Fibromyalgia (FM) and Chronic Myofascial Pain (CMP)
is often the most prominent symptom of FM, but there are many others, especially
when CMP gets in the picture. Trigger points (TPs) cause muscle spasticity
(tightness), which disrupts the flow of liquids in the body. Your eyes may
often be dry, yet at times they water. Your thermal regulatory system is
out of whack. This is noticeable when you get out of bed (often, due to
bladder irritability) during the night. You then wait for your temperature
to regulate after getting back in bed, before you cover up again.
Spasticity can constrict your peripheral blood vessels--those close to the skin. Then, in the winter, certain areas of your body- most often the buttocks and thighs--feel like cold slabs of meat.
Perhaps you have "vasomotor rhinitis"--a chronic runny nose, which starts a "domino effect". It's "mechanical"--not caused by a virus or bacterium. As you sleep, stuffiness in your nose moves from side to side as you roll. Postnasal drip hits the back of your throat. Throat and neck TPs--especially in the sternocleidomastoid (SCM)--develop satellite TPs. You get TPs down your arm, and loss of motion in your neck and shoulders. The constant drip into ever-more restricted vessels can result in a sinus infection, because viruses and bacteria take advantage of the situation. Dr. Janet Travail, in her autobiography, "Office Hours Day and Night," noted that dizziness, ringing of the ears, loss of balance, and other symptoms can all be caused by SCM TPs. Dr. Travail was White House physician to John F. Kennedy. She and her partner, David Simons, wrote the definitive texts on CMP.
The tight SCM complex transmits nerve impulses that inform the brain of the position of the head and body in the surrounding space. It doesn't match the input from your eyes. When head movement changes the SCM message--when you turn, or look up from changing the kitty lifter, you get dizzy. This, coupled with poor equilibrium, can make it seem that the walls are tilting. When we take corners while driving, we get the impression that we're "banking" the turn at a steep angle, as if we're on a motorcycle.
Cold drafts can bring on neck TPs. Be careful how you move in bed. When you turn, roll with your head flat, and use your arms to help. Don't lift your head and "lead with it" as you roll. That puts a great strain on the neck area and "loads" TPs, just as climbing steps or walking uphill "loads" the muscles of the thighs.
A common symptom of SCM TPs is a "drunken" walk, as we bump into doorways and walls. Muscle weakness causes much FM grief. This is often due to "latent" TPs. They aren't "active"--they don't cause pain unless we press them. But if we stress them, they "give out". You try to take a drink from a glass, and end up wearing your drink. As you twist your wrist to bring the drink to your mouth, a latent TP-stressed muscle is asked to support the drink. Your body couldn't tell where the drink was in relation to your mouth, nor how heavy it was.
Learn to use two hands to carry things, not to carry heavy things, and be prepared for lots of spills. When our muscles frustrate us, don't dwell on it. Move on. Don't berate yourself for something you can't help. Our worst enemy isn't pain, and it isn't muscle weakness, it's negativity. Cultivate a sense of humor. Wear printed fabrics. Use straws.
Another distressing facet of TP-inspired muscle weakness is the so- called "weak-ankle, weak-knee". You're walking across level ground and bam! You're down. Or you 'Catch yourself' and avoid the fall, meanwhile stressing muscles even more. Be cautious on steps. Be especially careful on uneven surfaces.
Vary your tasks--use different muscle groups. Slow your working pace. Listen to your body. Rest often. Cultivate a rhythm of movement. Play music while you work, if you can. Don't fight your body, work with it. If at all possible, lie down for a few minutes at times during the day. Muscles are constantly working to hold your head up. Don't sit too long in any one position. When you drive, pull off the road every hour and walk around the car. Stretch. At home, use a rocker to prevent the muscles from building up electrical activity. When you must lift, keep the load close to your body, and look up just before you lift. That tightens the long spinal muscles and prepares your back to lift.
Added stress to the body will cause FM to flare up. Any infection, or yeast overload, is also stress. Disrupted carbohydrate metabolism of FM patients causes intense craving for sweets, which feed yeast. In a January 1989 Scientific American article, the Wurtmans discuss the relationship of sleep deprivation, melatonin, serotonin, (neurotransmitters), and carbohydrate craving. Carbohydrate-cravers snack not because they're hungry, but because eating is used to combat tension, anxiety, or mental fatigue-- especially in the late afternoon and early evening.
The alpha-delta sleep anomaly of FM makes it just about impossible to get rest. When morning comes, you're stiff, achy, and your muscles are unresponsive. Your body/mind hasn't received the proper quality nor quantity of sleep it needs. You feel as though you've had a run-in with a truck the day before, and the truck won. Level 1 sleep (alpha stage), is the lightest sleep we get. Delta is the deepest. In delta, immune chemicals and rebuilding chemicals are created, and the body/mind is repaired. When an FM patient enters delta stage, sleep is interrupted by alpha wave intrusion. We never get the deep, refreshing sleep others enjoy. This is a major handicap. Medications, such as amitriptyline, may increase the quantity of our sleep, but they do nothing for the quality. FM patients can also get bruxism (teeth clenching and grinding), muscle spasms in the arms and legs, (myoclonus), sleep apnea and shallow breathing (check out those chest TPs). We also feel sleepy at "inappropriate" times. If we push ourselves 'over the hump', we slide into a wakefulness/ insomnia pattern. It is important for us to eat regularly (and not too close to bedtime), avoid stimulants, avoid alcohol, and develop regular sleep patterns. Some of us need waterbeds, and almost all of us need cervical pillows.
Visit Dr. Devin Starlanyl's Fibromyalgia & Chronic Myofascial Pain website for more information for patients and physicians.
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