Dr Davis' Back & Wrist Pain Blog

Fibromyalgia – Where Does the Pain Come From?

Fibromyalgia (FM) is a very strange condition. Can you think of any other condition that creates so many symptoms and yet all the blood and imaging tests are negative? FM symptoms include chronic fatigue, muscle aches and pains, depression, sleep disturbance, memory affects, and more. The degree or severity of FM varies from mild to severe, leaving some totally disabled and distraught. So, the question of the month is, where does the pain come from?

            Since the usual markers of injury are negative (that is, blood and other tests), we can tell you first that the pain is NOT coming from damaged tissue such as muscle, bone, organs, and the like. If it did, abnormal enzymes &/or inflammatory tests would result. Rather, the origin of pain appears to be arising from within the central nervous system. That is to say, there are portions of the brain and spinal cord where pain signals are received and when they reach a certain level or threshold, the sensation is felt. When the sensory input is below that level, it will not be felt. In fact, there are MANY MORE incoming sensory signals that are NOT felt compared to those that are. This “thermostat-like” function is vital so we DO NOT feel everything that arrives to the brain. This is why we don’t feel the clothes hanging from our backs or the shoes on our feet (unless the laces are tied too tight!). It’s been said that if we DID “sense” all the incoming signals we would, in a sense, “…short circuit.”

            In the FM patient, this thermostat is “messed up.” It is set lower than what is considered normal, and as a result, patients do sense or feel more than they should. This “nervous system overload,” sometimes referred to as a “sensory storm,” occurs in the FM sufferer. A more fancy term called “central sensitization” can be searched and you will find a LOT to read about this interesting subject (check it out)!

            So how does this hypersensitive situation start? Fibromyalgia is classified into two main categories – type I and type II. In type I, or primary FM, the cause is unknown. The cause could include one’s genetic make-up, but the bottom line is, we really don’t know. In type II or, secondary FM, some other known condition or situation can be identified such as irritable bowel syndrome, rheumatoid arthritis, after a trauma, or following an illness or infection. Some also feel the lack of sleep or sleep loss can cause FM. This is because it takes about four hours of sustained sleep to reach deep sleep, and because of frequent sleep interruptions, the person never reaches deep sleep. Over time, deprived of the relaxing deep sleep benefits, the body gradually tightens up, “re-setting the thermostat” and too much sensory information reaches the brain, resulting in overload, and a heightened pain level is perceived. Studies have shown that when sleep is restored, many FM patients gradually improve and function better. This focus on sleep restoration is important in the management strategies of FM treatment. We all know our tolerance to just about everything suffers when we are over-tired, similar to the toddler who cries at the drop of a dime when they need a nap.

            Chiropractic adjustments, certain nutrients like melatonin, valerian root, and vitamin B complex can facilitate sleep restoration. Treatment for sleep apnea can also help patients with FM. As we’ve said before, FM is usually multi-factorial and including chiropractic in the FM treatment “team” is essential for a satisfying result!

            If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

To schedule an appointment for Fibromyalgia Treatment in San Francisco call 415-392-2225.

                                   

Fibromyalgia Facts and Learning Quiz

We have been providing treatment for Fibromyalgia in San Francisco for over 21 years.

Fibromyalgia (FM) has quite a history! There is evidence that dates as far back as Hippocrates in ancient Greece, when he described a mysterious condition affecting the muscles which portrays FM quite accurately!

            FM is a complex condition that includes fatigue and chronic muscle, tendon, and ligament pain that is wide-spread (NOT contained to one small region). Generalized pain and fatigue are the hallmarks of FM, which can range from mild to severe disability. However, there are many misconceptions about FM.

