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What is Fibromyalgia?

  [ 6 votes ]   [ 1 Comment ]
www.ProHealth.com • May 6, 2017


In this video, Dr. Ginevra Liptan of The Frida Center for Fibromyalgia provides an overview of the illness and describes possible treatment approaches. 
 

 
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This hypothesis
Posted by: IanH
May 8, 2017
sounds plausible doesn't it?
The idea that Fibromyalgia is a flight or fight response gone wrong is purported by many people but actually there is little good evidence for this. Here Dr. Liptan proposes that FM is a variant of myofacial pain syndrome ie the fascia around the muscle fibres are "faulty" and over tight. This is the thesis of her 2010 paper in "The journal of bodywork and movement therapy" There is certainly evidence that fascia over many tissues can be pathological and produce problems in the underlying tissue. She then relates myofascial pain to the "stress response gone wrong".

I don't see much good evidence that FM is caused by a faulty stress response. FM certainly affects the stress response and sleep but does it do this because the condition is painful. Pain affects sleep, it affects sleep in many diseases and conditions.

I have not found much problem with muscles per se. The pain in FM arises more from the ligament and tendon junctions not the muscle surfaces. That is, pain is heightened around joints. You can actually press or pinch most muscles firmly without eliciting pain but even mild pressure on the tender points elicits strong pain. This is not suggestive of myofascial disturbance.

That is not to say that some people do not have myofascial pain but I doubt this applies to all people with FM. Of course we have a serious diagnostic problem in FM and the widespread pain is probably heterogeneous.

Myofascial release is not evidence based. Who knows what is going on with pressure applied to muscles. Applying relaxing pressure to a muscle fails to reduce the pain elicited at the tender point. The tender point itself must be pressed in a prolonged way to reduce the pain but this only lasts for a short period of time.

In addition I have not found much problem with muscles per se. The pain in FM arises more from the ligament and tendon junctions not the muscle surfaces or deep within the muscle. That is, pain is heightened around joints. You can actually press most muscles firmly without eliciting pain but even mild pressure on the tender points elicits strong pain. This is not suggestive of myofascial disturbance.

That is not to say that some people do not have myofascial pain but applying to all FM patients is likely wrong as is the hypothesis that FM is caused by a faulty stress response.
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