Fibromyalgia: "Why Won't The Pain Stop?"

Fibromyalgia (FM) is a chronic condition that does not limit itself to just one area, but rather it manifests as a generalized, whole body condition where basically everything hurts. The diagnosis is typically made by exclusion, or by eliminating all other possible conditions as there is no single blood test or diagnostic test for FM. Unless other conditions that are test sensitive are present at the same time, most tests come back negative.  Of course, this leaves the FM patient upset because, “….no one can figure out what’s wrong with me.” We all seem to want a test to prove what we have is “real.”
            Unfortunately, in the real world, no blood test, x-ray, or exam procedure is 100% accurate (sensitive and specific), so even when tests return positive, there can be “false positives” that are caused by many things such as drug induced test alterations and/or other conditions that alter the same test. On the other hand, there are “false negatives,” so even though the test came back negative, it’s still possible that the problem one is present but the test may just not be sensitive (accurate) enough to detect it.  FM is one of those conditions where only after a myriad of tests have been run and come back negative, can the diagnosis of FM be made with some degree of confidence.
            Essentially, we have to prove that you don’t have something else causing similar symptoms before we can confidently (or at lease more confidently) diagnose you with fibromyalgia. To complicate this further, in “secondary FM,” the cause of FM is known and is due to an underlying condition such as rheumatoid arthritis, lupus, hypothyroid, HIV, cancer, as well as physical trauma such as after a car accident or a work injury. When an accident is involved, the symptoms may be more confined to one area (then called “regional FM”) making the diagnosis even more challenging as the classic 11 of 18 tender points may not hold up in these cases.
            Finally, there are doctors out there that simply don’t “believe in” the condition and may say to the FM patient, “…there is no such thing, it’s all in your head, you simply have learn how to live with it. There’s nothing that can be done.” Well, they actually may be partially right – that is, the “…it’s all in your head” part (don’t get mad… just wait!). Another finding that is well-published in peer review literature is the concept called central and peripheral “sensitization.” This occurs when increased incoming sensory information from injured skin, muscles, and/or organs, in a sense bombard areas in the central nervous system (spinal cord and brain) leaving it “sensitized” or, more sensitive to “normal” incoming information.  This is because the threshold or tolerance to normal incoming sensory stimuli is reduced and results in increased muscle pain commonly described by patients with FM.
            To better illustrate this, hypersensitivity or central sensitization was found in people after a whiplash injury.  They recruited 14 whiplash patients and 14 “normals” to compare their responses when stimulating the leg (the non-injured area) as well as the neck (injured area). Theoretically, if central sensitization didn’t exist, the responses to the exact same stimulus on the healthy leg of both the whiplash patients and the normal subjects would be equal. Instead, what was found was that the whiplash patients had significantly lower pain thresholds for 2 of 3 tests (a single electrical stimulus in the muscle, repeated electrical stimulation in the muscle and on the skin, but not from heat when applied to the skin). Each pain threshold was measured at the neck and leg before and after local anesthesia was applied to the painful, sore neck muscles. In the whiplash cases, the lower pain threshold was found when stimulating both skin and muscles at the healthy leg and at the injured anesthetized neck equally. That proves that the central nervous system (brain and spinal cord) has a “pain memory” which lowers the threshold so the whiplash patients feel pain more intensely and quicker than the non-injured people. This can help patients understand the answer to the question, “…why won’t this pain go away?” This pain memory or hypersensitization is similarly found in FM patients.

Chiropractic care, in conjunction with the best fibromyalgia diet, and specific fibromyalgia exercises, can go a long way when it comes to effective fibromyalgia treatment.

Wanting to be Healthy vs. Planning to be Healthy

One of the most valuable lessons I have learned is that there is a difference between wanting to be healthy and planning to be healthy.
First of all...everyone WANTS to be healthy...but just wanting is NOT enough.
Just like wanting to be successful is not enough...everyone desires that.
You have to have the will to plan to be successful...the discipline to learn what it takes from successful people and to put in the necessary time learning and spoon feeding yourself information that is necessary to advance in this direction. Then you need to put this information to use...day in and day out...refining and perfecting it as you go. This is not easy and takes time and energy, and dedication...which is why so few reach the top.
Well...the same is true with achieving optimum health. You have to have the will...the desire to express life to it's fullest...which is not possible unless you have your health.
I have spent my career teaching whoever is willing to listen about the principles of natural healing and creating the conditions of health. According to these principles health is a spontaneous occurrence when the conditions are right. Creating the right conditions is the key and takes planning and ongoing implementation.
The beauty of creating the conditions of health is that YOU are the one in charge. You steer your own ship...either in the direction of health...or in the direction of illness with every lifestyle decision you make. What you eat, how often you exercise, how much water you drink, your pillow, your chair at work, how you relax, what you think, what you read, and what you believe...to name a few...are all conditions of health...and you have control over all of them.
When you consider that over 70% of the dollars in the US that are spent on health-care each year are spent to treat conditions that were preventable (diseases of excess), it makes me think...as a nation are we planning to be healthy...or planning to be sick?
The answer is obvious...it's in the statistics. But since you have control over your own lifestyle choices you don't have to be a statistic. I know you want to be healthy...but are you planning to be healthy? 