            How much do you THINK you know about FM? Try the self-test below. For each statement, decide if the statement is true or false. The answers can be found below…

1. FM shortens one’s life span.
2. A patient may see several doctors before finding someone willing to help them.
3. FM can affect children, though it is most common in adults ages 20-55.
4. To properly diagnose FM, you must have at least 11 of 18 tender points.
5. With FM, you should not exercise if your body hurts.
6. A multi-discipline treatment approach usually works best (chiropractic, primary care, massage therapy, and others).
7. If you have FM, you were probably born with it.
8. Women usually develop FM more often than males.
9. The presence of pain associated FM signifies muscle deterioration.
10. It is easy to confuse FM with other diseases.

            FM is present in 2-4% of the population and affects everyone differently, so each case is best managed by an individualized form of treatment. In other words, one treatment approach for every FM patient is NOT the proper approach. For some, fatigue is the primary issue, while for others, it’s the sleep disturbance, irritable bowel syndrome. or bladder problems that require the most attention. There is frequently a co-existing psychological condition that may include depression, anxiety, and/or a stress-related condition, such as post-traumatic stress disorder. In reference to the 10 statements above, FM does NOT shorten one’s life span, but it does affect quality of life. The primary goal of treatment is to help the FM patient gain control of their condition. It truly can take multiple visits to different doctors before finding one that’s willing to work with you and coordinate care with other “team” providers to give you the best quality care. FM can affect children, though it’s rare – it’s primarily the 20-55 year old age group with a 9:1 ratio favoring the female population. The “old” 11 of 18 tender point diagnostic requirement has been replaced by “widespread, generalized pain,” NOT limited to specific points. Exercise is one of the BEST self-management strategies and should be encouraged. Though a genetic component has been identified, FM is NOT something you are “born with.” The pain associated with FM is NOT indicative of muscle deterioration. FM is often confused with other diseases and the diagnosis is made by eliminating the other more easily diagnosable disorders. Chiropractic is a VERY important part of the management team in the care of the FM patient.

Answers: 1. False; 2. True; 3. True; 4. False; 5. False; 6. True; 7. False; 8. True; 9. False; 10. True.

            If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

Altadonna Communications ©

To schedule an appointment for Fibromyalgia Treatment in San Francisco please call 415-392-2225.

 

 

Fibromyalgia and Nutrition Recommendations

Fibromyalgia (FM) management involves many treatment approaches. As was pointed out last month, the importance of sleep quality, hormonal balance, infection management, nutritional supplementation, exercise and more was discussed as the “SHINE” approach. This month, we are going to explore how important diet is in the management of FM.

                It’s been said that one of the most powerful tools the FM patient has in their possession is their FORK because, “…food becomes cells.” That is to say, the food we eat is used to build cells, tissues, and support our organ systems. The National Fibromyalgia Association (NFA) has reported that all FM patients have some common physiological abnormalities that include:

1. Too much Substance P (a pain producing neurotransmitter).
2. Too little tryptophan (an essential amino acid that helps make serotonin which helps mood and many other things).
3. Not enough serotonin (a brain neurotransmitter that fights depression)..
4. Abnormalities in muscle cells, especially the mitochondria that provides energy (ATP) to the cell.

                With the exception of substance P, we can control ALL of the above, at least in part, with diet and eating the right food. The following 7 nutritional recommendations can make a significant improvement for the FM sufferer:

