Chronic Fatigue Syndrome, Chronic Pain, Fibromyalgia, Fibromyalgia Blog, Health

Fibromyalgia: The “F” Word of the Medical Community, by Paul from The Chiropractic Guy

Paul from The Chiropractic Guy has written a very interesting article about Fibromyalgia from a clinicians perspective and has provided some thoughts on chronic pain treatment. I hope you find this informative. You can connect with Paul on Instagram.

Hi Fibro Warriors

There has never been a bigger platform to raise awareness and knowledge of chronic pain conditions such as Fibro.

Dedicated accounts and forums offer support and information to lost souls who have meandered through the diagnosis journey and beyond. With campaigners and accounts doing a great job to fight the corner of the Fibro community, there are also some horror stories from people which involve the very system which designed to help us…. the medical system.

During this article I’ll be talking about some sensitive subjects. To prevent flare ups or distress there will be a “flare warning” that looks something like this 👇

………………………………………………….🔥 Flare Warning 🔥………………………………………………
                                                              ⛔️   ⛔️

If you’re in a sensitive spot right now, it might be best to skip past that part or read later if it’ll cause a flare up 🤗

After reading and hearing from my own Fibro Warriors some of the experiences people post about their Doctors or clinicians, I reached out to Fibro Ramblings to try and give a practitioners perspective of what we see when a Fibro or ME/CFS person walks through the door.

I have to hold my hands up and say initially I was part of the problem with the medical system. I saw many, many chronic pain conditions and people who came to the Chiropractor as a last-ditch effort to try and ease their pain and I couldn’t help them.

It led to creating a framework to try and help address the horrific condition which is Fibro. Many medical doctors are still stuck in the stone age when it comes to pain conditions. Although this may be no fault of their own…

The Doctors primary focus when we turn up may be to rule out any serious pathology. The severity & frequency of Fibro symptoms can be quite alarming and mimic more serious conditions. How do doctors rule the serious conditions out? Usually a battery of tests. It’s not unusual to have the following:

  • Bloods
  • 24 Hour ECG
  • MRI // X-Rays

As many of you will have experienced, these tests often provide no information. This can be frustrating for both the Fibro sufferer and the Doctor.

So, what happens next?

You may be given a dose of pain meds. Depending on how many times you’ve been through the above cycle, the strength of these drugs can vary. Maybe Tramadol in the initial stages, then onto the stronger GABA family & Amitriptyline after a few months.

When these drugs aren’t useful, maybe you’ll be referred to a Rheumatologist after a long battle, who will do pretty much the same thing. Rule out systemic conditions like Rheumatoid arthritis, Lupus or Ankylosing Spondylitis. You may get a diagnosis based on the infamous press test. Quite often when a diagnosis is given, we can get put on the shelf and forgotten about.    

Welcome to the never-ending cycle that is the medical system.

When doctors have exhausted all of their modalities, they may tell you the pain is psychologically induced or my personal favourite; All in your head 🤬

………………………………………………….🔥 Flare Warning 🔥………………………………………………
                                                             ⛔️   ⛔️

This is probably the worst phrase or feeling a person suffering with chronic pain can experience. I see so many cases where a person believes they have been sentenced to a life of pain.

Do any of these sound familiar?

  • There is no cure
  • Doctors can’t find a cause
  • There is no research being done
  • This is my life now
  • Learn to live with it
  • Develop a coping strategy
  • Pace yourself
  • Avoid flare ups at all costs

Usually at this stage the symptoms can become aggressive and downright frightening. But no cause can be found. Here’s a list of symptoms which occur as Fibro takes hold.

  • Pain (obviously!)
  • Burning
  • Itching
  • Numbness
  • Weakness in limbs
  • Crippling Fatigue
  • Bowel changes
  • Rashes
  • Hot // Cold sensitivity
  • Visual changes

But nothing is found to be causing it. Some people will spend their life in this cycle, and it is truly, truly upsetting and a total disgrace to our understanding of chronic pain.

……………………………………………….🔥 Flare Warning Over 🔥………………………………………………

Before we move on, I want to make some things perfectly clear. The context of this message can get lost in translation through the medium of writing and I don’t want to cause anyone distress or anxiety. Here’s my views on chronic pain.

  1. The pain and other symptoms you are experiencing are absolutely 100% real. We know this from MRI’s of people’s brains who suffer chronic pain which light up like xmas trees during flare ups.
  2. Your pain & symptoms are not imaginary, exaggerated or made up in any way. Some of my patients have been accused of malingering in the past!

Bear these two points in mind when reading the next paragraph.

