Wednesday 28th June, 2023

Fibromyalgia: how to treat the cause, not the effects (symptoms)

Overview

As an overview, according to the medics the cause of fibromyalgia is unknown, but it is understood that the key issue is sensitisation of the nervous system, and because the nervous system is the master control system of the body this creates a host of adverse effects and symptoms.

Most treatments, "causes" and miracle cures focus on remedying those adverse effects and symptoms. For the real cause we need to look at what causes the sensitisation, and and like most sensitisations the underlying cause is prolonged or repeated exposure to something.

The good news is that:

  1. scientists ave identified the common exposures responsible, and
  2. have found that if you remove those exposures the fibromyomyalgia can settle down.

The video: Fibromyalgia- how to treat the cause, not the effects (symptoms)

Video transcript: Fibromyalgia- how to treat the cause, not the effects (symptoms)

What is fibromyalgia

First, lets start with what fibromyalgia is. Fibromyalgia is very complex, but the basic concepts are simple. If you have fibromyalgia you’ll probably be aware that the symptoms are pain, and a whole heap of other seemingly unrelated things.

The medical view of fibromyalgia

The medics will tell you the cause is unknown, and there are no diagnostic tests. What that means that they basically they do a heap of tests and if they all come up negative give you a diagnosis, which in doctor speak means “we have no idea”. That’s true even if it comes from a highly qualified specialist. That just means they are even more sure that they have no idea. All they have is a big shopping list of drugs and therapies to treat the symptoms.

The "fibromyalgia gurus"

If you’ve had fibromyalgia for a while you’ll probably be aware that there are countless gurus who claim to have the cause or some wonder treatment. As I said I get messages all the time telling me about the latest revelation, but they’re all just secondary effects and symptoms..

What is really going on with fibromyalgia

So, what is going on with fibromyalgia. Lets start with the one things medics seem to understand: that is that fibromyalgia involves sensitisation of the nervous system. So, what does that mean?

The cause of the pain

You’ll probably understand that your nervous system allows you to feel pain. So, when it’s sensitised it acts like a big amplifier. Things you normally wouldn’t notice become painful, and any pain becomes much worse.

Autonomic nervous system
The nervous system is the master control system
The cause of the other symptoms

That explains all the pain you get, but what about all the other symptoms? As you can see from this diagram your nervous system is the master control system of your body. Directly or indirectly it controls every organ, the levels of every blood chemical and hormone: basically everything that’s important

What happens when your nervous system is sensitised it starts sending out a bunch of abnormal nerve signals. These can have some pretty profound and wide reaching effects, which explains why you get the wide range of symptoms.

The sensitisation of your nervous system

The next question is how does your nervous system become sensitised in the first place? It’s basically like any way you get sensitised. You get exposed to something over a long period of time until you can’t cope any more.

The main causes of sensitisation

Now your nervous system has a lot of different inputs so there’s a lot of things that can sensitise it. That can even be things like really bad psychological stress, but the main one by far is being bombarded by pain over a long period of time. You can become sensitised have something like an arthritic joint or even a tennis elbow, but the scientists found that by far the biggest source of this pain is myofascial trigger points, or trigger points for short. They’re those tender lumps in your muscles that therapists find. We’ll get to them shortly.

The causes of sensitisation add up

The other thing you need to understand is that you usually get sensitised to by exposure to things long term, and, different exposures can add together. What that means is you can have a long term source of pain, then something like say a virus, a traumatic event or even emotional stress comes along and pushes your nervous system over the threshold. The virus, trauma or emotional stress will get the blame, but really they are just the proverbial straw that breaks the camel’s back.

The cause vs effects (symptoms)

Now you know what’s going on it’s a good time to look at cause vs effect.

The effects of sensitisation

For a start we’ve got pain, altered blood chemicals and all those other things sensitisation causes. They’re obviously effects. There’s a huge range of drugs and therapies that target these, but all they can do is help reduce your symptoms. There’s no way they can ever fix the problem.

The sensitisation

Next we’ve got the sensitisation itself. The drug companies have a range of drugs that basically suppress your nervous system, or to use simple terms turn down the amplifier. This works on the cause of the symptoms, but not the cause of the fibromyalgia itself. The big issues with this are you’ve still got whatever is causing the sensitisation in the first place, and as well as sending out abnormal signals your nervous system is still performing critical functions. The drugs can’t turn down one and not the other.