1. ELIMINATE FOOD TRIGGERS: Eliminate foods that irritate the digestive system. The NFA reports that 40% of FM patients have irritable bowel problems and food sensitivities that trigger abdominal pain, diarrhea, and headaches. Common food triggers include: monosodium glutamate (MSG), caffeine, food coloring, chocolate, shrimp, dairy products, eggs, gluten, yeast, milk, soy, corn, citrus, sugar and aspartame. Regarding aspartame and MSG - a 2010 study out of France reported FM symptoms subsided significantly after eliminating both from the diet, as they found that they stimulated certain neurotransmitters.
2. EAT MORE TURKEY! That’s because turkey contains tryptophan, an essential amino acid that can help combat chronic fatigue and depression, which are common FM symptoms. In a large NFA 2007 survey of 2,596 FM patients, about 40% of the group complained of energy loss. Tryptophan is only acquired through food as our bodies cannot make it or convert it from other substances. Tryptophan is needed by our body to make serotonin (the “happiness hormone”) which improves our mood and makes melatonin, the chemical that helps us sleep deeply. Hence, to fight fatigue, avoid the food triggers mentioned in #1 and increase tryptophan, which can be found in certain protein rich foods such as cold-water fish (salmon, tuna, anchovies, and mackerel), nuts and seeds, soy (soymilk, tofu, and soybeans), turkey, and yogurt. Many of these foods also contain tyrosine, which increases levels of brain neurotransmitters dopamine and norepinephrine. These brain neurotransmitters help with cell messaging, alertness, and reduce cognitive “fog,” often described by FM sufferers. Also consider taking melatonin if sleep is an issue.
3. EAT MORE SARDINES! Okay, turkey is more “palatable,” but sardines have the ability to reduce muscle pain, of which, according to the NFA survey, 63% of FM sufferers experience. This is thought to be due to coenzyme Q10 (CoQ10) deficiency, essential for muscle function and found in sardines and organ meats. Of course, if these natural food approaches don’t appeal to you, a CoQ10 supplement may be easier. In two studies, FM patients were found to be 40% deficient in CoQ10, and 30% experienced less muscle pain and fatigue after taking 300mg/day for 9 months.

If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

To schedule an appointment with one of our Fibromyalgia Treatment in San Francisco call 415-392-2225 and ask for a complimentary consultation.

 

Related articles

Fibromyalgia Treatment and "SHINE"

Fibromyalgia and Neurotransmission

San Francisco Chiropractor: Weekly Health Update

Sitting All Day is Even Worse Than You Think!

Doctors Health Press Reports on Study: Many People with Fibromyalgia Misdiagnosed

Fibromyalgia Treatment and "SHINE"

We have been providing natural solutions for Fibromyalgia in San Francisco for over 20 years.

Fibromyalgia (FM) management can be as difficult as making a definitive diagnosis.  FM is characterized by generalized body aches and feeling exhausted, and yet, in spite of the exhaustion, the inability to sleep is a “classic” FM complaint. Some have referred to FM as “blowing a fuse” or as an “energy crisis,” as more energy is expended than what’s being made. FM sufferers, as well as the caregivers, know how physically and mentally difficult it is to manage this controversial condition. Many management strategies that have been published; SHINE is one approach. SHINE stands for Sleep, Hormones, Infections, Nutritional supplements, and Exercise. By focusing treatment strategies on these 5 areas, significant benefits can be achieved.

            SLEEP: Some feel this is the most important problem to manage in order to gain control of FM. If we cannot reach “deep sleep,” (which is the sleep stage that is usually reached after about the 4th hour into sleep) then the body cannot fully rest. When discussing sleep problems with the FM patient, it is common to hear them say, “…I wake up every 1-2 hours and can’t get back to sleep for at least 15-30 minutes.” This results in NEVER getting to the deep sleep stage and eventually, because the body hasn’t fully relaxed often for years, everything starts hurting. This is the hallmark of FM. Some “tips” to help us get to sleep and stay sleeping include: keeping the bedroom cool (such as 65°), taking a hot bath before sleep to relax your tight muscles, spraying the pillow with lavender oil (helps promote sleep), taking 75-150mg of magnesium, avoiding caffeine (especially later in the day), the use of Valarian Root (a muscle relaxing herb) and/or melatonin (an amino acid that promotes sleep) can also help. The goal is to try to get 8-9 hours of sleep a night. Establish a routine in the evenings and go to bed at the same time or close to it.

            HORMONES: These chemicals are produced by our endocrine glands (pituitary, thyroid, parathyroid, adrenals, ovaries/testes, and part of our pancreas. They are in balance with each other, and somehow, in FM they often fall out of balance. Have your health care provider perform tests (usually blood and/or urine) to determine your hormone levels and get them balanced!

