid. This chemical is released when a painful stimulus is detected by the nerve cells. Substance P is involved with the body’s pain threshold, or the point when a sensation turns into pain. High levels of substance P could explain why the pain threshold is low in individuals with fibromyalgia.
Increased Activity in the Brain
Brain imaging tests, like magnetic resonance imaging or MRI, have shown that fibromyalgia is associated with greater than regular activity in areas of the brain that interpret pain signals. This can suggest that pain signals are overwhelming those areas or that the pain signals are being processed dysfunctionally.
Triggers
Certain factors can trigger a flare-up. These include:
Diet
Hormones
Physical stress
Too much exercise
Not enough exercise
Psychological stress
Stressful events
Sleep Patterns changed
Treatment changes
Temperature changes
Weather changes
Surgery
Chiropractic
Chiropractic focuses on whole-body wellness. 90% of the central nervous system goes through the spinal cord. A misaligned vertebral bone can create interference and irritation on the nerves. Fibromyalgia is a condition related to the hyperactivity of the nerves; therefore, any vertebral subluxations will complicate and aggravate fibromyalgia symptoms. By realigning the misaligned vertebrae releases the stress off of the spinal cord and spinal nerve root. That is why individuals with fibromyalgia are recommended to add a chiropractor to their healthcare team.
Clauw, Daniel J et al. “The science of fibromyalgia.” Mayo Clinic proceedings vol. 86,9 (2011): 907-11. doi:10.4065/mcp.2011.0206
Cohen H. Controversies and challenges in fibromyalgia: a review and a proposal. Ther Adv Musculoskelet Dis. 2017 May;9(5):115-27.
Garland, Eric L. “Pain processing in the human nervous system: a selective review of nociceptive and biobehavioral pathways.” Primary care vol. 39,3 (2012): 561-71. doi:10.1016/j.pop.2012.06.013
Goldenberg DL. (2017). Pathogenesis of fibromyalgia. Schur PH, (Ed). UpToDate. Waltham, MA: UpToDate Inc.
Kamping S, Bomba IC, Kanske P, Diesch E, Flor H. Deficient modulation of pain by a positive emotional context in fibromyalgia patients. Pain. 2013 Sep;154(9):1846-55.
A fibromyalgia diagnosis involves the process of eliminating other disorders and conditions with similar symptoms. It can be difficult to diagnose fibromyalgia. There is no common exam or test that a doctor can use to definitively diagnose fibromyalgia. The elimination process is utilized because of several other conditions with similar symptoms. These include:
Rheumatoid arthritis
Chronic fatigue syndrome
Lupus
It can take some time when an individual first notices symptoms and actually being diagnosed with fibromyalgia, which can be frustrating. Doctors have to become detectives, working hard to find the right cause of pain and other symptoms. Developing the right diagnosis is necessary to create an optimal treatment plan.
Fibromyalgia Diagnosis Criteria
Pain and symptoms based on the total number of painful areas
Fatigue
Poor sleep
Thinking problems
Memory problems
In 2010, a study was published that updated fibromyalgia diagnosis criteria for fibromyalgia. The new criteria remove the emphasis on tender point examination.The 2010 criteria’s focus is more on the widespread pain index or WPI. There is an item checklist about where and when an individual experiences pain. This index is combined with a symptom severity scale, and the end result is a new way to classify and develop a fibromyalgia diagnosis.
Diagnostic Process
Medical History
A doctor will look at an individual’s complete medical history, asking about any other conditions present and family condition/disease history.
Symptoms Discussion
The most common questions asked by a doctor are where it hurts, how it hurts, how long it hurts, etc. However, an individual should offer as much or added details of their symptoms. Diagnosing fibromyalgia is very dependent on the report of the symptoms, so it is important to be as specific and accurate as possible. A pain diary, which is a record of all symptoms that present will make it easier to remember and share information with the doctor. An example is giving information on trouble sleeping, with a feeling of tiredness a majority of the time, and headache presentation.
Physical Examination
A doctor will palpate or apply light pressure with the hands around the tender points.
Other Tests
As previously stated symptoms can be very similar to other conditions like:
A doctor wants to rule out any other conditions, so they will order various tests. These tests are not to diagnose fibromyalgia but to eliminate other possible conditions. A doctor could order:
Anti-nuclear antibody – ANA test
Anti-nuclear antibodies are abnormal proteins that can present in the blood if an individual has lupus. The doctor will want to see if the blood has these proteins to rule out lupus.
Blood count
By looking at an individual’s blood count, a doctor will be able to develop other possible causes for extreme fatigue like anemia.
Erythrocyte sedimentation rate – ESR
An erythrocyte sedimentation rate test measures how quickly red blood cells fall to the bottom of a test tube. In individuals with a rheumatic disease like rheumatoid arthritis, the sedimentation rate is higher. The red blood cells fall quickly to the bottom. This suggests that there is inflammation in the body.
