The Nerve To Muscle Connection In Fibromyalgia and Chronic Myofascial Pain

Research continues to tell us that fibromyalgia involves the breakdown of normal messaging between the brain (central nervous system) and the peripheral nervous system. Pro-inflammatory cells called glial cells are still in the news, eight years after publishing Integrative Therapies for Fibromyalgia, Chronic Fatigue, and Myofascial Pain Syndrome. In 2018, researchers documented widespread inflammation in the brains of patients with fibromyalgia for the first time. (Accessed, 11/10/2019).  Add a highly sensitized peripheral nervous system such as seen in chronic myofascial pain and centralization of pain in the brain is off and running.

Dr. Karl Hurst-Wicker did a wonderful job explaining how our peripheral nervous system can contribute to the centralization of pain in the brain in an article I wrote for Health Central.

“According to Dr. Hurst-Wicker, chronic pain from myofascial pain syndrome (MPS) is a common cause of chronic pain. In fact, one study showed that it constituted 30% of the pain complaints in a primary care/internal medicine practice. Myofascial pain syndrome can be the primary pain generator, and at the same time, MPS may flare up or indicate some other pain generator in the same area. That’s why a big part of evaluating a patient with pain is getting a good history and physical exam to determine if they have only MPS, or if they have MPS and some other concurrent problem.”
 Excerpt: Fibromyalgia Centralization and Peripheral Myofascial Pain: Interview with Karl Hurst-Wicker, MD, Health Central. Read on…

Chronic myofascial pain from myofascial trigger points, which are thought to be caused by an excessive release of the chemical neuro-transmitter, acetylcholine, is prevalent in fibromyalgia and helps explain some of the muscle pain and dysfunction we experience. Check out the heading here at The Pained Ink Slayer labeled “What is a trigger point?”

It is difficult to deny the brains ability to resurrect previous pain experiences or detach the emotional center from the physical response. Conditioning responses is important and why treatment takes a multidimensional approach. These various treatments, medication, stretching movement such as Yoga, gradual exercise after bringing myofascial trigger points under control, meditation, T’ai Chi for promoting balance input to the brain are all important for putting a tire tool in the spokes of this wheel spinning out of control between the brain and the periphery.

Additional Reading

·        Myofascial Trigger Points and Chronic Pain

·        Do Tight Muscles Cause You Pain? What You Should Know About Chronic Myofascial Pain

·        Proprioception: Are you a bull in the china cabinet? Is it fibro or myofascial pain syndrome?

In healing,

Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!

http://www.CelesteCooper.com

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Learn more about Celeste’s books here. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others. 

2018 Musings From The Pained Ink Slayer

Celeste on Amazon

I am blessed to have wonderful people who collaborate. So many give of themselves in an effort to offer support to those suffering with chronic pain, FM, ME/CFS, myofascial pain, CRPS/RSD, Lupus, Migraine, Lyme's Disease, Ankylosing Spondylitis, interstitial cystitis, arthritis and other painful conditions. It is because of the fortitude of others, I am inspired to keep on keeping on. Following is a compilation of what I have written in 2018.

PROHEALTH

Complex Regional Pain Syndrome: Similarities and Contrasts with Fibromyalgia

THE PAINED INK SLAYER

Could Biofeedback Be On Your Chronic Pain Gift List?

THE PAINED INK SLAYER  

The GERD-Fibro Connection

PROHEALTH

Five Things You Should Know About Dysautonomia If You Have Fibromyalgia 

THE PAINED INK SLAYER  

A Fall Lesson on Mindfulness

10 Fast Facts Fibromyalgia is Real (Blog Reprint of original 2016 ProHealth article)

PROHEALTH

Brain Under Siege: Centralization, Chronic Pain, and Fibromyalgia

THE PAINED INK SLAYER  

Chronic Pain: Does Sex Matter?