Carpal Tunnel Syndrome and Night Pain

Have you ever woken up in the middle of the night and noticed your hand sleeping to the point where you had to get out of bed and shake or flick your fingers to alleviate the numbness? If the numbness was primarily on the thumb-side half of your hand, it may have been carpal tunnel syndrome that woke you up. So, the question is, why is it such an issue at night?
To properly answer this question, let’s get familiar with the anatomy of the wrist.  There are 2 bones that make up the forearm – the ulna (on the pinky side) and the radius (on the thumb side). Just beyond that, there are two rows of four bones each called the carpal bones for a total of 8 small bones that make up the wrist joint. These carpal bones are arranged in a horseshoe or tunnel shape. When you look down at your wrist and wiggle your fingers quickly, you can see all the movement that occurs on the palm side of the wrist.  That’s a lot of movement!  You can also see the muscles on the upper half of the forearm moving rapidly as the fingers wiggle.
            There are 9 muscle tendons that travel through the carpal tunnel, as well as some blood vessels and most important, the median nerve sits on top of all those moving tendons. Just beneath the floor of the tunnel is a ligament called the transverse carpal ligament. The tendons inside the tunnel are surrounded by lubricating sheaths that make it easier for the tendons to slide back and forth as we wiggle our fingers, grip to open a jar, type on a computer, play a musical instrument, or so on. Without the tendon sheaths, the friction between the rubbing tendons would quickly build up heat, resulting in swelling, pain and numbness.  However, in spite of the lubricating function of the sheaths, when we work our fingers and hands too much, swelling and inflammation does occur.
            So, why do we have numbness at night when we aren’t working, gripping and moving our fingers repetitively? The answer lies in how we sleep. Since we are asleep, we cannot control where we position our hands and wrists. Most of us curl up in a ball and tuck our hands under our chin or someplace cozy.  Normally, when we bend our wrists, the pressure inside the carpal tunnel doubles. However, a carpal tunnel patient already has a higher level of pressure in their wrist. So, when a carpal tunnel patient bends their wrist in the exact same way, the pressure goes up even more – that is, 3, 4, 5, or more times than a normal person without their wrist bent. That is why a wrist “cock-up” splint works so well at night!  It keeps the wrist straight so we can’t bend it.  Often, this allows the CTS patient to sleep through the night instead of waking up 2, 3, or more times with numbness, tingling, and/or pain on the thumb half of the hand.

Fibromyalgia: A Detailed Patient Description

Fibromyalgia (FM) is surrounded by much controversy in what establishes a diagnosis, what are the consistent historical features, and most importantly, what can be done about it – the treatment strategies.  Doctors seem polarized, either they “believe in it” or don’t. The result is a frustrated patient because after multiple attempts, they can’t get a straight answer from their health care provider. Consequently, the patient doesn’t know where to turn.  A very important article, published in September 2011, discusses from the patient’s point of view, their experience in living with this condition.
            The study consisted of 6 female patients diagnosed at a university hospital with FM, which by the way, means all other conditions that create similar symptoms have to be “ruled out” or, considered first. Therefore, many tests are typically run to make sure there isn’t some other serious underlying condition hiding behind the symptoms associated with FM. As a background, the authors describe FM as “…a chronic syndrome with no cure.” Because of this, they state, “…a thorough understanding of the illness experience is therefore key in the palliative care of patients…” They acknowledge that care givers of FM patients often include chiropractors and other manual therapists and knowledge of the “…meaning and reality of living with this condition” is reported as being ESSENTIAL for all health care providers who manage FM patients. The focus of the study was to carefully look at the personal, occupational, and social impact of the condition on patients’ lives and their views about the future. Structured interviews with each participant were analyzed.
            Results showed that FM impacted all aspects of life with 4 main themes arising from the data: 1) Personal life impact; 2. Occupational life impact; 3. The forecasted impact on future life; 4. Social interaction impact. Specifically, most of the participants had stopped working and felt useless. Leisure activities were greatly affected, as many described opting to not participate in various leisure oriented activities (such as going for walks, shopping, attending social events). FM was described as altering family bonds with some being made stronger while others were destroyed, resulting in separation and/or divorce. FM patients were reported to be “relieved” when a diagnosis was “finally” made, as it marked an end to a period of uncertainty. The participants were often ambivalent to interaction and despite some positive points, frustration prevailed from “perceived incomprehension” or, not really understanding why they feel the way they do. At times, this made it hard to discuss their symptoms and personal experiences. This study reveals the negative impact of FM and how complex and individual that is.
            What is important about this study is that it alerts those of us who treat FM that we need a more efficient diagnostic process and we need to be better educated so that we can provide a multifaceted treatment option approach as each FM patient’s needs vary because of how each patient “deals with” the condition. We need to really listen to the patient to determine what treatment goals they are interested in and we must create treatment plans that center around those needs and desires, possibly including checklists so everyone stays on task as it’s quite easy to become distracted by the symptoms of FM. We are sharing this information with you so that you can feel comfortable approaching us with the many concerns and issues that surround FM.