Rheumatoid factor – RF test
For individuals with an inflammatory condition like rheumatoid arthritis, a higher level of the rheumatoid factor can be identified in the blood. A higher level of RF does not guarantee that the pain is caused by rheumatoid arthritis, but doing an RF test will help the doctor explore a possible RA diagnosis.
Thyroid tests
Thyroid tests will help a doctor rule out thyroid problems.
Final Note Fibromyalgia Diagnosis
Again, diagnosing fibromyalgia can take awhile. A patient’s job is to be proactive in the diagnostic process. Be sure you understand what the results will tell and how that specific test will help figure out the cause of the pain. If you don’t understand the results, keep asking questions until it makes sense.
InBody
Body composition and Diabetes Connection
The body needs a balance of lean body mass and fat mass to function properly/optimally and maintain overall health. The balance can be disrupted in overweight and obese individuals because of excess fat. Individuals that are overweight should focus on improving body composition by reducing fat mass while maintaining or increasing lean body mass. Balanced body composition can reduce the risk of diabetes, other obesity-related disorders, and a positive effect on metabolism. Metabolism is the breaking down of foods for energy, the maintenance, and repair of body structures.
The body breaks down the food nutrients/minerals into elemental components and directs them to where they need to go. Diabetes is a metabolic disorder meaning it changes the way the body makes use of the nutrients, in such a way that the cells are unable to utilize digested glucose for energy. Without insulin, the glucose cannot get into the cells, so it ends up lingering in the blood. When the glucose can�t make its way out of the blood, it builds up. All the excess blood sugar can potentially be converted to triglycerides and stored as fat. With an increase in fat mass, hormone imbalances or systemic inflammation can happen or progress. This increases the risk for other diseases or conditions. A buildup of fat and diabetes are associated with increased risk for:
Heart attacks
Nerve damage
Eye problems
Kidney disease
Skin infections
Stroke
Diabetes can even cause the immune system to become impaired. When combined with poor circulation to the extremities, the risk of wounds, infections, can lead to amputation of the toes, foot/feet, or leg/s.
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
American College of Rheumatology. Fibromyalgia. 2013.�http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Fibromyalgia/. Accessed December 5, 2014.
Living with Fibromyalgia:�Mayo Clinic Proceedings.�(June 2006) �Improvement in Fibromyalgia Symptoms With Acupuncture: Results of a Randomized Controlled Trial��www.sciencedirect.com/science/article/abs/pii/S0025619611617291What Are Common Fibromyalgia Symptoms and How Does It Cause Back Pain?:�Clinical Biomechanics.�(July 2012) �Functional capacity, muscle strength and falls in women with fibromyalgia��www.sciencedirect.com/science/article/abs/pii/S0268003311003226
Fibromyalgia is a musculoskeletal condition that consists of pain symptoms and fatigue that can make diagnosis a challenge. Through chiropractic therapeutics, individuals can find relief from pain, fatigue, inflammation, and improve their quality of life. Individuals dealing with fibromyalgia and searching for answers should consider consulting a chiropractor to determine what treatment options will provide the most benefits. Treatment can be as much of a challenge without clear underlying issues. This often leads to frustration when trying to develop a treatment plan that works. �
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Fibromyalgia
Fibromyalgia is characterized by:
Body aches and pain
Tender points in muscles
General fatigue
Accompanied issues include:
Headaches
Anxiety
Depression
Sleep issues
Poor concentration
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It is believed that fibromyalgia causes the brain and spinal cord to transmit amplified/overresponsive signals. The exaggerated response of the neural pathways in the spine and body generate chronic pain. This is where specific diagnostic tools for assessing symptoms, underlying cause/s, and treatment development are necessary. Risk factors include:
When the body is rebalanced it can better manage symptoms because of the improved nerve circulation. Home treatments can include:
Exercise
Stretching
Heat therapy
Ice therapy
A full medical team consisting of the doctor, physical therapist, massage therapist, and chiropractor could be utilized to maximize results and ensure the highest quality of life.
Increasing muscle mass is a great way to improve body composition and boost the immune system. Research shows that senior adults with greater skeletal muscle mass have an increased number of immune cells in the blood. This indicates that muscles and the immune system are interrelated.
When the muscles are worked out, myokines are released. These are hormone-type proteins that strengthen the immune system that helps protect against diseases. A study revealed that regular exercise increases the release of T lymphocytes/T cells. Regular exercise also helps reduce the risk of developing chronic diseases like type 2 diabetes, obesity, various cancers, and cardiovascular diseases.
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Schneider, Michael et al. �Chiropractic management of fibromyalgia syndrome: a systematic review of the literature.��Journal of manipulative and physiological therapeutics�vol. 32,1 (2009): 25-40. doi:10.1016/j.jmpt.2008.08.012
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