Understanding the Musculoskeletal Pain Syndrome - Fibromyalgia and Back Pain Part II

Fibromyalgia is one of two conditions knownlocalized, and generally triggered by a "gentle
collectively as the musculoskeletal pain syndrome.touch" or allodynia, it is still extremely painful to
The constellation of symptoms expressed bythe fibromyalgia sufferer.
fibromyalgia patients is often referred to as theUnfortunately, no one knows the etiology or
fibromyalgia syndrome. Fibromyalgia symptomscause of fibromyalgia. Fibromyalgia is debilitating
are found in approximately two percent of theand often disabling, and patients often present
population, it affects vastly more women thanwith such significant levels of pain that it is almost
men, with reports of ratios are as high as ten toimpossible for them to function without
one, women to men. Fibromyalgia, while difficult toaccommodation. The pain is found in the muscles,
diagnose, is usually found in individuals as early astendons, ligaments, joints, and, what has been
childhood but predominantly in patients fromreferred to as, deep skeletal pain. Pain associated
twenty years of age to fifty. Significantly,with the fibromyalgia syndrome often varies in
pregnant women are affected by this disorder inlevel and location from day to day. While it is
greater numbers than the remainder of women inunclear what causes fibromyalgia, some possible
the population. The most notable symptoms ofexplanations include some sort of physical or
this widespread, often debilitating condition include:stress-related trauma or event, a psychologically
deep and throbbing low back pain; chronic,or emotionally upsetting or stressful event, and/or
non-specific pain; painful trigger points, areasa catastrophic illness or related immune disorder.
tender to the touch; and stiffness, sometimesWhile researchers are still searching for the
known as morning stiffness.ultimate explanation, many believe that
Additionally, fibromyalgia is known to producefibromyalgia is the result of any abnormal amount
sleeplessness and sleep dysfunction, extremeor imbalance of certain chemicals in the brain,
fatigue, and even anxiety and depression. In theparticularly substance P, norepinephrine, dopamine
previous article, "Understanding Theand, perhaps most significantly, serotonin.
Musculoskeletal Pain Syndrome: Fibromyalgia andConsequently, pain levels usually in check for the
Back Pain Part I," we discussed in some detail the"normal" individual are out of whack or out of
various symptoms associated with theproportion for the fibromyalgia sufferer. It has
fibromyalgia syndrome. In this article, we willbeen suggested, that fibromyalgia patients have
specifically address fibromyalgia-related pain, itstheir pain "volume control" set on high. Finally and
consequences, and possible treatment strategies.as stated previously, fibromyalgia pain is
Fibromyalgia pain is widespread and prevalent incharacterized as one of two types of pain, pain
more than ninety-seven percent of all patientsaffecting the soft tissue and particularly the
with the disorder. Fibromyalgia back pain, unlikemuscles, tendons, and ligaments around the joints,
other expressions of neck pain, back pain and/orand the existence of trigger points at skin level,
sciatica is generally widespread and difficult, if notparticularly around the joints.
impossible, to pinpoint. The pain may be felt in theAs suggested in the previous article on this topic,
tendons, the muscles, and even the ligamentsand noted above, treatment should be holistic in
surrounding the joints. It has been described asnature bringing to bear the various disciplines and
ranging from slight and mild to acute andsubdisciplines of medicine required to treat this
throbbing. Other adjectives used to describe thecontroversial and little understood syndrome. A
pain are deep, sharp, dull, aching, tender, throbbing,combination of medications, particularly NSAIDs
sore, annoying, gnawing, burning, and manyand antidepressants, along with behavioral therapy
others. For many fibromyalgia sufferers the painto deal with stress and anxiety-related conditions,
is transitory, it comes and goes and may expressas well as the depression, alternative medicine,
itself at a variety of locations on or in the body.and a thorough and complete, individualized and
In addition to deep and throbbing muscle achesmedically supervised exercise program should all
and pains, individuals suffering from fibromyalgiabe part of the treatment strategy. Neck pain,
may have what is referred to as "pain to theback pain, and sciatica, as well as pain levels
gentle touch" or allodynia. This type of pain isexpressed at other areas the body, may remain
expressed at various trigger points or specificproblematic until a specific cause for the
locations sensitive to the touch. The fibromyalgiasyndrome can be found and treated. The
trigger points are generally found at or near theprognosis can be good, depending on a number of
joints. Interestingly, it's the area around the jointsfactors, including but not limited to the individual
that is the most sensitive. In these areas, it mayfibromyalgia syndrome sufferer's motivation and
be at skin level and is not generally associatedadherence to the treatment strategy prescribed.
with the deeper, throbbing pain. Once again, theAny program must include a complete exercise
pain associated with these trigger points may alsoprogram to help overcome the neck pain, back
be described as prickly or needle-sharp pain,pain, and sciatica, and a program of education,
rather than deep and throbbing in the body. Itboth self and group administered.
must be understood, that while this pain is