            INFECTION: The lack of sleep lowers our immune function, and infections can occur more readily. In addition to treatments, there are nutritionally based approaches to improve immune function, and if recurrent illnesses are part of your FM profile PLEASE consult with us regarding ways to boost your immune system!

            NUTRITIONAL SUPPLEMENTS: This topic is related to the last as there are MANY supplement recommendations that have been found to boost immune function, increase energy, enhance sleep quality, and more. This is an area of FM management that is largely overlooked by traditional medical management approaches. Remember, a “team” of providers offers the FM sufferer the best way to manage this challenging to treat condition. Look for health care providers who are willing to work together as a team on your behalf.

            EXERCISE: This is a MUST! For example, in a 2010 Oregon Health & Sciences University study, women with FM who practiced yoga for 8 weeks had a 24% pain reduction, 30% fatigue reduction, and 42% depression reduction.

            If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

To schedule an appointment with a Fibromyalgia doctor in San Francisco call 415-392-2225.

Fibromyalgia and Neurotransmission

We have been providing treatment for Fibromyalgia (FM) in San Francisco since 1992.

Neurotransmission is the method by which nerves “speak” to each other so impulses can be sent from one part of your body to the brain and back. For example, when you touch a hot plate by accident, it doesn’t take long before you quickly let go of the plate. The reason you let go quickly is because of neurotransmission. Certain types of neurons or nerves (called afferents) bring information to the central nervous system where the information is processed and then signals are transferred back to the target site (such as your hand touching the hot plate) by different nerves (called efferents) telling you to immediately let go of that hot object. It’s like the flow of traffic into a city during rush hour. People work all day and then drive in the opposite direction on their way home (afferents in the morning going in the city or “brain” and efferents in the evening bringing new information home). This “give and take” process of information coming in, being processed and going out helps coordinate our bodily functions. This allows us to constantly adapt to surrounding changes in temperature, stress, noise, and so on.

            Each neuron has as many as 1500 connections from other neurons, but they don’t actually touch one another. Rather, there are “synapses” where nerve impulses stimulate the release of calcium and neurotransmitters, which either inhibit or excite another neuron and each neuron may be connected to many other neurons. If the total excitatory stimuli are greater than the inhibitory stimuli, that neuron will “fire” and create a new connection resulting in an action (like dropping the hot plate).

            Okay, sorry for the enthusiastic description and details of neurotransmission. More importantly, how does all this relate to fibromyalgia?  A new study (published May 14, 2012 in NATURE by scientists at Weill Cornell Medical College) discovered that a single protein (alpha 2 delta), “…exerts a spigot-like function controlling the volume of neurotransmitters and other chemicals that flow between the synapses of brain neurons.” This study shows how brain cells “talk to each other” through these synapses relaying feelings, thoughts, and actions and how this powerful protein plays a crucial role in regulating effective communication in the brain. They found that if they added or decreased this single protein (alpha 2 delta), then the speed of neurotransmission increased or decreased by opening or closing the calcium channels that trigger neurotransmission release.

            The relationship between calcium and neurotransmission has been known for 50 years, but how to “turn on or off” the volume is a new discovery. They hope this finding will help in the design of new medications that will help regulate the neurotransmission in the brain, thus help reduce the increased pain perception found in people suffering from fibromyalgia.

            Our aim in sharing this information with you is to keep you informed with what is on the cutting edge of research as we’ve said many times before, a “team” of health care provision is the BEST way to manage FM including chiropractic and primary care!

            If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

To schedule an appointment with one of our Fibromyalgia Doctors in San Francisco call 415-392-2225.

Serving local 94111 for over 20 years.

