The condition of Fibrositis is brought about by a change in the regulation of a person’s internal pain management system in a given body area.
It is the term given to people who complain of essentially a chronic widespread generalised muscular type of pain. Patients with this syndrome of symptoms complain of mostly three core factors. That is: Pain, Stiffness and Fatigue.
Also often present are
- Irritable Bowel syndrome
- A subjective feeling of swelling in areas
- Bizarre Pins and Needles or numbness in the hands
- Disturbed sleep patterns
- Decreased grip strength
- Mottled skin appearance
- Decreased endurance to exercise
- Psychological stresses
Other typical signs more noticeable to the therapist
- Allodynia – Decreased pain threshold to pressure on a sore area. It is measurable by using pressure gauges.
- Dermatographia – A flare response where reflex vasodilation occurs over a sensitive area if patient is scratched gently for example.
- Presence of Tender Points on the body.
- Decreased muscle compliance.
- Vertebral dysfunction
This condition is 7 times more prevalent in females, is present in 2% of the Western population and it gets more prevalent as we get older.
This condition is modulated or controlled by many different factors. You would be aware that you have good days and bad days with your pain. Essentially what makes for a ‘bad day’ is a decrease in your pain threshold.
You may have a good pain tolerance, but the threshold at which you notice pain becomes lowered when compared to painfree subjects. Pain threshold is regulated in the brain, but modulated by external factors.
Factors which regulate pain threshold daily
- The weather
- Menstrual cycle
- Drug usage
- Cigarette/coffee addiction
- Work postures
- Seasonal – patients are worse in winter
- Activity levels – athletes have an increased pain threshold
- Hormonal changes
- and most importantly stress levels and sleep disturbance.
So in summary you have a recognisable pain syndrome characterised by many different observable and measurable entities.
We now believe that central changes deep in the brain which are influenced by the above threshold regulators cause the various pains and problems you experience. It is the brain that controls our blood flow, muscle tensions, sleep patterns, pain threshold, so you see that there is not one factor eg. your job or your husband, that causes your pain, but many factors which affect many different areas of the brain, and so lead to your pain syndrome. This condition evolves slowly and takes a long time and a lot of work to disappear. It is not in your head, but it is in your brain, which in turn affects your body.
How then do we treat and manage this widespread and multi-factoral pain problem? Firstly you have to want to get better. You have to be able to recognise all the causative factors, and work at all of them to change the problem. It is no good having psychological counselling for your stress if you are going to continue to smoke heavily, won’t exercise and can’t sleep.
Management Strategies include:
- Managing pain eg. by use of pain killers
- Easing muscle tension eg. sustained aerobic exercise or massage
- Fixing sleep patterns eg. using mild sleeping tablets, anti-depressants
- Stress relief eg. counselling, exercise, needing to address the psychological causes
- Postures eg. physio and exercise, vocational advice
- Education and understanding eg. that you will have ‘bad days’
- Hydrotherapy eg. is gentle and allows muscles to relax. A very effective form of exercise.
- Work and exercise – it is important to regain a normal lifestyle
- Your Physio will co-ordinate with your doctor/specialist, to organise a combined plan of action, medication and rehabilitation. He will also progress you through a graduated exercise and hydrotherapy program as your condition improves.
- MASSAGE HURTS (10)- you have a lowered pain threshold and allodynia. Even gentle relaxation massage will cause an increase in pain initially. Eventually though you will tolerate it better as your condition improves.
- MEDICATION IS BENEFICIAL – none of us like taking tablets, but sometimes it is necessary to regulate your sleep pattern and to control pain. If you can’t rest how can your body?
- TIME – this process takes time and understanding, don’t be impatient.
- HARD WORK – It is not your doctor, the physio, or time off work that will fix this complex problem.
- It will be you and exercise and management. We will help but you’ll do all the work.
- If you have any further questions, please talk to your doctor, specialist or ourselves. Understanding your problem is very important in working to alleviate it.