Seeing an Osteopath when you have chronic pain or fibromyalgia
Pain is described as “chronic” when it has been present for more than three to six months. “Fibromyalgia” is a form of chronic pain in which specific points on the body are tender to the touch. It basically means you hurt everywhere.
These related conditions can have a really wide number of causes. But after pain has been present for a long time, there can be a tendency for your whole system to become sensitised. This can happen in one part of your body, or all over it (in which case it is called “central sensitisation”). What is called the “resting membrane potential” of your pain-conducting nerve fibres can change. This means that, for example, a light touch, which would normally be ignored by your danger-sensing nerve fibres, can trigger the fibres to produce the sense of pain in your brain.
There are clinics that treat chronic pain largely by educating you about what causes it, by encouraging you keep active and not to focus on it, and by giving you mental exercises to help you to think about it differently. If you are reading this, you may already have been referred to one, and if not, it may be worth your while finding out about one. It can be helpful to understand that your nerves don’t actually send “pain” signals to your brain; they send “danger” signals. Your brain decides how to interpret that; it sometimes decides that it should be interpreted as “pain”. Sometimes your brain can get it wrong; it interprets something as causing danger, when it really isn’t. Sometimes it is helpful to understand where the danger is and is not.
I will certainly educate you about what is happening, and will do things to reduce the stress you feel with your pain. But I’m mainly interested in finding the underlying cause of the “danger signals”, and helping your body to resolve it. In my experience, once this is done, thecentral sensitisation normally settles down.
I’ve seen central sensitisation caused by an inflamed gall bladder. The patient had no extra pain around her gall bladder; she just hurt everywhere. But when her gall bladder was dealt with, her pain went. It is often associated with an undiagnosed low thyroid condition; which is something that is often missed. (The standard blood tests for thyroid only look at the top of a chemical cascade; there is a lot that can go wrong further down the chain). When your thyroid is sluggish, first, you may feel a bit depressed, which can make your perception of pain worse. Second, your lymphatic drainage will be sluggish, which means that inflammatory chemicals will tend to pool where they are, instead of being dealt with. Your swollen lymph channels can be tender, giving you pain everywhere. And the stress of you pain can have an effect on your thyroid metabolism, creating a vicious cycle.
Of course, the mechanism of your pain might be quite different to that. But whatever it is, I will look hard to find the underlying cause, and to help you deal with it. There is clinical research demonstrating that treatment by an osteopath can help a lot with chronic pain and fibromyalgia (see below). See also the “tough cases” page, to get more of an idea of what I might look at.
References for seeing an osteopath when you have chronic pain or fibromyalgia:
Castro-Sánchez AM, Matarán-Peñarrocha GA, Arroyo-Morales M, Saavedra-Hernández M, Fernández-Sola C, Moreno-Lorenzo C. 2011 Effects of myofascial release techniques on pain, physical function, and postural stability in patients with fibromyalgia: a randomized controlled trial Clin Rehabil Sep;25(9):800-13
Castro-Sánchez AM, Matarán-Peñarrocha GA, Sánchez-Labraca N, Quesada-Rubio JM, Granero-Molina J, Moreno-Lorenzo C 2011 A randomized controlled trial investigating the effects of craniosacral therapy on pain and heart rate variability in fibromyalgia patients. Clin Rehabil Jan;25(1):25-35
Degenhardt BF, Darmani NA, Johnson JC, Towns LC, Rhodes DC, Trinh C, McClanahan B, DiMarzo V. 2007 Role of osteopathic manipulative treatment in altering pain biomarkers: a pilot study. J Am Osteopath Assoc Sep;107(9):387-400
Degenhardt BF, Johnson JC, Gross SR, Hagan C, Lund G, Curry WJ. 2014 Preliminary findings on the use of osteopathic manipulative treatment: outcomes during the formation of the practice-based research network, DO-Touch.NET. J Am Osteopath Assoc Mar;114(3):154-70
Ekici G, Bakar Y, Akbayrak T, Yuksel I. 2009 Comparison of manual lymph drainage therapy and connective tissue massage in women with fibromyalgia: a randomized controlled trial. J Manipulative Physiol Ther Feb;32(2):127-33
Farthing RJ, Gosling CM, Vaughan B 2005 The effects of slow rib raising on heart rate, blood pressure, respiration rate and pain pressure threshold Osteopathic Medicine, School of Health Sciences, Victoria University, Melbourne (unpublished thesis)
Gamber RG, Shores JH, Russo DP, Jimenez C, Rubin BR 2002 Osteopathic manipulative treatment in conjunction with medication relieves pain associated with fibromyalgia syndrome: results of a randomized clinical pilot project. J Am Osteopath Assoc Jun;102(6):321-5
Jäkel A, von Hauenschild P 2011 Therapeutic effects of cranial osteopathic manipulative medicine: a systematic review. J Am Osteopath Assoc Dec;111(12):685-93.
Knebl JA, Shores JH, Gamber RG, Gray WT, Herron KM. 2002 Improving functional ability in the elderly via the Spencer technique, an osteopathic manipulative treatment: a randomized, controlled trial. J Am Osteopath Assoc Jul;102(7):387-96
McReynolds TM, Sheridan BJ. 2005 Intramuscular ketorolac versus osteopathic manipulative treatment in the management of acute neck pain in the emergency department: a randomized clinical trial. J Am Osteopath Assoc Feb;105(2):57-68
Sonberg M, Mullinger B, Rajendran D 2010 Can osteopathy help women with a history of hypothyroidism and musculoskeletal complaints? Outcome of a preliminary, prospective, open investigation International Journal of Osteopathic Medicine Vol 13 (1) pages 11-16
Yuan SL, Matsutani LA, Marques AP 2015 Effectiveness of different styles of massage therapy in fibromyalgia: A systematic review and meta-analysis. Man Ther Apr;20(2):257-64