 

Fibromyalgia and Sleeping Problems

Fibromyalgia (FM) and sleep dysfunction seem to go hand in hand. In fact, most people who have FM complain of problems associated with sleeping. Sleep problems can include difficulty falling asleep with or without waking up one to multiple times a night. Also, the inability to reach “deep sleep” results in waking up un-restored. People with fibromyalgia frequently state, “… I feel exhausted when I wake up; I have no energy.” They often feel more tired in the morning, and many go back to sleep during the day to ease their fatigue. Another common FM complaint is having great difficulty concentrating during the day, often referred to as, "…fibro fog." Other sleep disorders such as sleep apnea and restless leg syndrome are also often associated with FM.

            Restless legs syndrome (RLS) is a neurologic disorder that is characterized by an overwhelming urge to move the legs at rest, thus interfering with sleep. Restless legs syndrome is more common among those who have fibromyalgia. Patients with RLS describe this as an unpleasant sensation in their legs and sometimes their arms or other parts of the body accompanied by the irresistible urge to move the legs in attempt to relieve the sensation. The terms, “itchy” or “pins and needles” or “creepy crawly” are frequently used when describing the sensations and can range from mild to intolerable. Symptoms are typically worse at rest, especially when lying or sitting and frequently results in sleep deprivation and stress. The intensity of the symptoms can vary, frequently worse in the nighttime, better in the morning. RLS may affect up to 10% of the population in the United States, especially women, and can affect both young and old, even young children. The severe cases usually affect the middle-aged or older and account for about 2-3% of the 10% incident rate. The diagnosis is often delayed, sometimes for 10-20 years. Although the cause is not clearly described, genetics seems to play a role given about 50% of those affected have a family member with the condition.

            Other conditions often associated with RLS include iron deficiency, Parkinson’s disease, kidney failure, iron deficiency, diabetes and peripheral neuropathy. Treatment applied to these conditions often indirectly helps RLS resulting in sleep quality improvement. Medications such as anti-nausea drugs, antipsychotic drugs, some anti-depressants, and cold/allergy medications that contain antihistamines can worsen symptoms. Pregnancy can also trigger RLS, especially in the last trimester. It commonly takes about 3-4 weeks for the symptoms to quiet down after delivery. Other factors that affect RLS include alcohol intake and sleep deprivation itself. Improving sleep and/or eliminating alcohol can be quite effective treatment strategies. There are no medical tests that confirm the diagnosis of RLS, but blood tests can at least rule out other conditions, and when all the tests are negative, the diagnosis is made based on a patient’s symptoms, family history, medication use, the presence of an interrupted sleep pattern with daytime fatigue, and knowledge about the condition.

            Treatment utilizing chiropractic management has been reported to be effective in managing RLS associated symptoms including the use of spinal manipulation, muscle release techniques, exercise training, and at times, physical therapy modalities. Nutritional approaches that emphasize muscle relaxation have also been reportedly helpful.

            If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

To schedule an appointment with one of our San Francisco Fibromyalgia Doctors call 415-392-2225. Mention this article for a complimentary consultation.

 

Fibromyalgia Nutrition Tips

We have been providing treatment for Fibromyalgia in San Francisco for over 20 years.

Fibromyalgia (FM) is a disorder that affects everyone a little differently. Therefore, promoting a one diet approach for every FM patient doesn’t make a lot of sense. However, according to Ginevra Liptan, MD, medical director of the Frida Center for FM in Portland, OR, it is clear that what is included in a diet vs. what is eliminated makes a big difference for many FM patients. It has been reported that 42% of FM patients surveyed indicated their symptoms worsened after eating certain foods. Here are some recommendations about diet to consider:

