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Science Behind Fibromyalgia???
View the new "Science Behind Fibromyalgia" video at: http://www.fmaware.org/site/News2?page=NewsArticle&id=9455&...
The 60-second clip reveals recent scientific findings attributing fibromyalgia (FM) to a central nervous system problem involving the brain and the spinal cord. Using functional MRI scans, researchers have discovered that people with FM have increased activity in the areas of the brain dealing with pain, resulting in an abnormal response and a hyper-sensitivity to painful stimuli.
While scientists at the present time have found no generally accepted way to medically document the existence of fibromyalgia, it is known that there are physiological changes present in many who have the disorder. The debate will continue to rage as to its origin and the very existence of this overly-diagnosed disease. Some insist it is a medical condition while others are convinced it is primarily a mental health issue. What's your take on this?
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Replies to This Discussion
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Permalink Reply by Erik Dalton, Ph.D. on
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What really 'gags' me about this beautifully produced fibromyalgia clip -- other than the absence of new information on why FM patient's brains process pain differently -- is that it was funded by a drug company...Pfizer.
I suppose someone's gotta pay and the drug companys definitely have the $$$ but I always question their research motives, i.e., goals. Are they constructing the studies based around a new drug they've created or are they trying to find a cure?
Getting cynical in my old age but in my defence, I do hear some unbelievable stories about research manipulation from my daughter who's a 4th year Internal Medicine resident and her husband, a genetic pharmacological researcher.
How many of your FM diagnosed clients seem to benefit more from a natural approach, i.e., massage, diet, exercise, chiropractic, accupuncture, etc. vs drug therapy?
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Congratulations Rick on your recovery using drug therapy. I'm very interested in how your neurologist shut down those pain signals.
The burning question at the bottom of the FM debate is "How are pain messages actually delivered?"
I think as we develop a better understanding of the process of sensitization, scientists and somatic practitioners will better understand why a client's chronic pain can be so severe, and in some cases, seem out of proportion to the degree of injury or disease in the affected body tissues. This understanding also might help explain why specific treatments directed at pain relief often provide only limited benefit.
The neurobiology of sensitization is extremely complex, but the basic idea behind it is fairly straightforward. When pain signals are transmitted from injured or diseased tissues, these signals can then activate (sensitize) pain circuits in the peripheral nervous system, spinal cord and brain by burning a memory pathway.
The process of sensitization can be compared to overly adjusting the volume control on a stereo system, thereby amplifying and sometimes distorting the pain message. This results in a painful condition that is severe and out of proportion to the actual dysfunction or original injury. Sensitization has the innate ability to alter all regions of the central nervous system that process pain messages. This includes the sensing, feeling and thinking centers of the brain. I believe this may be one explanation why chronic pain often is associated with, not only physical disorders, but also emotional and psychological suffering as well.
Rick Britton said:Hi again Erik
another subject very close to my heart because I suffered from the condition myself back in the early 90s....
and the Specialist neurologist that treated me (successfully) put the condition down to a change that occurred in my brain activity. What had happened was I was went from being a full time athlete, training 30 to 40 hours per week, to a bed bound MVA victim. A few months after leaving the hospital and seemingly fully recovered I started getting the FM symptoms and it took about a year to get a diagnosis. Saw several therapists, doctors, nutritionists etc to no avail. Eventually saw the neurology guy and he prescribed some drugs and they had an immediate effect. They were a kind of anti-depressant designed to change some part of the brain chemistry. Went through a ramping up to max dose and then ramping down again over about 6 months. Made a full recovery. Count myself very lucky
So yes I see it as a mental health issue primarily and I treat it as such (prescribe exercise, diet change, sleep enhancement, qi gong, meditation, binaural beats, NLP, weight loss combined with pain relieving bodywork - seems to work pretty well)
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Permalink Reply by Peter Lelean on
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Hi all viewers. Its time to get outside the medical square on FM to see that a major contributor is fascial derangement. (Anatomy train networkers know the general links, and high praise to Tom for amazing pioneering work.)I acknowledge the role of the limbic system in response to stressors, and other insults to homeostasis as outlined by Erik. Specifically, the newly discovered iliolumbar fascial element (Lelean's ligament, 2004) has a crucial role in pelvic stability/function which can produce triggerpoints in strain patterns associated with FM . But wait . . . there's more . . . the same fascial dysfunction underpins several other diseases e.g. adhd, migraines, scoliosis etc. . . and a novel manip protocol addresses it. Be prepared to rethink everything - for example, that QL triggerpoint may in fact be a cluneal nerve protesting. Do you know that resolution of that apparent tp takes 2 seconds with an elbow-driven shunt? Looking for some out-of -the-box bodyworkers to help present an alternative to poisoning the neural network into submission. Your views are welcome . .