FMa Test - BCG Fibromyalgia Vaccine Trials Receive FDA Approval

PAINS Project Moves to Academy of Integrative Pain Management (AIPM)

PROHEALTH

Standing On The Shoulder Of Giants: Managing Chronic Pain And Invisible Illness With Words From the Wise

THE PAINED INK SLAYER  

A Day in the Rockies Poem about Rockies for mom

THE PAINED INK SLAYER  

4 Ways to Power Up Your Positivism

PROHEALTH

The Physicality Of Fibrofog, The Brain, And Pain

Diagnosing And Living With Irritable Bowel Syndrome

THE PAINED INK SLAYER  

FDA responds on behalf of chronic pain patients who require opioids to treat their pain

The FM/a® Blood Test and Participation in Fibromyalgia Vaccine Study

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You can follow my ProHealth profile page where I write about fibromyalgia and its frequent partners, and Health Central has archived the articles I have written for them, here.

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PROHEALTH

Fibro Playmate of the Month – The Migraine Connection

THE PAINED INK SLAYER  

Opportunity Knocks Again: Public Comments on Patient-Focused Drug Development for Chronic Pain

Migraine and Me: If you could see me now #MHAM2018 challenge

Comment Now to NIH Pain Management Best Practices or Forever Hold Our Peace

12 Months and 14 Fibro Musings

PROHEALTH  

7 Tips for Reclaiming Control over Fibromyalgia

THE PAINED INK SLAYER  

Science, Fibromyalgia, and Exercise

PROHEALTH

3Tips for Reducing Stress in Fibromyalgia

THE PAINED INK SLAYER  

9 Reasons Tai Chi Reduces Pain and Promotes Health

Balancing Pain and Illness through Poetry

PROHEALTH

Myofascial Pelvic Pain in Men and Women with Fibromyalgia

THE PAINED INK SLAYER  

Mindfulness and Chronic Pain

Never Again Will I Travel Without My Oska® PEMF Device. #sponsor discount code CCRN60

PROHEALTH

Does Rare Disease—EDS—Plague Fibromyalgia?

THE PAINED INK SLAYER  

Fibromyalgia FM/a Blood Test and EpicGenetics Landmark Clinical Research Efforts

Making the Best of AFFIRMATIONS

THE PAINED INK SLAYER  

A PATIENT's VOICE – Life in Chronic Pain with Frank Elliot

PROHEALTH

Fibromyalgia and Thyroid Resistance

THE PAINED INK SLAYER  

The Thyroid and Fibromyalgia: Is there more than a butterfly connection?

Avoiding Lockdown

HEALTH CENTRAL

How Kinesiology Can Help Manage Chronic Pain

THE PAINED INK SLAYER  

New Year’s Wish for Fellow Pain Warriors (January, 2018) 

  

As I look back at 2018, I am filled with gratitude, love, and admiration for each of you, and look ahead to the New Year with hope and promise.

THANK YOU for your comments and for sharing any and all information, not only from me, but from the many other advocates, bloggers, and writers who share this space with all of us.

In healing,

Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!

http://www.CelesteCooper.com

~ • ~ • ~ • ~ • ~ • ~

Learn more about Celeste’s books here. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others. 

Fibro-mates, GI Disturbance, and Hypnosis

(C) The Forest of  an Open Mind

For years, we have known an extraordinary number of us with fibromyalgia also live with one or more frequently co-occurring, comorbid, conditions. One of those is irritable bowel syndrome (IBS). I have vocalized my own experiences with IBS, interviewed Dr Stephen Wangen, board certified, licensed physician in naturopathic medicine and co-founder and Medical Director of the IBS Treatment Center, and I have written about it in what our readers call “The Big Book”. 