1. Pay attention to how food makes YOU feel. Many FM patients have sensitivities to particular foods, but this is highly variable from person to person. Sensitivity to MSG, certain preservatives, eggs, gluten, and dairy are quite common. Keep a daily food journal for at least 2 weeks and write down the foods eaten and any associated symptoms like headaches, indigestion (irritable bowel syndrome irritation – IBS), or fatigue.
2. Try Eliminating Certain Foods. Many FM patients have irritable bowel symptoms, and using an elimination diet can help determine which foods to cut out. Try it out for no less than 6-8 weeks in order to get the best results. Then, add it back into your diet and pay attention to how it makes you feel. The most commonly eliminated foods are dairy and gluten and the most common improvement is in fatigue reduction and reduced IBS symptoms like bloating and constipation.
3. If you think you might have food sensitivities or allergies, talk with us. Sometimes it is best to obtain an evaluation from an allergist for food allergy testing. Dietitians can also assist in assuring that you don’t eliminate essential nutrients when foods are eliminated from the diet.
4. Make it easier to Eat Healthy. Everyone, including the FM sufferer, should try to eat fruits, vegetables, whole grains (if not gluten sensitive), and lean meats or protein. A well balanced diet will give you more energy, which in turn, can improve your overall health. When pain and exhaustion are present, choose healthy foods that do not require a lot of preparation such as buying pre-washed vegetables, or purchase pre-prepared foods like beet salad and quinoa.
5. Use Food to Help Fight Fatigue. Consume foods in a way that increases energy levels and prevent fatigue. Anecdotally, FM patients have reported that eating small meals frequently vs. restricting themselves to 3 meals a day can keep blood sugar levels more even and prevent the “hypoglycemic lows.” A snack high in protein around 3pm can prevent mid-day fatigue.  Make sure your breakfast includes some protein and whole grains (again, assuming there is no gluten sensitivity). Focus on getting enough sleep and staying active during the day as these can also prevent fatigue during the day.
6. Check on Your Supplements. Some supplements have significant side effects and can interact with medications. Talk to the prescribing doctor or pharmacist about this. For example, antidepressants and certain supplements can interact.
7. Focus on Your Overall Well-Being. A multiple approach to managing FM symptoms works better than a single approach. Things like yoga, massage, and deep breathing exercises, as well as routine chiropractic treatments can improve the overall quality of life. Increasing the quality of life is the ultimate goal for managing the FM patient. Going to bed at a consistent time, not eating too late, and exercising regularly are key components.

Our Chiropractors are experts when it comes to providing natural solutions for FM. To schedule an appointment with one of our San Francisco Fibromyalgia Doctors call 415-392-2225.

Serving zip code 94111 since 1992

 

Fibromyalgia Basics You Should Know

Fibromyalgia (FM) is a disorder that includes widespread musculoskeletal pain along with fatigue, sleep disturbance, memory changes, mood changes and more. Studies show that FM amplifies or increases painful sensations by changing the way the brain processes pain signals. FM is NOT a psychological disorder that only people with a troubled past or present acquire. Nor is it due to being inactive or lazy. If ANY doctor suggests that, PLEASE find a different doctor who understands the pathogenesis of FM. Unfortunately, this can be a challenge!

                FM symptoms can begin after a physical trauma, surgery, an infection and/or after a significant stress experience. It can also just gradually appear over time without an obvious triggering event. Women are more vulnerable to acquire FM than men. Many FM patients have other conditions that may be associated with FM including (but not limited to) headache, TMJ, irritable bowel syndrome, anxiety, depression, thyroid/hormonal imbalances, endometriosis, and more.

                Though the cause of FM may not be clearly identified, studies suggest there are a variety of factors that work together resulting in FM. Some of these include genetics, infections and physical and/or emotional trauma. Because FM tends to run in families, there may be certain genes or genetic mutations (changes that occur to genes) that make one more susceptible to developing FM. Infections appear to be a trigger for developing or aggravating FM. Post-traumatic stress disorder and less obvious physical or psychological trauma has been linked to the development of FM.  The amplified or heightened pain response has been termed, “central sensitization,” meaning, increased sensitivity to normal pain stimulation in the central nervous system (brain and spinal cord). Because of this heightened nervous system response, what normally isn’t processed as pain in the non-FM person, does reach and exceed the pain threshold in the FM patient (sort of like when amputation of a limb occurs and the brain still “thinks” there is a limb and “phantom pain” is felt). Studies show that repeated pain signals result in an abnormal increase in certain brain chemicals (called neurotransmitters). As a result, the brain’s pain receptors seem to develop a “memory” of the pain and become “sensitized” or they overreact to the pain signal input and pain is felt at an increased intensity. Certain risk factors come into play with developing FM, some of which include: your sex (female), family history (increased risk if other family members have FM), and rheumatic diseases such as rheumatoid arthritis and lupus.

