Fibromyalgia is a chronic musculoskeletal syndrome characterized by pain, aches, tenderness, and stiffness in the muscle tissue, ligaments, and tendons. It most frequently affects the neck, shoulders, chest, legs, and lower back. Pain is generally accompanied by sleep disorders, fatigue, gastrointestinal disorders, and depression. Many of its symptoms are similar to those of chronic fatigue syndrome, myofascial pain syndrome, and temporomandibular joint syndrome (TMJ).
Who Is Affected by Fibromyalgia?
Risk factors for fibromyalgia include the following:-
- Age (more common in young adults)
- Gender (more common in women than men)
- Genetic (familial patterSleep disorders (whether sleep difficulties are a cause or a result of fibromyalgia is unknown).
Causes of fibromyalgia are not known. The condition produces vague symptoms that may be associated with diminished blood flow to certain parts of the brain and increased amounts of substance P, which is thought to be a sensory neurotransmitter involved in the communication of pain, touch, and temperature from the body to the brain. Researchers have identified several other possible causes, including the following:-
- Autonomic nervous system dysfunction
- Chronic sleep disorders
- Emotional stress or trauma
- Immune or endocrine system dysfunction
- Upper spinal cord injury
- Viral or bacterial infection
What Are the Symptoms of Fibromyalgia?
While the symptoms of fibromyalgia can be debilitating, they are not life threatening. Symptoms vary, depending on stress level, physical activity, time of day, and the weather. Pain is the primary symptom, found in virtually 100% of cases—specifically, pain and tenderness in certain areas of the body when pressure is applied to them. These areas include:-
- Back of the head
- Upper back
- Upper chest
Pain may be aching, burning, throbbing, or move around the body (migratory). Many patients also experience muscle tightness, soreness, and spasms. The patient may be unable to carry out normal daily activities, even though muscle strength is not affected. The pain is often worse in the morning, improves throughout the day, and worsens at night.
Fibromyalgia is a chronic condition and symptoms may be constant or intermittent for years or even a lifetime. Other common symptoms of fibromyalgia include:-
- Sleep disorders (e.g., restless leg syndrome, sleep apnoea)
- Gastrointestinal (e.g., abdominal pain, bloating, gas, cramps, alternating diarrhoea and constipation)
- Numbness or tingling sensations
- Chronic headaches (may include facial and jaw pain)
- Heightened sensitivity to odours, loud noises, bright lights, various foods, medicines, and changes in weather
- Painful menstrual periods (dysmenorrhea) and painful sexual intercourse (dyspareunia)
- Frequent urination, strong urge to urinate, and painful urination (dysuria)
- Rapid or irregular heart-rate, and shortness of breath
- Sensation of swelling (oedema) in the hands and feet, even though swelling is not present.
Diagnosis of fibromyalgia can be difficult, because tiredness, fatigue, poor sleep and muscle pain are symptoms common to many conditions that need to be ruled out before a positive diagnosis is made. There are certain criteria that are required to be passed before a diagnosis of fibromyalgia can be confirmed. Widespread pain that should have been present for more than three months, and pain (or tenderness) should be felt in at least 11 of the 18 specified tender points when pressure is applied.
- (1 & 2) Occiput: on both sides (bilateral), at the sub-occipital muscle insertions.
- (3 & 4) Low Cervical: bilateral, at the anterior aspects of the inter-transverse spaces.
- (5 & 6) Lateral Epicondyle: bilateral, 2 cm distal to the epicondyles
- (7 & 8) Knee: bilateral, at the medial fat pad proximal to the joint line.
- (9 & 10) Second Rib: bilateral, at the second costochondral junction, just lateral to the junctions on upper surfaces.
- (11 & 12) Trapezius: bilateral, at the midpoint of the upper border of the muscle.
- (13 & 14) Supraspinatus: bilateral, at origins, above the spine of the scapula (shoulder blade) near the medial border.
- (15 & 16) Gluteal: bilateral, in upper outer quadrants of buttocks in anterior fold of muscle.
- (17 & 18) Greater Trochanter: bilateral, posterior to the trochanteric prominence.
There are various treatments for Fibromyalgia.
This pilot study aimed to evaluate the potential effects of Shiatsu massage on the symptoms of adult patients with primary fibromyalgia, propose a Shiatsu treatment protocol, verify patient acceptability, and evaluate the feasibility for a larger study.
This pilot study showed the potential of Shiatsu in the improvement of pain intensity, pressure pain threshold, sleep quality, and symptoms impact on health of patients with fibromyalgia. The proposed Shiatsu treatment protocol was feasible and well accepted by the patients.