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Thx for the post Peter:
Like Tom, I was born in the fascial network of Rolfing and, indeed, research there is virtually untapped. Fortunately, there are major projects in the works. In fact, two other Advanced Rolfers (Adjo Zorn and Robert Schleip) from Ulm University have written chapters on their latest research about the neurobiological nature of fascia for my upcoming book.
Neuroscience too is in its infancy and every day new studies are surfacing regarding how the brain processes pain. I personally really love how this group is enlightening the discussion: http://www.noigroup.com/
I highly recommend these books for all manual therapists:
Explain Pain (Butler & Moseley 03) and Painful Yarns (Moseley 07). Great stuff on an intriguing field.
Wanna see some fireworks about fascia, myofascial release, etc. Visit this PT blog at your own risk: http://www.somasimple.com/forums/showthread.php?t=1841
Peter Lelean said:Hi all viewers. Its time to get outside the medical square on FM to see that a major contributor is fascial derangement. (Anatomy train networkers know the general links, and high praise to Tom for amazing pioneering work.)I acknowledge the role of the limbic system in response to stressors, and other insults to homeostasis as outlined by Erik. Specifically, the newly discovered iliolumbar fascial element (Lelean's ligament, 2004) has a crucial role in pelvic stability/function which can produce triggerpoints in strain patterns associated with FM . But wait . . . there's more . . . the same fascial dysfunction underpins several other diseases e.g. adhd, migraines, scoliosis etc. . . and a novel manip protocol addresses it. Be prepared to rethink everything - for example, that QL triggerpoint may in fact be a cluneal nerve protesting. Do you know that resolution of that apparent tp takes 2 seconds with an elbow-driven shunt? Looking for some out-of -the-box bodyworkers to help present an alternative to poisoning the neural network into submission. Your views are welcome . .
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These guys (actually the editor's name is Diane) have a very popular facebook group called Neuroscience and Pain Science for Manual Physical Therapists . Never seen such a brutal group of therapists...but love many of their research posts.
Rick Britton said:Whoa!!
Some serious arguing going on over there on that blog!
Blimey, I never knew MFR was so controversial. I'm keeping my head down on that one.
I use MFR in some way in nearly every session I do and it gets results that last.
Erik Dalton, Ph.D. said:Thx for the post Peter:
Like Tom, I was born in the fascial network of Rolfing and, indeed, research there is virtually untapped. Fortunately, there are major projects in the works. In fact, two other Advanced Rolfers (Adjo Zorn and Robert Schleip) from Ulm University have written chapters on their latest research about the neurobiological nature of fascia for my upcoming book.
Neuroscience too is in its infancy and every day new studies are surfacing regarding how the brain processes pain. I personally really love how this group is enlightening the discussion: http://www.noigroup.com/
I highly recommend these books for all manual therapists:
Explain Pain (Butler & Moseley 03) and Painful Yarns (Moseley 07). Great stuff on an intriguing field.
