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Chronic Pain - Fibromyalgia (Dr. Michael Berglund)

Fibromyalgia: Chronic pain sucks.

Dr. Berglund wishes he could give you some more eloquent phrasing, but it just sucks. Fibromyalgia (FM or FMS) is a chronic pain condition that doesn't have a known explanation (i.e. rheumatoid arthritis, osteoarthritis, etc). If that wasn't bad enough, fibromyalgia also typically includes fatigue, insomnia, and a variety of other chronic maladies. The difficult part of fibromyalgia is that most medical doctors that specialize in it simply manage the inflammation and pain, and if needed, give sleep aids.

The challenge of fibromyalgia

Obviously, fibromyalgia seems like a terrible condition to have. Are there lab tests or diagnostic imaging to verify fibromyalgia? No. What is the medical treatment? Anti-inflammatories and pain killers for the pain, sleep aids to improve sleep, and anti-depressants to apparently make people less sad about their poor life quality. Many fibromyalgia sufferers also get at least temporary relief from massage, myofascial release technique, rehabilitative exercises/stretches and chiropractic manipulation. However, the relief from those treatments is short-lived enough requiring these people to see chiropractors or massage therapists on a regular basis (i.e. 1-4x/month). 

We know that by these comments it may seem like Dr. Berglund is against people being diagnosed with fibromyalgia. He's not. He thinks it's a great first step. He thinks many of these people have been labelled as complainers all their life. The blood tests, the X-rays all come up normal, so medical doctors historically have labelled these patients as hypochondriacs or malingerers. They are basically implying that these patients are either making it up consciously or subconsciously. For this reason, he thinks it's great that people have a condition name to at least help explain to people what is going on with them.

Having said that, fibromyalgia is not really a disease. It's a syndrome. It's an amalgam of signs/symptoms that enough people have to justify creating a diagnosis for them. The problem is that fibromyalgia has no known cause. The diagnosis doesn't lead us to know how to prevent it or to a corrective or restorative program which will reverse the condition. 

Trading band-aids for solutions

Dr. Berglund treats his patients for whatever conditions he diagnoses them with. Almost all fibromyalgia patients have some food allergies/sensitivities. Since the pain of fibromyalgia is an indicator of inflammation and foods can be inflammatory, it makes sense to eliminate any offending foods first. The second very common problem seen is an underactive thyroid. Someone who has an underactive thyroid can have symptoms such as chronic pain, chronic fatigue, and poor sleep. Recognize those symptoms? They are very similar to fibromyalgia. Stress and adrenal fatigue are usually very commonly seen with fibromyalgia patients. He has seen a strong correlation between those with fibromyalgia and those that experience abuse in their childhood or as young adults. If there's insomnia, he likes to check to see if this is due to a lack of serotonin or if it's because of chronic anxiety/worrying. He also likes to make sure the sex hormones (estrogens, progesterone, and testosterone) are at proper levels. 

His goal with fibromyalgia patients is to give them control back. He tells them that their pain levels may increase due to no fault of their own (e.g. falling barometric pressure), but for the most part, if they eat properly and manage their thyroid, adrenals, anxiety, sleep, (etc), they will be guaranteed to be dealing with significantly less pain than if they didn't. Then the massages and chiropractic adjustments tend to last longer and be more effective.

Occasionally, Dr. Berglund finds patients with chronic pain that have been misdiagnosed with fibromyalgia that actually have an autoimmune disease (like systemic lupus erythematosus, rheumatoid arthritis or Sjögren's syndrome) or an infection (Lyme's disease or Epstein Barr Virus). Whatever the reason for the chronic pain, his goal is to find the causes of the inflammation and attempt to solve the problem. 

Fibromyalgia tender points 

Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. To get a medical diagnosis of fibromyalgia, patients need to have 11 of 18 predetermined "tender points". (See diagram to the left.)

Concurrently, we typically see insomnia or poor sleep quality (80% of fibromyalgia sufferers), chronic fatigue (70%), tension headaches (53%), dysfunctional bowel movements (40%), numbness/burning (35%), and "brain fog" (20%). 



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