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VIDEO: The Four Rs of Fibromyalgia

  [ 8 votes ]   [ 1 Comment ]
www.ProHealth.com • March 11, 2017


Dr. Ginevra Liptan describes her Four Rs treatment approach to fibromyalgia.





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explanations to justify a protocol
Posted by: IanH
Mar 11, 2017
Another person who strings together a commonly known set of symptoms with pseudo explanations and weak connections in order to justify their clinical approach to FM..

Unfortunately the premise from which she starts is weak:

that "continually tight" is the main cause of most problems and that this is in turn caused by :hyperactive stress response - fight or flight response, leading to overactivity of pain sensing nerves. She also talks about myofacial pain and trigger points rather than tender points.

She fails to explain; neuropathy, vascular shunting, myofacial pathology does not explain muscle cramps, cognitive and s.t.m. disruption, imbalance, light hypersensitivity, temperature sensitivity.

The links to "energy system" are very tenuous - we are just supposed to accept that the hyperactive stress response leads to leaky gut, fatigue and disrupted slow wave sleep.

In fact there is no good evidence for this, actually the reverse relationship is likely, ie reduced slow wave sleep leads to musculoskeletal pain.
http://europepmc.org/abstract/med/10405949

In fact sleep wake cycles are controlled by the basal ganglia and dopamine levels are known to be reduced in FM. Reduced dopamine levels contribute to poor pain dampening. That is pain is poorly modulated.

While the treatment protocol here is fine, part of the problem with this unitary treatment approach is that FM is likely to be heterogeneous and partly genetic. This author is suggesting that all people with FM have the condition because of their response to stress. I doubt it, and research suggests that this is too simplistic. Always a problem when clinicians explain the etiology of disease.
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