The cause of sensitisation

Now lets look at treating the cause, and as I mentioned earlier there are scientists who got it right. A bunch of scientists over the years have investigated and found that trigger points were a big problem, and how they cause sensitisation. They also did studies that found that compared with non-sufferers people with fibromyalgia were riddled with trigger points.

The final test was establishing cause and effect, and to find out what happens when you remove the cause. This study here it the key one where they did all that. What they did was get a bunch of fibromyalgia sufferers and inject their trigger points with anaesthetic, stopping them bombarding the nervous system with pain, and what do you think happened?

The fibromyalgia symptoms settled down across the whole body, even far away from the actual trigger points. The problem here is that anaesthetics only stop the pain for a limited time. I’ll cover how we get rid of the trigger points later. However, it did show two very important things. First it confirmed that trigger points were the major cause of the sensitisation that causes fibromyalgia symptoms, but most importantly when the cause of the sensitisation is removed your nervous system can go back to normal.

I’ll repeat that. When the cause of sensitisation is removed your nervous system can go back to normal. No more pain amplifying, no more abnormal nerve signals, and no more weird symptoms.

(Myofascial) trigger points: the main cause of sensitisation

What we need to do now is show you why trigger points are so important, how they’re properly treated, and the special considerations for treating fibromyalgia.

Trigger point
Trigger points are the tender lumps in your muscles therapists find

Why trigger points are the biggest cause of sensitisation

First, why are trigger points such a major cause of long term pain bombarding your nervous system. Three reasons.

  1. they are so common that practically everyone has them. For example, one study looking at just the shoulder muscles of people with no pain found about 90% had trigger points, and most had a lot of trigger points. So, even if you’ve got no pain you’ll still have them, but trigger points eventually start arcing up. If you have any sort of musculoskeletal pain they’ll surely be involved.
  2. they don’t show up in any medical scans or tests so doctors don’t diagnose them, and the drug companies have brainwashed doctors to prescribe pain killing drugs instead.
  3. even if they are diagnosed most of the treatments you get, whether its trigger point releases, needles, laser or whatever usually just temporarily stop them shooting pain, not get rid of them.

So, that’s why they’re the major source of pain that causes the sensitisation: everyone gets them and they practically never get treated properly.

Treating trigger points

That said, lets look at how to treat them. We’ve got an excellent rosource here , but what I’ll do here is give you a brief overview.
Trigger points are parts of your muscle that tighten or spasm forming a lump. That tightens the muscle, putting pressure on the blood vessels, restricting blood flow. Because of this it gets a build up of waste products, causing a toxic environment. The toxic environment causes the lump to spasm more more, so the thing grows.

What that means is trigger points start off small, so you only know they’re there if someone presses on them, but like this snowball gradually grow until something stirs them up and they start shooting pain like scientists map in charts like these.

Snowball effect
Like a snowball trigger points gradually grow until they are large enough to cause pain
Trigger point chart

Because tightness and blood flow are the big issues the way trigger points are treated is by relaxing the muscle and increasing blood flow. A lot of treatments relax muscles and increase blood flow, so that’s why there are so many different trigger point therapies.

Why most courses of treatment do not get rid of trigger points

That brings us to the issue I mentioned before: most treatments just remove pain but not the trigger points. The basic principle here is we’ve got our snowball. It gets down near the bottom, something arcs it it up and it starts hurting. What your trigger point therapies do stop it arcing up and maybe shrink it a bit, but obviously they’re still there and going to keep rolling.

Trigger points remaining after 12 sessions of therapy
After 12 extensive weekly sessions by the best trigger point scientists in the world 2/3 of the trigger points were still there

To give you an idea how totally useless long term treatments like needles, lasers or the trigger point releases people show you on YouTube are, a while back the best trigger point scientists in the world got a bunch of people with shoulder pain and basically hit their trigger points with everything but the kitchen sink for 12 weeks. The people felt a lot better, but as this chart from the report shows the trigger points had all shrunk, but 2/3 of them were still there.

Warning about trigger point therapies

At this stage I’ve got to make a little side track to help prevent you getting sucked in, spend a lot of money, and have nothing long term to show for it.