Why a Chiropractor Should Be On Your Car Accident Recovery Team

Anyone who has survived a car accident will tell you that the recovery process can be long and difficult.  There is paperwork, legal activities, not to mention the various medical situations that may arise.  For many, the road back to a full and healthy life can take a great deal of time to travel.

It is important as you travel on the road to full recovery that you have the expert help you need.  There are many people there to help you, family and friends, and the various professionals that you will work with to get your body in full health.  If the car accident has caused a neck injury or whiplash, a chiropractor can offer immense help during the recovery process.
Whiplash, as it is commonly called, is simply a neck sprain, or another type of injury to the neck area.  Specifically, damage occurs within the joints between the vertebrae, discs, ligaments, cervical muscles and possibly the nerve roots.  A sudden, abrupt jerking motion of the head causes the cause of these injuries, which is often experience during a car accident.
The symptoms that can develop over time, and sometimes can be delayed for 24 hours or more after the car accident.  In most cases, people who are suffering from whiplash can exhibit one or more of the following symptoms:

• Headaches
• Pain in the shoulder, or between the shoulder blades
• Neck pain and stiffness
• Lower back pain
• Pain or numbness in the arm and hand
• Dizziness
• Ringing in ears
• Difficulty concentrating
• Fatigue
• Irritability

The symptoms of whiplash are truly varied, and some of them can be indicator of other conditions or diseases.  Therefore, a full diagnosis should be made by your chiropractor prior to the start of treatment.  In most cases, injuries like whiplash, which affect the soft tissues, will not be visible on standard X-rays.  Instead, specialized imaging tests, such as CT scans or magnetic resonance (MRI) is often used as a diagnostic tool.
Once whiplash is properly diagnosed by your chiropractor, effective treatment can begin. Perhaps one of the most effective means of treating whiplash is through chiropractic manipulation of the spinal column and neck area.  In fact, a study conducted by Woodward and others in 1996, and published in the industry magazine Injury indicated that nearly 93% of the patients studied were found to have a statistically significant improvement in pain and discomfort, and relative movement ability after chiropractic care.  Symptoms ranging from headaches to back pain, even related extremity pain in the arms and hand showed marked improvement over a short term of chiropractic care.
Time and time again, the experience of chiropractors and their patients have reflected these impressive results.  Many people suffering from the long-term effects of a car accident have used the skills of a qualified professional to find relief from their symptoms.
Given the available data, and the many cases of people finding relieve for their soft tissue injuries beyond what a normal doctor can do, is it any wonder why many people turn to chiropractors as a viable option for recovery?  It is our sincerest hope that you are never injured in a car accident.  However, if the unforeseen does occur, having a qualified chiropractor on your recovery team can make all the difference in the world.

Health is Precious

It's easy to take good health for granted. The reason for this is because when we do things that do not promote long term health, such as drink, smoke, expose ourselves to too much stress, not get enough rest, or eat junk food...we don't necessarily pay the price for our poor decisions now...we pay the price later.
Most of us know the things that are good and bad as far a lifestyle choices. What we don't know is how quick a steady dose of poor decisions can manifest into a disease process, such as diabetes, heart disease, or cancer, that we do not even know is happening...often times until it's too late.
Did you know that half the time a fatal heart attack is the first symptom of heart disease? That's right...many people develop heart disease, which is mostly a disease of excess and poor lifestyle choices, don't know it, and suffer a fatal heart attack as the first sign or symptom. The others are lucky...they survive and are given another chance to do something about it. Some do...most don't.
It is very common for very successful people to ignore their health as they seek wealth. Only to find out later that health is true wealth. For without it, one is unable to enjoy life to it's fullest.
My favorite quote says it all:
"When Health is absent, Wisdom cannot reveal itself.  Art cannot become manifest.  Strength cannot be exerted.  Wealth is useless and Reason powerless" - Herophilus, 300 B.C.
Bottom Line: The lifestyle choices you make today matter. Once we become adults we are the stewards of our own health. Life is like a cafeteria. You can have whatever you want...but there is always a price to pay for your decisions...and the deserts are always at the front of the line. Sure, health is your natural state...but you must care for it and safeguard it against illness day in and day out with healthy choices. Why? Because Health is Precious.