                 Tests to establish the diagnosis of FM are few. In 1990, the American College of Rheumatology established 2 criteria for diagnosing FM. The first is widespread pain lasting at least 3 months, and the second is the presence of at least 11 out of 18 positive tender points. Since then, less emphasis has been placed on the exact number of tender points, while ruling out other possible underlying conditions that might be causing the pain is now utilized. There is no lab test to confirm a diagnosis of FM, but blood tests including a complete blood count, an ESR, and thyroid function tests are commonly done to rule out other conditions that have similar symptoms. Treatment is best approached by a “team effort” combining the skills from multiple disciplines including a primary care doctor who “believes in FM” and is willing to work with chiropractors, and others. Exercising, pacing yourself, accepting your limitations, yoga, psychological counseling, nutritional counseling, and having strong family/friend support are all important in the management of FM.

                If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

To schedule an appointment with a Fibromyalgia Doctor in San Francisco call 415-392-2225.

 

How Do You Know If It's Fibromyalgia?

Fibromyalgia (FM) symptoms are characterized by chronic generalized pain, and can include debilitating fatigue, sleep disturbance, joint stiffness, numbness or tingling, bowel/bladder dysfunction, and sometimes effects our ability to process thought clearly (cognitive dysfunction).  It can come on fast, almost overnight, or, develop very slowly over years of time. This highly variable onset makes establishing a diagnosis very challenging, and can also sometimes take years before the diagnosis is firmly established. In fact, the term “fibromyalgia” was not formally recognized as a diagnosis by the American College of Rheumatology and American Medical Association until 1987, and it remains a diagnosis made by excluding other diseases!

POPULAR MYTHS

MYTH: “Your symptoms are all in your head.” TRUTH: FM is a “MEDICAL DISORDER” where the nervous system’s ability to process pain is different when compared to those who don’t have FM. Why there is a difference between individuals is the big question. Some research suggests these brain processing differences may be the result of childhood stress, or prolonged or severe stress.

MYTH: “Only lazy, inactive people get fibromyalgia.” TRUTH: Research shows this not to be the case. In fact, most people with FM are focused and driven, and that stress associated with that intense drive may play a significant role in the development of FM symptoms.

MYTH: “There are no effective fibro treatments.” TRUTH: The good news is that as more studies on FM arise, we are beginning to understand more about FM, resulting in more effective treatments. The “catch” is that what works for one individual may not work for another making it essential to find a “good doctor” (or rather, a good team of health care providers) who is willing to listen and continually try different approaches until an effective management approach is found.

COEXISTING CONDITIONS

                There are some specific conditions that go hand in hand with FM, and though it’s not clear which comes first (FM or the condition), a clear relationship has been established. Some of these co-existing conditions include irritable bowel syndrome, arthritis (several different types can be associated), chronic fatigue syndrome, various sleep disorders, post-traumatic stress syndrome, anxiety, depression, and others. Often, blood and other lab tests come back negative and hence, the diagnosis is made by excluding those other conditions. What is MOST important is that to feel your best, these other conditions also need to be managed.

