Fibromyalgia (FM) is a chronic condition that impacts every aspect of life for those who harbor it. The diagnosis is often made on individuals with chronic widespread bodily pain in the absence of any specific condition and when no specific cause, such as tissue inflammation or damage, can be identified. Hence, the cause of FM remains illusive and confusing, resulting in beliefs that range from it being a purely a psychological condition to an entirely physical condition, while others simply do not feel it’s a “real” condition at all. This begs the question: What causes fibromyalgia?
Thankfully, there is currently enough research published to confidently say that FM is at least partly (possibly mostly) due to a disorder of “central pain processing” (that is, how the brain “feels” pain), where a higher than normal pain response occurs to a normal, not-too-painful stimulus (technically called “hyperalgesia”), as well as a pain response that occurs to a non-painful or shouldn’t hurt at all stimulus (technically called “allodynia”). There are several other conditions that include central or brain processing problems that include both genetic as well as environmental factors. Some of these include irritable bowel syndrome, TMJ or jaw dysfunction, chronic low back pain, and others. This central or brain problem may be caused by chemical changes in the brain which have been clearly identified in FM sufferers. Some of these include a deficiency (too little) of serotonin and noradrenergic substances, as well as too much or an excess amount of glutamate and substance P (chemicals that help transmit movement information from our feet and arms to the brain). In some cases, there are also psychological and behavioral issues that play a role in the cause of FM. Another study reported the cause of FM as being a “neurologic disease.” They found that interactions of environmental stressors (financial, marital, etc.) PLUS “neuroendocrine dysfunction” (that is, hormonal and neurotransmitter issues) in people who are genetically predisposed to be the cause of FM.
So, it appears the cause of FM is not one thing but rather, the presence of environmental issues like stress AND chemical imbalances in our endocrine (hormone) and nervous (brain) systems that team up to clobber those of us who may be genetically geared towards having FM. This explanation of causation is important as there are both outside/environmental and inside/chemical issues that MUST be addressed in the treatment or management program of FM. This is why a “multidisciplinary approach” or a “team” of healthcare providers works so well in the management process. Because there are biological, psychological, and social issues that require management, the team may consist of primary care (by a medical doctor who is willing to work in a team approach and “believes” FM is real), counseling, and chiropractic. Chiropractic is an integral, important service to include as the primary complaint of FM is “widespread musculoskeletal pain” and NO OTHER profession focuses more on that system than chiropractic. Patients with FM frequently report that a regimented treatment plan that includes regular chiropractic adjustments, soft tissue therapies, often different forms of physical therapy modalities such as electrical stimulation, ultrasound, pulsed magnetic field, laser and/or light therapy, as well as nutritional counseling and exercise guidance are HUGE in the management process – ALL of which can be quarterbacked by your chiropractor.
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