Fibromyalgia is a common cause of multi-regional pain and disability. This condition shows a female preponderance and is a condition whose etiology is poorly understood, despite the various intensive and invasive investigations of modern medicine. Two hypotheses have been proposed to be the underlying etiological factors in relation to this condition. The first being an abnormality in the non-rapid eye movement sleep stage, which may be due to biochemical disturbances in the body. Abnormal pain processing is the second theory that may be responsible for the exaggerated pain in response to a stimulus. (Sarac & Gur, 2006)
Worldwide literature on the subject has established that stress is an important and established risk factor to this condition. Such life stressors can cause significant psychosocial distress. In some cases of fibromyalgia, the pain remains refractory to medications. In such cases, non-pharmacologic modalities are used, such as, psycho-social modification and relaxation therapies.
Non-pharmacological modalities can be classified into physiological and psychological methods. Chiropractic and massage therapies are examples of physiological modes of therapy. Behavior modification through cognitive behavioral therapy is an example of a psychological approach to treatment. The aim of this article is to analyze the usefulness of two non-pharmacological treatments, mentioned above, for the management of fibromyalgia.
The rationale for using manipulative or massage techniques in fibromyalgia is based on their modes of action. Activation of trigger points in the human body has been postulated to be the underlying mechanism of chronic pain experienced by patients suffering from fibromyalgia. Trigger points are tiny bands of contracted muscle fibers. These points develop when over stimulated sarcomere become unable to release their contracted state. Prolonged contractions of these muscle fibers can cause significant injury and soft-tissue changes. These tissues eventually become chronically congested, thus hampering blood flow. During therapy, these spastic points are located and techniques are employed to increase blood flow and allow the injured tissue to heal in a way that allows mobility. (Bennett & Goldenberg, 2011)
Chiropractic techniques can be considered when designing an integrated approach for the management of chronic pain in fibromyalgia. The efficacy of this care has been established for musculoskeletal pain, such as lower back pain, neck pain and headaches. The effectiveness of this approach has been a matter of debate. However, chiropractic techniques can decrease the use of pharmacological drugs, thus reducing its various adverse effects. Moreover, no pharmacologic therapy has proven to be successful in the long-term treatment of fibromyalgia. This method causes a positive cascade of biochemical effects that help to reduce pain and inflammation. (Sarac & Gur, 2006)
Results of one study, conducted on chiropractic management of fibromyalgia patients, revealed an improved range of motions in the lumbar and cervical region. There was also an improvement on straight leg raising ability and on pain levels. Although the improvement was clinically significant, this study only included a sample of twenty one patients, and so the results can not be generalized. (Blunt, Ranjwani & Guerriero, 1997)
Remedial massage therapy is one of the many types of massage techniques. This technique uses controlled pressure on deep muscles to reduce muscle tension, facilitate recovery of injured myocytes, and increases blood flow and lymphatic drainage. Blood flows from high pressure areas to low pressure areas. This technique creates the pressure difference required, thus enhancing blood flow. The increased blood flow allows rapid healing and also removes toxins and prevents their accumulation. Currently, there is no literature that supports the use of remedial massage therapy in particular; however, other massage techniques have been discussed as a cure for fibromyalgia. (Sarac & Gur, 2006)
According to a meta-analysis of 740 research articles by the Australian Association of Massage Therapy, therapeutic massage improved pulmonary function, decreased exercise related muscle tension, improved the outcome of chronic pain and anxiety disorders. In this review, 5 out of 740 studies were found related to fibromyalgia, which displayed limited evidence (Level C) for its incorporation into current guidelines. (Kenny & Marc, 2008)
The usefulness of massage therapy in fibromyalgia was analyzed in three studies, other than those used in the meta-analysis conducted by AAMT. Out of these, in only two studies were the effects isolated. Both these studies used different types of massage techniques. In the study conducted by Brattberg (1999), the connective tissue massage technique was employed, which displayed a thirty seven percent decrease in pain. It also reduced depression and the use of analgesics, thus improving the quality of life. On the other hand, Hanen et al. (1991) used a form of massage that promoted relaxation. Key factors analyzed in this study were...
Fibromyalgia One might consider fibromyalgia to be one of the most confounding conditions around today. It is debilitating. It results in several quality of life issues. The confounding aspect of this condition is that it is difficult to diagnose. It is also difficult to treat. Most treatment modalities today recourse to treating one or more specific symptoms -- but there is no treatment that can comprehensively treat all the symptoms. (NIAMS,
Fibromyalgia is a rather mysterious condition, with no known cause and no known cure. The symptoms of fibromyalgia consist primarily of muscle and joint pain and heightened sensitivity to pain, experienced globally. Secondary symptoms, which are also common in sufferers, include chronic fatigue, cognitive and memory dysfunction, sleep disorders, and mood disorders. Women are far more likely to suffer from fibromyalgia than men, and age of onset is generally between
Psychological Test Evaluation: Beck Anxiety Inventory (BAI) Section 1: General Features a) Title: Beck Anxiety Inventory (BAI) b) Author(s): Aaron T Beck, Robert A Steer c) Publisher: Pearson Education, Inc. d) Publication Year: 1993 e) Age Range: 17 years to adult (Beck & Steer, 1993) f) Qualification Code: CL2 Section 2: Instrument Description a) Instrument Function: What does it measure? BAI is a tool used to measure the level of anxiety in persons aged 18 and above. It is the
Fibromyalgia syndrome (FMS) is a complex medical condition that affects about 5 million American people. The condition is characterized by "chronic widespread pain, fatigue, sleep disturbance, stiffness, impaired memory and concentration, anxiety and depression." (Facts of Life, 2001). Sleep disturbance and an increased sensitivity to pain follow a cyclic pattern in individuals having FMS, the result of which is a positive feedback loop. (Etiology of Fibromyalgia, 2003). Typically, fibromyalgia affects women,
Findings showed that 95% of the respondents' overall health status was slightly higher compared to that of the general U.S. population of the same age and sex. Factors identified with the favorable health status were male gender, married state, higher educational attainment, higher military rank and inclusion in the Air Force service. Lower quality of health was associated with increased use of health care, PTSD, disability, behavioral risk factors
This is especially true to the extent that various aspects of the natural response to stress are learned rather than functions of innate genetic predisposition. Typical methods of behavioral conditioning capable of reducing the secondary consequences of stress include coping mechanisms for the recognition of the earliest symptoms of stress and training to respond to stress in more positive ways instead of either repressing it or overreacting to it (Acosta,
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