TREATMENT

                As stated above, the management of FM is aimed at all the condition(s) affecting the person with FM. This is why a multidiscipline “team” of health care providers is so important, as we all have our own emphasis and perspective on what to do for patients. Options include: a clinical psychologist to manage the chemical and hormonal imbalances, a primary care doctor whom “believes in FM,” and a chiropractor to manage the musculoskeletal issues of FM. Other alternative approaches such as massage therapy, Yoga classes, and acupuncture can also provide significant relief. Nutritional counseling is also highly effective in the management strategy of FM. Most important is the fact that coordination between these various approaches be supervised. Since we deal with the whole person, chiropractors are the PERFECT CANDIDATE for that job!

                If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

To schedule an appointment with a fibromyalgia doctor in San Francisco call 415-392-2225

 

 

Fibromyalgia and Foot Pronation

We have been providing 100% natural Fibromyalgia treatment in San Francisco for over 20 years now.

Fibromyalgia (FM) is a condition that (typically) evolves slowly over time and often occurs for no apparent reason. The diagnosis is usually made by excluding other conditions leaving you with a diagnosis that in the absence of anything else, “….must be fibromyalgia.” Of course, the problem with that approach is that we all want to know, “…what caused this problem to start with?” In the end, we typically have to accept the fact that, “…it just did,” and move on to, “…now what are we going to do about it?”

            A multi-disciplinary (involving several different types of doctors and approaches) treatment approach has been found to work well with Fibromyalgia patients. This approach may include medications from a primary care doctor who is aware and sensitive to this potentially disabling condition, massage therapy from a muscle relaxation point of view, clinical psychology when the stresses associated with FM become overwhelming and out of control, and chiropractic to quarterback joint mobility, diet management, exercise training, modality use, as well as offering foot orthotics. Coordinated care effort utilizing several disciplines is what is reported to be the most successful approach.

            Because chiropractic embraces the concept of treating the whole person, this premise fits perfectly in the treatment plan for the FM patient since the entire body is considered, not just a specific area or system. In this approach, we assess posture, movement, alignment, and function and implement treatments to improve each of those areas.

            During the postural assessment, because we are a 2-legged species, the feet must be carefully assessed for function and alignment. If you watch people walk, you will often see their ankles roll in with each step and for some, this can be quite dramatic where the ankle rolls in almost hitting the floor. What’s interesting is that most people don’t even know they are doing it! The truth is, most people with flat feet (technically called pes planus) and rolling-in ankles (or, ankle pronation) don’t have any foot pain or symptoms associated with the altered function. In fact, people with very high arches (pes cavus) usually have more foot pain than the flat footed person. If you look at shoes of those of us who pronate (which is about 80% of us), the wear pattern is usually quite excessive on the outer corner of the heel. Sound familiar? It is very common! So, why bother “fixing” ankle pronation if it doesn’t hurt? The answer is that biomechanical function is altered and it negatively affects the rest of the body quite significantly. Here’s what happens. When the ankle rolls in, the knee has to “knock” inwards, the hip has to impinge inwards, the pelvis on that side drops and the spine has to compensate for the pelvic drop and bend away from that side. Watch the shoulders and head sway back and forth as the pronated/flat footed person walks the next time you’re walking at the grocery store, mall, or airport.

            So, how does the use of foot orthotics help the FM patient? It has been reported that it takes up to seven times more energy to walk when the ankles pronate excessively. Chronic fatigue is a frequent complaint in the FM patient, and the less energy expended from walking, the more energy will be left over for other daily tasks. Also, the biomechanical stresses on the ankle, knee, hip, and spine will be smaller from wearing foot orthotics, correcting the excessive side-to-side strain on the various joints. The journal Clinical Rheumatology recently reported a significant benefit when foot orthotics were used in the treatment of FM. The bottom line is that this is a VERY SIMPLE FIX and when so much of FM is so difficult to treat, this a no brainer!

            If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

To schedule an appointment with one of our Fibromyalgia Doctors in San Francisco call 415-392-2225. Mention this blog post for a complimentary electronic foot scan to detect pronation or any other pedal foundation abnormalities (Value $99).

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