Fibromyalgia and “Perpetuating Factors”
Trigger Points in Pain
by Miryam Williamson, author of Fibromyalgia: A Comprehensive
and The Fibromyalgia Relief Book (1998)
Copyright © 1999 Miryam Williamson. Permission is granted to copy
article as long as it remains intact and is not sold.
Janet Travell, MD, who died in August, 1997, was the White House
physician when John F. Kennedy was president. He probably had
fibromyalgia (FM), although his illness wasn’t recognized as such.
Dr. Travell specialized in myofascial pain syndrome (MPS) and
musculoskeletal disorders. With David Simons, MD, she wrote the
two-volume textbook Myofascial Pain and Dysfunction: the Trigger
Simons suggest that these perpetuating factors must also be
identified and treated if the patient’s myofascial pain syndrome is
to be cured. The concept is as important in dealing with
fibromyalgia as it is in treating MPS.
Insomnia. It has been shown by Moldovsky and others that
anything that interferes with sleep for a few days will induce FM
symptoms even in otherwise healthy people. When these people are
allowed to sleep normally again, their symptoms disappear, but they
are apt to linger and become permanent in people with the
predisposition to fibromyalgia, which appears to run in families.
Insomnia can be a perpetuating factor in fibromyalgia, as well as a
cause or trigger for the disorder. And there are conditions that are
perpetuating factors for insomnia. Chief among them is obstructive
sleep apnea (OSA), in which the back of the throat closes repeatedly
when the individual relaxes into sleep, causing the sleeper to gasp
for air. As a result, the person never achieves deep sleep. OSA is
found in about half of all men with FM, and in many women, too. This
condition is usually rather easy to deal with and people whose
insomnia is caused by OSA usually find dramatic improvement in their
FM symptoms when the OSA is successfully treated.
Metabolic dysfunction. Another example is related to the
deficiency in the brain chemical serotonin that is found in people
with FM. The body uses nutrients in food to manufacture serotonin.
If the digestive system is not efficient in extracting nutrients
from food, that inefficiency – a problem in metabolism – is
another perpetuating factor. It may be that the person has a “leaky
gut” that allows nutrients to escape from the intestines rather than
being absorbed to be used where they are needed. It may be that the
person lacks the vitamins or enzymes required to synthesize
serotonin. Both of these situations can have a variety of causes.
Chronic yeast overgrowth is one such cause. Therefore, “leaky gut,”
vitamin deficiency, and yeast overgrowth can be perpetuating factors
dysfunction. Both an underactive and an overactive thyroid gland
can yield many of the same symptoms found in fibromyalgia, including
muscle stiffness, insomnia, fatigue, and depression. Therefore,
thyroid dysfunction can be a perpetuating factor in FM. Part of
everyone’s FM workup should be a full set of thyroid function tests
to rule out or point to the need to correct this condition.
Faulty body mechanics. Pain on movement causes people to adjust
their posture and way of moving in an attempt to minimize the pain.
These adjustments, known as “guarding,” make matters worse by
putting undue strain on other parts of the body. Poor posture and
faulty body mechanics are yet another perpetuating factor in FM. A
skilled physical therapist or practitioner of the Alexander
Technique, Feldenkreis, or Trager method can help eliminate this
cause of FM pain.
Myofascial trigger points.
please read the newly discovered cause of Fibromyalgia