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FIBROMYALGIA TRIGGER POINTS

Fibromyalgia-related pain is pain that causes you to ache all over. You may have painful “trigger points,” places on your body that hurt no matter what medication you take. Your muscles may feel like they have been overworked or pulled even though you haven’t exercised. Sometimes, your muscles will twitch. Other times they will burn or ache with deep stabbing pain. Some patients with fibromyalgia have pain and achiness around the joints in their neck, shoulders, back, and hips. This kind of pain makes it difficult to sleep or exercise.

How Does the Brain Perceive Pain?

There are over 20 different kinds of nerve endings in your skin that tell you if among other sensations something is hot, cold, or painful. These nerve endings convert mechanical, thermal, or chemical energy into electrical signals that convey information to the brain and spinal cord — also known as the central nervous system or CNS. These signals travel to areas of your CNS where you perceive the stimuli as the sensations you actually feel — sensations such as searing, burning, pounding, or throbbing.

If you have fibromyalgia, one of the main symptoms is likely to be widespread pain. This may be felt throughout your body, but could be worse in particular areas, such as your back or neck. The pain is likely to be continuous, although it may be better or more severe at different times.

The pain could feel like:

• an ache

• a burning sensation

• a sharp, stabbing pain

Extreme sensitivity

Fibromyalgia can make you extremely sensitive to pain all over your body, and you may find that even the slightest touch is painful. If you hurt yourself – such as stubbing your toe – the pain may continue for much longer than it normally would.

You may hear the condition described in the following medical terms:

• hyperalgesia – when you’re extremely sensitive to pain

• allodynia – when you feel pain from something that shouldn’t be painful at all, such as a very light touch

You may also be sensitive to things such as smoke, certain foods and bright lights. Being exposed to something you’re sensitive to can cause your other fibromyalgia symptoms to flare up.

Stiffness

Fibromyalgia can make you feel stiff. The stiffness may be most severe when you’ve been in the same position for a long period of time – for example, when you first wake up in the morning. It can also cause your muscles to spasm, which is when they contract (squeeze) tightly and painfully.

Fatigue

Fibromyalgia can cause fatigue (extreme tiredness). This can range from a mild, tired feeling to the exhaustion often experienced during a flu-like illness. Severe fatigue may come on suddenly and can drain you of all your energy. If this happens, you may feel too tired to do anything at all.

Poor sleep quality

Fibromyalgia can affect your sleep. You may often wake up tired, even when you’ve had plenty of sleep. This is because the condition can sometimes prevent you from sleeping deeply enough to refresh you properly. You may hear this described as “non-restorative sleep”.

Cognitive problems (‘fibro-fog’)

Cognitive problems are issues related to mental processes, such as thinking and learning. If you have fibromyalgia, you may have:

• trouble remembering and learning new things

• problems with attention and concentration

• slowed or confused speech

Headaches

If fibromyalgia has caused you to experience pain and stiffness in your neck and shoulders, you may also have frequent headaches. These can vary from being mild headaches to severe migraines, and could also involve other symptoms, such as nausea (feeling sick).

Irritable bowel syndrome (IBS)

Some people with fibromyalgia also develop irritable bowel syndrome (IBS).

IBS is a common digestive condition that causes pain and bloating in your stomach. It can also lead to constipation or diarrhoea.

Other symptoms

Other symptoms that people with fibromyalgia sometimes experience include:

• dizziness and clumsiness

• feeling too hot or too cold – this is because you’re not able to regulate your body temperature properly

• restless legs syndrome (an overwhelming urge to move your legs)

• tingling, numbness, prickling or burning sensations in your hands and feet (pins and needles, also known as paraesthesia)

• in women, unusually painful periods

What Are Fibromyalgia’s Tender Points?

Tender points are localized areas of tenderness typically above muscles, tendons or bones– that hurt when pressed. Tender points are not areas of deep pain. Instead, they are superficial areas seemingly under the surface of the skin, such as over the elbow or shoulder. People with fibromyalgia often have 11 or more out of a possible 18 tender points.

How Does the Chronic Pain of Fibromyalgia Impact Lives?

Fibromyalgia’s chronic pain seems unending. The ongoing headaches, neck pain, aching joints, and painful tender points prevent sleep, causing you to awaken frequently at night. The chronic sleep disorder of fibromyalgia results in increased achiness, morning stiffness, and daytime fatigue. While you want to exercise and be active, you may suffer with foot pain, hip pain, knee pain, or other painful joints. All of these make it next to impossible to exercise with friends or to play with your kids or grandkids.

The constant pain causes more irritation and difficulty dealing with others, including family members, friends, and people at work. For women with fibromyalgia who must take care of family members and work full-time, coping with pain is a challenge. If there is undiagnosed pain and no effective treatment or medication for the fibromyalgia, the overwhelming feelings can lead to irritability, exhaustion, anxiety, social isolation, and depression.

Sensitivity to fragrance. This fibromyalgia symptom is almost directly tied to allodynia and occurs for many of the same reasons. “Increased light, sound, and smell sensitivity are all common,” says Teitelbaum. “We have an enormous amount of sensory input coming in, and it takes energy to sort through all of this to separate the noise from the static. Fibromyalgia predominantly represents an energy crisis, and as the body has trouble sorting through the signal from the noise, it reflects as increased sensitivities.” In addition to whole-body approaches to treating fibromyalgia, Teitelbaum says the anti-seizure medication gabapentin (Neurontin) can often help decrease these sensitivities.