Modern pain science tells us that all we thought we knew about pain has been terribly, terribly incorrect. Some doctors still work from the Cartesian model of pain created in the 1600’s. And we wonder why record numbers of people have to suffer Fibro & ME/CFS.

So, what is the answer? Now this is the part many people don’t like. Many outright reject it and hang onto info given by a doctor and suffer indefinitely. 

………………………………………………….🔥 Flare Warning 🔥………………………………………………
                                                             ⛔️   ⛔️

In an effort to try and help the chronic pain cases I was seeing, during some research I stumbled across the works of Lorimier Moseley & David Butler. Two pain scientists who claim that full recoveries are possible in Fibro and ME/CFS cases. But there is no cure? We know this. It’s not even up for debate.

But….

Here’s where it gets super interesting as we go deeper down the chronic pain rabbit hole. Chronic pain conditions like Fibro don’t appear to have a pathological cause. That is, no disease process or cause and effect treatment. As many people know, the tests doctors perform quite often draw a blank.

So, what is the explanation given by these pain geeks?

The nervous system itself is the culprit. Now when I heard this, I thought “yeah right, basically another dude saying it’s all psychological.” Being a sceptic, I kept reading and thought I knew better.

These pain geeks weren’t saying the pain was all in the head. They were saying it’s all in the brain. And they had overwhelming scientific proof and recovery stories to support what they were saying. People actually overcoming their symptoms of Fibro after years, in some cases decades of suffering. Yet I still couldn’t believe it. I was seeing one person at the time who couldn’t tie their shoes without causing a flare. How was I meant to make a difference in that person’s life with what seemed a new “juice plus” type gimmick? 

Being the conservative type, I looked at the recovery stories documented by Moseley & Butler and they all had one pertinent thing in common. The stalwart. The lynch pin. The keystone.

And that staple was pain education. Learning about pain, what it does or doesn’t mean and how to overcome it. But it didn’t end there. The symptoms such as brain fog and all the other nasties listed above are all associated with the nervous system. And all disappeared along with pain.

Could this really be the answer we’ve all been looking for? Is this new information to chronic pain what penicillin is to bacteria?

It quickly became clear that there are so many harmful narratives, beliefs & experiences which all contribute to a pain experience. When doctors use the term psychological, they may be using it incorrectly. Moseley’s research shows that pain can be influenced by fear, past experience, traumatic life events, avoidance and most of all…. not knowing what’s causing the pain. All of these are psychological factors. Doctors may be using the term flippantly which can cause resistance and anger in some people when the suggestion of psychological factors is made. So, it’s written off amongst us all in the pain community as BS.

All of these psychological factors send our nervous system into panic mode. The result is a total shut down of the body. Pain, fatigue, nausea, itching and bowel changes. Symptoms at the drop of a hat which can vary day to day, hour to hour.  Very similar to the symptoms of Fibro.   

It’s a perfect storm and the fire is stoked when our doctor tells us that there is nothing more they can do. It’s extra ammo for the nervous system to shut down the body from an unknown threat.

The promising news is that there’s a way to get out of chronic pain. Once we understand what flare ups are and their purpose, we can make steps towards getting better. It seems counter-productive to use movement when movement causes flare ups but moving is actually the most beneficial tool in recovering from chronic pain. “Have you tried Yoga” I hear you scream. Movement in a graded manner and the assurance that no damage is being done is often enough to calm a panicked nervous system. A “move it to prove it” type scenario. Move your body to prove to the nervous system that all is well, knock it off with the pain, fatigue and damn itching!

……………………………………………..🔥 Flare Warning Over 🔥………………………………………………

I understand completely that this will not be everyone’s cup of tea. It might go against everything you’ve been told or believe. But that really is the first step. Looking objectively at all of the science and recovery stories to challenge our ideas of pain. It doesn’t happen overnight. Chronic pain is chronic for a reason, it took a long time to manifest and may have been there for years. Naturally, it takes time to overcome. It is not glamorous, and it is not pleasant. Flare ups and setbacks are part of the process but framed in a new narrative we can understand they are a necessary evil towards recovering.

When COVID restrictions ease and life returns more towards normal (whatever that is!) I’ll be running a volunteer program and documenting the recovery of someone suffering with Fibro. Many people think they will be in the Fibro nightmare forever. I hope by seeing someone go through the journey, experience the flares and get their life back it can inspire you to see the right clinician and make progress, even a recovery.

I’m always open to questions, queries & theories from the pain community. I’ll do my best to answer all your concerns (or even rage which can sometimes happen from these posts).

Please get in touch with your questions and concerns.

Warm thoughts

Paul.

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