Quintessential Fibro-mate: Irritable Bowel Syndrome (IBS)

If you have IBS, you know the drum-like tightness and resonance caused by belly bloat. When not in an attack, I can explain it like this; I am in a canoe that is lazily floating through my gut. There I am with my feet up, hands behind my head relaxing in a tranquil gently moving environment. Then suddenly, I am holding on for dear life. My canoe ricochets from side to side like a ball hitting the bumpers of a pinball machine, threatening to throw me into a toxic abyss. If you have FM and IBS, you know.

What you may not know is that during an attack I practice creative visualization. I envision my bowel being coated and cloaked with a calming gel that clings to the walls of my intestines. The gooey colorful substance protects the lining against caustic toxins. As I control my breath, I call on my reserves to translate what is happening differently, without judgment. I have not mastered the technique enough to prevent an attack, but it does ease my minds interpretation of the event. In the past, things like creative visualization were not seen as valuable tools by traditional medicine. But, could times be changing? 

Fibro-mate: Gastro-esophageal Reflux Disease (GERD)?

A stronger connection has been made between fibromyalgia and GERD, as reported in an article I wrote for ProHealth. What’s interesting about this connection is that all three; FM, IBS, and GERD share two things

1.     Relationship to the immune system

2.     Relationship to brain, centralization

What’s even more interesting is that traditional medicine, thanks to neuroscience, is now embracing the things my co-author, Jeff Miller, PhD, and I have written about in our books.

Hypnosis— Really?

According to Medscape, a continuing education website for physicians and registered nurses, hypnotherapy for IBS, GERD and inflammatory bowel disease  looks promising. Did I ever think conventional medicine would look outside the box? Yes, but when we wrote our book on integrative therapies for fibromyalgia, ME/CFS, and chronic myofascial pain I would not have predicted the robust acceptance or the change taking place in traditional medical paradigms.

Hypnotherapy, as I can personally attest, gives us a sense of control and like my reported experience with creative visualization; it exposes our internal dialogue to change. As a qualified hypnotherapist makes suggestions, we gain power over autonomic body dysfunction, such as IBS and GERD. Biological changes, i.e. temperature, pulse, and blood pressure occur in response to our thoughts as evidenced by biofeedback.  

There is a well-documented bidirectional pathway between the brain and gut, and I believe integrative therapies, such as creative visualization, hypnosis, and biofeedback have a positive effect because fibromyalgia, IBS and GERD share a brain-body connection, centralization and the autonomic nervous system.

Articles of interest:

·        Is There a GERD—Fibro Connection?

·        A Nervous System at Odds: Dysautonomia and Fibromyalgia

·        What is Centralized Pain: An Interview Dr. Karl Hurst-Wicker, MD

·        Incredible Ways to Visualize Pain in the Brain

·        Chest Wall Pain, Esophageal Spasm, and GERD

 In healing,,Celeste

"Adversity is only an obstacle if we fail to see opportunity."

~ • ~ • ~ • ~ • ~ • ~

Celeste Cooper, RN

Author—Patient—Freelance Writer at Health Central & ProHealth —Advocate

Celeste’s Website: http://CelesteCooper.com

Learn more about Celeste’s books at her website or find links here on Celeste's  blog. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.

All blogs and comments are based on the author's opinions and are not meant to replace medical advice.  

Is Chronic Pain a Disease? My Interview with Pain Specialist, Dr. Karl Hurst-Wicker, MD

To kick off this interview, I asked Dr. Hurst-Wicker this predominant question among the scientific community,

Is Chronic Pain a Disease?

Here is what Dr. Hurst-Wicker had to say.

Pain is a symptom of some other underlying problem, much like a runny nose is a symptom of a cold or allergies. The key to solving a problem is identifying the problem and figuring out how to fix it. If we invest all our time and energies in treating only the symptom, pain, without diagnosing the cause, we risk missing the chance to fix the problem and remove the symptom. We miss the opportunity to get the patient the right treatment, right away.