Wanna see some fireworks about fascia, myofascial release, etc. Visit this PT blog at your own risk: http://www.somasimple.com/forums/showthread.php?t=1841
Peter Lelean said:Hi all viewers. Its time to get outside the medical square on FM to see that a major contributor is fascial derangement. (Anatomy train networkers know the general links, and high praise to Tom for amazing pioneering work.)I acknowledge the role of the limbic system in response to stressors, and other insults to homeostasis as outlined by Erik. Specifically, the newly discovered iliolumbar fascial element (Lelean's ligament, 2004) has a crucial role in pelvic stability/function which can produce triggerpoints in strain patterns associated with FM . But wait . . . there's more . . . the same fascial dysfunction underpins several other diseases e.g. adhd, migraines, scoliosis etc. . . and a novel manip protocol addresses it. Be prepared to rethink everything - for example, that QL triggerpoint may in fact be a cluneal nerve protesting. Do you know that resolution of that apparent tp takes 2 seconds with an elbow-driven shunt? Looking for some out-of -the-box bodyworkers to help present an alternative to poisoning the neural network into submission. Your views are welcome . .
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Actually Rick, it's quite entertaining if you can restrain your emotions and just hear all sides of the argument....but ironic that this group of respected PTs can beat up everything in manual therapy but cannot offer a single piece of irrefutable research to support the modalities they use every day in clinic (even most assessments). For example, where's the pain research to justify electrical stim, ultrasound, heat/cold therapy, tens units, home-retraining stretching....and so on?
However, I love the PTs' sudden rise in passion for neuroscience. Reminds me of when PTs were first allowed to attend Michigan State of College Osteopathic Medicine in the late 80s. Sitting in class with them was a crack-up. Entirely lacking hand-on skills (just wasn't in their training), they worshiped Fred Mitchell's muscle energy concepts and Phil Greenman was GOD. Now, many seek to mutilate all things they once adored about osteopathy, i.e., strain-counterstrain, functional unwinding, cranial, myofascial release, visceral, high velocity thrust, etc.
For a select group of PTs, neuroscience is now king of the hill...fascia sucks and you'll be damned if you speak of any type of undocumented skills you've learned over the years that science has yet to double-blind.
It certainly stunts the growth of creativity waiting for research to catch up. But, somehow, I don't think this dogma will ever curtail all the hard working bodyworkers in the trenches...loving their success and learning by their failures.. each day being schooled by the innate wisdom of the body.
In the world of research, precise documentation is imperative and I'm happy to see faulty theories/concepts/laws fall by the wayside. Conversely, it saddens me that some think touch therapy should be strictly governed by self-elected elitist whose life's goals are to spend all waking hours copying and pasting from PubMed in an effort to discredit and belittle anyone who isn't as smart as the elite think they should be.
This leads to entertaining, but sometimes embarrassing, dialog as demonstrated in this emotionally-loaded blog: http://www.somasimple.com/forums/showthread.php?t=1841
In his keynote address to the American Society of the Study of the Lumbar Spine in the mid-80s, one of my favorite researchers Nikolai Bogduk opened with this statement, "In God We Trust...all others bring data!" Cool quote but not one all touch therapists must live by.
Rick Britton said:I've just spent a few hours reading the battle on that blog posted above by Erik.
Wow! Am I glad I don't have to justify my therapeutic approach! Man, that is some hard battling.
In the end, the PTs are saying 'we don't doubt you get great results just we don't accept the mumbo-jumbo you use to explain it'
Having a range of tools and techniques that really work, being able to free clients from chronic pain and the sense of fulfilment that comes with it is enough for me.
When someone clever comes along and really explains what I/we/you are doing that will be another step forward.
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Permalink Reply by Stephen Jeffrey on
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Thanks for the link Eric (Walt fritz has just joined mbp)
I am learning so much from these battling blogs .......I am learning how not to store the negative emotions generated in my tissues by reading it :)
Same as I had to do with this bunch! = http://mtevidence.ning.com
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Funny Stephen...but, sadly, no research to support the storing of negative emotions while reading 'battling blogs"....thx for the post.
Stephen Jeffrey said:Thanks for the link Eric (Walt fritz has just joined mbp)
I am learning so much from these battling blogs .......I am learning how not to store the negative emotions generated in my tissues by reading it :)
Same as I had to do with this bunch! = http://mtevidence.ning.com
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Permalink Reply by Rajam K Roose on
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Thought the video would be interesting as I watched it before reading any replies on this thread. It gave just a piece of information, with a touch of fear-- your nervous system is wacked, but didn't explain anything else and gives the impression that only medicine could help with this condition. But, as Eric has pointed out, it is important to look at who is supplying the source of the information and how they are supplying it. And this goes for anything research or non-fiction that you read or hear about. Like the study about needing more sleep for better health, one of those was put out by a company that also makes sleeping pills.
