Ltd 2011 fibromyalgie

What about Fibromyalgia? by Johnny Carlsson, LMT

Johnny Carlsson
Trager practitioner/Massage Therapist
Owner SWEHAB Företagsmassage AB
Who am I?

Fibromyalgia
Fibromyalgia (FM) is a chronic pain syndrome whose primary symptoms are widespread chronic pain and fatigue.

Causes
There are several theories
Mental illness
Abnormal processing of the signals/hyper sensitivity to the brain
Miss interpretation of the signals to the brain
Neuro-immune-hormonal disease
Neuro transmitor cascades

Triggers to the first onset
Crisis
Pain
Trauma
Infection

FM that starts with local pain or mental crisis
usually a slow progress

FM that started with an infection
usually occurs suddenly.

International statistics:
About 2-4 % of the adult population.
Women: 80-85%
About 10% are children or adolescents.
Who is affected?

Diagnosis

The diagnosis of FM is a so called criteria diagnosis.
A certain number of set criteria must be met.
Impossible to diagnose by laboratory tests or other medical examination.

At least three months of general pain in all four quadrants of the body
Pain on palpation (pressure) in at least eleven of eighteen tender points. (pressure should be relatively light. Max 4 kg)
Weakness of muscles
Stiff muscles
Recent research suggests 75 more tenderpoints… FM or MTrP?
Main criteria for determining FM

Constant pain at rest.
Abnormal fatigue.

Muscle pain affects motor skills.

The pain affects sleep.
Healthy persons show a multitude of FM symptoms after only a few days of disrupted sleep!
Are there more symptoms?
Symptoms

Pain (100%)
Disturbed sleep (80%)
Headaches/migraine (50%)
Numbness/tingling (70%)
Anxiety (50%)
Balance problems/dizziness (50%)
Decreased muscle strength
Lower leg cramps
Stiffness
Nausea
Cold fingers and toes
Tics
Disturbed heart rhythm
Voice is changing or is hoarse
More symptoms!

Irritable bowel (30%)
Sensitivity to light sound and smell
Growing pains as a child
Fatigue
Loss of short term memory
Hard to concentrate
Irritability/mood swings
Swelling
Symptoms from the eyes nose and groin
Feeling of fever, hot and cold sensations
Even more symptoms!
Frequent urination
Itching
Depression
Blurred vision
Diffuse skin reactions
Sensitivity to infections especially herpes zoster
Abnormal sweat
Bruises easily
Fragile hair and nails, hair loss
Dry skin
Cravings for sugar and carbohydrates

Lack of sleep
A bad bed and or bad pillow
Static work (computer)
Repetitive work
Over work
Hard physical activity
Depression
Anxiety and worries
Stress
Mental illness
Snoring
Psychological trauma
Physical trauma
Body asymmetry
Poor posture
Perpetuating factors
Morton’s foot or flatfoot
Infection
Allergy
Asthma
Diabetes
Poor breathing patterns
KOL
Malnutrition
Dehydration
Caffeine
Smoking
Cigarettes
Drugs
Medicines
Whether changes
Heavy handbags and backpacks

2 hours of watching television
+
8 hours in a bad bed
+
8 hours at a computer
=
18 hours/day!
The joy of television!

Trigger points (of course)
Depression
Arthritis
Carpal tunnel syndrome/thoracic outlet syndrome
Hyper mobile joints
Migraine
MS
Restless legs
SAD (seasonal affective disorder)
IBS (Irritable bowel syndrome)
Esophageal reflux
Chronic fatigue syndrome
Yeast infections
HIV
Co existing diagnoses

Treatment
Within the EU : NO approved drug
In the U.S. three drugs are approved:
Lyrica
Cymbalta
Savella.
Causes of FM unknown, hence: no cure! BUT We CAN relieve it!

Get the client motivated!
Make a list of the worst culprits:
television,
bed,
computer
work.

Make necessary changes
Not too many at once!

A good bed and pillow
bedroom not to warm. 18 °C is good for a healthy person but with FM it can be to cold.
Sleep is hormonally induced. Catch the sleep train!
6 hours after a cup of coffee half of the caffeine is still in the body. Black tea and coca cola have the same effect.
Avoid computer work and TV an hour before bedtime. No TV or computer in the bed room!
Dim the lights an hour before bedtime.
Sleep !!!!!!!!!
Dont go to bed with your to-do-list. Make a list and forget about it!
Some may sleep better after eating or drinking. Some may not. Experiment
If you can´t fall asleep get up, read a book. The sleep train will return
Make sure it is quiet! Do not accept to be called “easily disturbed” If nothing else works get good earplugs.
Alcohol=big no-no!
Nicotine= withdrawal after 2 hours
Exercise, but not within two hours before bedtime
Meditate
Avoid arguing
Use a Trigger Mat to induce sleep .

Why Zebras do not get ulcers… The fight or flight system is the reason. Sympathetic nervous system + Para sympathetic nervous system = Autonomic nervous system

Zebra meets lion Sympathetic system: Fight or flight response activated Heart rate is up Muscles are ready to go Blood pressure increases Digestion shuts down. The pupils are constricted TRY TO SLEEP NOW!!!
Hormones released:
Adrenaline
Cortisol
Noradrenalin
Glucagon
Insulin

The zebra runs for its life and if it is lucky it can have a bite to eat…
The para sympathetic nervous system is activated.
Acetylcholine is released
Adrenaline goes down
Heart rate goes down
Blood pressure is reduced
Insulin level drops
Digestion starts up again

We are surrounded by attacking “lions” all the time:
Alarm rings
Wake up the kids
Make breakfast
Off to school and work
Avoid all cars on the way
Stress-stress-stress at work
Avoid traffic on the way home
Buy some food
Pick up the kids
Cook dinner
Clean the house
Pay the bills
Fulfill your dreams
Exercise (?)
Check the email
Watch TV
Try to sleep…
Are people stupid zebras without stripes?

Releases oxytocin
Releases endorfine
Activates the parasympathetic nervous system
Promotes relaxation
Reduces pain
Promotes sleep
Breaks first defense !
The Trigger Mat

Using the inflatable Triggermat
Inflate to max 2/3
Start with 5 min.
Increase to max 30 min.
Use a cloth if needed
Check client
Use for one month
Take a break for a few weeks

Before going to work
Anamnesis
Postural evaluation
Palpating the 18 tender points

Anamnesis
Fill out this form

Postural Evaluation
Ear to heel
Shoulders
Head forward
Rounded shoulders
Hunched back
Scoliosis
Fallout test
Mortons foot/flatfoot
Leg length

18 points
Max. 4 kg of pressure
Palpating Tenderpoints Go play!

Questions?
Questions

Triggermats for your practise? Ze zijn te koop tegen de volgende aanbiedingsprijzen: Tegenover de receptie, bij Nelleke

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Ltd 2011 fibromyalgie

by Rob Beenker on Oct 14, 2011

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Ltd 2011 fibromyalgie — Presentation Transcript