People experience chronic pain for many reasons, and many patients can be treated with injections, medication, surgery, or other modalities. The tough thing for both patients and physicians is realizing that human bodies are complex organisms. We are in the process of learning and understanding this intricate machine, but we don’t have all the answers to the problems we face readily available. This means that for some patients pain could be caused by something we don’t fully understand and therefore don’t have great treatments. Eventually we will get there. But if we started saying, “Oh, the problem is just chronic pain and we need to treat only the pain,” we’d miss the opportunity to find real causes, and we would miss opportunities to develop treatments that could truly help people, instead of only masking the symptoms.

Q. How important is a history and physical?

Take chronic myofascial pain as an example. Myofascial pain syndrome (MPS) is a common cause of chronic pain. It can be the primary peripheral pain generator and at the same time, it may flare up as an indicator of other pain generator in the same area. That’s why a big part of evaluating a patient with pain is getting a good history and physical exam. 

Q. Why does pain become chronic in some people and not others?

The transition from acute to chronic pain has a variety of contributing factors. Sometimes the problem is that the underlying problem can’t be fixed, like a bad joint that can’t be replaced because the patient is too sick for surgery. In other cases, people can develop the changes to central sensitization thus perpetuating pain even after the initial problem is fixed.

Some studies indicate genetic factors play a role and may explain why some people experience chronic pain and others don’t, and other studies indicate certain pain medications could initiate the process of central sensitization.

I’m not sure we will ever develop a quick or simple way to figure out what patient will develop or experience chronic pain. There are many factors at play and I think it is too complex to determine right away. But, we continue to learn more year after year.

Q. Are there other factors that contribute to chronic pain?

MRI of amygdala and hippocampus

Stress and sleep can certainly have an effect on pain. Stress alone can change the levels of neurological hormones in our central nervous system and thus, amplify chronic pain. We discussed a study in a separate interview on centralization in fibromyalgia. In this study, they used the MRI to evaluate the size of the hippocampus in fibromyalgia patients [the region of the brain responsible for with memory and spatial navigation]. One of the things they discussed was whether the hippocampus was small due to the stress of chronic pain in fibromyalgia, or if patients maybe had higher stress levels that shrunk their hippocampus and thus got fibromyalgia. Sleep, more specifically the lack of sleep, is known to worsen pain. The restorative process of sleep allows our bodies to refresh, regenerate, and heal. So when we don’t sleep, we not only miss out on restoration, we also have a concomitant increase in both the physical and mental stress that our bodies must endure.

Patients can help themselves by being more aware of stress in their life, take time to eliminate those that they can, and find better ways to deal with the ones they must. It may mean setting aside time to take a nap in the middle of the day, or other things to care for themselves. Regular exercise has shown it reduces stress and promote better sleep habits.

Stay tuned for more answers from Dr. Hurst-Wicker about what happens when our brain perceives chronic pain as a threat.

In healing,,Celeste

"Adversity is only an obstacle if we fail to see opportunity."  

Karl S. Hurst-Wicker, MD, is a board certified anesthesiologist practicing pain management at the Desert Pain Institute. He graduated from Columbia University College of Physicians and Surgeons and completed his residency in anesthesiology at the University of Utah.

Other contributing articles written for you:

Q and A on Chronic Pain - Health Central

TheCentralization of Pain - Health Central

Rolfing®and Chronic Pain – ProHealth

The Ins And Outs Of Chronic Myofascial Pain (updated Feb., 2020)

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Celeste Cooper, RN

Author—Patient—Freelance Writer at Health Central & ProHealth —Advocate

Celeste’s Website: http://CelesteCooper.com

Learn more about Celeste’s books at her website or find links here on Celeste's  blog. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.

All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  

The Why and the Way Fibromyalgia Studies are Important to You

To get a better understanding of fibromyalgia and the disorders that cluster with them, we need to study them side-by-side so any trends are exposed. Also important is screening for the presence of myofascial pain syndrome (MPS) to assure the participant pool has been identified correctly, because MPS is known as the great imitator.