Although Rick didn't get relief until he had medications for it, I know of several people who have overcome fibromyalgia by changing diet, exercise and introducing stretching into their lives. So, what does that tell us? Maybe they were able to utilize their brains in a manner to overcome the condition. So we know that it is possible to overcome it without necessarily using medications with all kinds of side effects. And good for you, Rick, for introducing alternative methods in the lives of other fibro sufferers so they can at least see if that will help before going the medicine route.
Don't mean to hijack the thread, about soma simple, it's like watching a train wreck against my profession, but I also enjoy some of the links and some of the posts. When I first joined about a year or so ago, after reading a lot of that stuff it was a real testament that I know massage can be helpful or I might have left this profession. Although I don't know all the why's there are many things that do work. Figured reading counter-arguments would keep me balanced in some odd, painful kind of way.... I read Explain Pain a while back and even Butler writes that massage (he calls it neuromassage) can be helpful to release the adhesions around nerves. It will be helpful for us when more research is completed or at least made more accessible to us massage therapists so we can use it better.
I also use some myofascial release therapy and some of that training was with Barnes and although I did see something working, what I was taught in his class and in my apprenticeship didn't really seem to make sense. It wasn't until Whitney Lowe sent me the articles written by Schleip in the JBMT from April 2003 that I read that fascia also contains muscle cells and mechanoreceptors and the pressure supplied by the therapist causes the mechanoreceptors to send messages to the brain via the nervous system that helps the deeper tissues to relax. (Well, that's my simplified version of it). So, I'm really looking forward to more of this research coming out and how we can utilize it in our field.
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"It wasn't until Whitney Lowe sent me the articles written by Schleip in the JBMT from April 2003 that I read that fascia also contains muscle cells and mechanoreceptors and the pressure supplied by the therapist causes the mechanoreceptors to send messages to the brain via the nervous system that helps the deeper tissues to relax. (Well, that's my simplified version of it). So, I'm really looking forward to more of this research coming out and how we can utilize it in our field."
Good points Rajam:
Robert Schleip and a couple of his research buddies (also Advanced Rolfers) from Ulm University have a bunch of new findings that document fascial contractibility and how it contributes to gait. Some other new research is also helping validate this contractibility idea.
In a recent e-mail from Robert he states: "At last, the 'missing link' between ANS and fascial tonicity may have been found! According to a new paper (J Leukoc Biol 86: 1275-83) activation of the symp. NS triggers an increase of TGF-beta. That's great news, since TGF-beta is also the main physiological trigger in the body for activation of myofibroblasts and their contractile activity. If valid, that will be great reconfirmation of the original 'stress leads to fascial contraction idea' of Staubesand, which had motivated me devoting my first 1-2 yrs as scientist in vain with adrenaline & acetylcholine experiments on fascia."
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Permalink Reply by Alex Frigino on
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Hi Erik,
I believe FM involves an over-excitation of the reticular activating system (RAS) and approach it in the same way as I would a mouse-trap, carefully.
Most MT's have the technical skill to significantly help sufferers of this condition but refining the delivery of the technique in a homeopathic fashion is key.
Discover how to safely remove the cheese and the purpose for the tension load on the spring may disappear.
Here's an interesting PDF article on topic.
Best regards,
Alex
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Permalink Reply by Walt Fritz, PT on
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Erik,
Whenever this thread (Somasimple) gets referenced, I'm vacillate between cringing and beaming. I am certainly in a different place now that when I participated in that thread on SomaSimple, having adjusted my views on how things work and why. I learned that I will never be able to get some there to change any part of their views, as the mistrust of all things fascial is too deeply ingrained. But I have come away with a deeper understanding of what I do not know, and am now getting to kow that side of myself better.
Interesting thread, thanks.
Walt Fritz, PT
www.myofascialresource.com
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