Recently I have been seeing an increasing number of patients with low back pain who also suffer from numerous other pains throughout their body. Fibromyalgia always comes to mind. Some of them have already had their diagnosis made by other medical practitioner, but most have not, and have not even heard of it before. The 2 main criteria for making the diagnosis is:
1 do they complain of pain in all 4 quadrants of the body ( 5 if you include the head )
2 do they have 11 or more of the required tender points.
Other things I ask about are
1 Life stressors such as shifting house, death of a significant relative/friend
2 Stress especially if it is still ongoing, such as conflicts at work, difficult teenagers.
5 Post traumatic Stress which may well have precipitated the condition.
Other precipitating factors may include:
1 Any accident especially including some whiplash of the neck and back
2 Severe illness especially infections such as Glandular fever or one requiring long stints in hospital or bed rest causing muscular deconditioning
3 Gastro-intestinal problems such as irritable bowel as I commonly find these patients have lactose/fructose intolerence/malabsorbtion.
Other associated conditions include:
1 Chronic fatigue,
4 nasal allergies,
5 Tempromandibular dysfunction,
7 hot flushes.
8 neuropathic pain.
As there is no specific cause and no standard cure for Fibromyalgia, I have found that in most cases, I can provide symptomatic relief. The 3 main areas I attend to are:
1 Low fructose/lactose/amine/trans fat /cholesterol diet, nutrition and some common supplments such as magnesium, zinc and krill oil.
2 Psychosocial issues using modified Emotional Freedom Technique (EFT )
3 Tender points and Myofascial Trigger Points which I will expand on in the next blog
4 Cognitive Behavioral Therapy in relation to posture, movement and exercise to avoid exacerbating symptoms ( also in the next blog at www.drchrischinbackpain.com )