Needles and lasers are flavour of the month at the moment, so just say you’re a scientist running a trial on them as a therapy for trigger points. You want to do a successful trial, but you’re not stupid. You’ve read the report on the trial I’ve just mentioned and know there’s no way known you’ll get rid of the trigger points, so what you do is don’t measure them. Instead you give your people say half a dozen treatments of needles or laser and just measure things like pain. The pain improves, so you’ve got a trial showing that the needles or lasers are an effective treatment for trigger points.

Next you’ve got the people selling lasers and needles having their sales people using the trial to sell to professionals. The professionals see what’s measured, but not what’s omitted, so they recommend you get half a dozen sessions of needles or laser. A few month later and the snowball has rolled further down the hill again. You’re not only back to square one, you’re another step closer to being sensitised and developing fibromyalgia.

This is exactly what drug companies do with a lot of their drug trials, and you’re either aware of it or their victim.

How to successfully get rid of trigger points

Back onto how we do successfully treat trigger points. The one positive from the trial I mentioned before is that after 12 weeks all the trigger points had shrunk and 1/3 were gone. What that tells us is that if we keep going we can shrink them further and get rid of more. So to get rid of trigger points we need an effective therapy that we can use initially to get rid of the pain, then continue over a long period of time to rid the trigger points altogether.

Technically you could do it with needles, lasers or professional therapists, but I can’t see many people fronting up for maybe 50-100 treatment sessions. Luckily we’ve got a therapy that’s easy to do on yourself and arguably a lot more effective. That’s using a genuine vibration massager like one of these.

This article gives full details , but what you do is sit one of these over the trigger point and let the vibrations penetrate. Those vibrations have been scientifically proven to relax the muscle and increase blood flow which is exactly what you need for a trigger point. Better still they are really easy to use and normally don’t hurt. Keep in mind that if you have fibromyalgia even just touching you can hurt, but of all the physical therapies vibration massage is by far the least.

Percussion vs vibration massage
Warning about massage guns

Just a warning here. We’ve got percussion massagers or massage guns vibrating and claiming to give these benefits. I’ll link the details, but in simple terms they are designed to jackhammer the surface rather than send vibrations deep into your muscles. You get far less of the beneficial vibrations, and the last thing you want when you’re sensitised is something jack hammering or pummelling you. You need a genuine vibration massager, not a massage gun.

Specific considerations for treating fibromyalgia

So, that’s treating trigger points in general. Lets have a look at some specifics for fibromyalgia.

The trigger points will be well entrenched

By the time you become sensitised you will have had the trigger points for a long time, so they will have become well entrenched, and the tightness of the muscles will have probably have caused biomechanical changes, which are changes to things like your posture and how your joints work. You can do a lot of the therapy yourself, but get a professional who deals in biomechanics and trigger points to check you out and advise you.

You will be sensitised

Next, is when you’re sensitised you become less tolerant to treatments. If you you use something like pressure techniques, foam roller or as I mention a massage gun you can easily stir the problem up big time. Vibration massagers are a lot easier on your body, but still just go very conservatively. Start off with shorter applications using maybe a slower speed, then increase as you improve or get an understanding of what your body will tolerate. If you’re doing it yourself rather that professional appointments it’s no big deal doing a little bit then coming back to it a bit later.

Fibromyalgia cause it's own stress

The final big issue when dealing with fibromyalgia is as I said inputs to your nervous system add up, and one of them was psychological stress. If you have long term pain, no one can explain it and everything you’ve tried has failed that can cause some pretty major psychological stress. You can even get into the situation where the psychological stress is enough to keep the sensitisation going even with the trigger points gone. This is something you’ll need to discuss with your professional, but here’s a couple of suggestions.

  1. To give you some confidence check out our complete guide with scientific references
  2. Also, you might some sort of temporary symptom or stress relief.

So, that’s your overview of fibromyalgia and how to treat the cause rather than symptoms. If you have any questions or comments don’t hesitate to leave them on that comments, and for more details on what you need to do just follow the links.

Thanks very much for watching. It has been most appreciated.

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Dr Graeme

About Dr Graeme

Several years ago Dr Graeme, a Chiropractor practicing in Victoria, Australia was looking for a serious hand held massager his patients could use at home to get the extra quality massage they needed. The ones he found in the shops and on-line for home use looked nice but were not serious, and... read more



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