It’s Not Just Fibro

Many pain disorders have centralization affects, probably most, so while looking at centralization in fibromyalgia; we may need to be more diverse in our thinking. Dr. Robert Bennett and his team 

found that fibromyalgia is often accompanied by another pain disorder. Therefore, while we do experience body-wide pain not directly related to injury or peripheral disease (which indicates centralization-involvement of the brain), and sleep problems, fatigue, and cognitive issues, we also have clustering of disorders. The American College of Rheumatology identifies depression or anxiety, migraine, tension headaches, digestive and bladder problems, pelvic pain, and TMJ. The CDC suggests FM occurs with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and ankylosing spondylitis (AS), and it could have a loose underlying genetic factor. Low back pain syndrome is also considered a disorder of centralization, but chronic low back pain patients do not share a clustering of noted disorders. If we compare the two, it suggests that centralization of pain is not the only factor at play in fibromyalgia. It could be, and is suggested in some studies that the amplification of pain by the brain (centralization) is not the only central nervous system involvement.

Investigators are doing some interesting work by looking at fibromyalgia and chronic fatigue syndrome together because they are often associated. Gene expression  might help us understand clustering in a meaningful way. Leaky gut syndrome has been associated with fibromyalgia and a study on ME/CFS and the association and treatment of leaky gut holds some promise. Since these two disorders frequently occur together, this might help us find better treatments. Though the results differ somewhat, studies suggest the need for more research regarding abnormal immune reactions in both FM and ME/CFS (SEID). Interestingly, leaky gut syndrome has been implicated in many autoimmunedisorders and in irritable bowel syndrome,  prevalent in fibromyalgia.

Myofascia and Fibromyalgia: Could There Be an Answer to Your Question?

Any time a person tells me their physician cannot explain neuropathy symptoms (numbness, tingling, sensitivity, weakness, cramping, spasms, etc.), I ask them to learn more about myofascial pain syndrome (MPS).  Myofascial trigger points  are pain generators in many of the comorbid conditions identified in this article. Rheumatologists are internal medicine doctors and many do not understand MPS, how to assess for it, or what treatments work. However, there are physicians and therapists who do.

You will find an article I did at Health Central from an interview with pain specialist, Dr. Karl Hurst-Wicker quite interesting.   It is a necessary read for anyone who wants to understand the role of centralization and peripheral pain generation in fibromyalgia and other unexplained pain.

It’s time to get it right. When funding by unbiased organizations is at an all time low, such as the NIH, we need to make every effort to do it the right way. If you have any of the clustering of symptoms, report them to your doctor and share this blog. Every piece of data counts and so do you.

Resources linked:

American College of Rheumatology, Fibromyalgia

Center for Disease Control, Fibromyalgia

Fasano A. Leaky gut and autoimmune diseases.

Health Central, Fibromyalgia Centralization and Peripheral Myofascial Pain: Interview with Karl Hurst-Wicker, MD

Hyland NP, et. al. Microbiota-host interactions in irritablebowel syndrome: epithelial barrier, immune regulation and brain-gutinteractions. 

Jacob E, et. al. Gene expression factor analysis todifferentiate pathways linked to fibromyalgia, chronic fatigue syndrome, anddepression in a diverse patient sample. 

Kosek E, et. al. Evidence of different mediators of central inflammation indysfunctional and inflammatory pain--interleukin-8 infibromyalgia andinterleukin-1 β in rheumatoid arthritis. 

Maes M and Leunis J. http://www.ncbi.nlm.nih.gov/pubmed/25617880

Myofascial Pain Syndrome at CelesteCooper.com

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"Adversity is only an obstacle if we fail to see opportunity."  

Celeste Cooper, RN

Author—Patient—Health Central Chronic Pain Pro —Advocate

NEW Website: http://CelesteCooper.com

Learn more about what you can do to help your body function to its potential in the books you can find here on Celeste's  blog. 

All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.