New Therapeutic Promise For Fibromyalgia

A novel approach using a non-invasive, painless laser called Fibrolux offers new hope for fibromyalgia, a notoriously challenging condition that affects about 4 million US adults, about 2% of the adult population, and is the only Food and Drug Administration (FDA) cleared device for the condition. The laser treatment was shown to reduce pain by more than half and the number of pain points by 20% or more in 87% of patients in a clinical study.

This month you might see the purple colors of Fibromyalgia Awareness Month, when people around the world try to raise awareness for fibromyalgia and other chronic pain conditions. The month is a time to reflect on how people with this chronic condition can be better supported and May 12 is National Fibromyalgia Awareness Day. You can support fibromyalgia awareness day with purple ribbons, pins and wristbands.

Understanding Fibromyalgia: Symptoms, Diagnosis, and Treatment

Fibromyalgia is a complex condition characterized by widespread muscle pain, weakness, overwhelming fatigue, insomnia, and short-term memory loss or confusion. Despite its prevalence, many individuals are misdiagnosed, leading to challenges in managing the condition effectively. To shed light on this often-misunderstood ailment, it's crucial to delve into its symptoms, diagnosis criteria, underlying mechanisms, and treatment options.

Symptoms and Diagnosis Criteria

Canadian Rheumatologists Moldofsky and Smythe described a link between sleep deprivation and chronic pain and muscle symptoms in 1975. Fibromyalgia was described as causing widespread pain and the doctors identified specific areas of the body called tender points to define the condition. Tender points are specific areas of pain that hurt when pressed, and became the diagnostic criteria recommended by the American College of Rheumatology (ACR). Additionally, it was determined that sleep deficiencies result in oxygen deficit, growth hormone changes, and deconditioning, exacerbating the condition. Central to fibromyalgia diagnosis is widespread pain in specific points of the body, accompanied by joint stiffness and insomnia. The condition can affect anyone, although it is more common in women.

Understanding the Complexities of Fibromyalgia

For individuals grappling with fibromyalgia, the experience extends beyond mere discomfort; it encompasses a complex interplay of muscle and tendon shortening, nerve compressions, and debilitating pain. Understanding mechanisms underlying this condition is key to developing effective management strategies and improving quality of life.

Fibromyalgia manifests as widespread pain, often stemming from muscle and tendon shortening exacerbated by nerve compressions throughout the spine and limbs. This compression can lead to direct pain from muscles crushing joints or referred pain from the spine into the joints. Additionally, headaches may arise from both neck-related referred pain and local muscle issues around the head. The spine, particularly in the neck, mid-back, and low back regions, emerges as a focal point for pain generation in fibromyalgia. Deep spinal muscles play a crucial role, causing nerve compressions and traction that further exacerbates muscle problems in various areas of the body. Pain, in essence, is the body's signal that something is amiss and requires attention beyond its innate capacity to heal.

Underlying Mechanisms

Fibromyalgia is associated with various factors, including age, repetitive work, accidents, hormonal imbalances, stress, and muscle function. People with fibromyalgia experience muscle and tendon shortening due to nerve compressions, leading to pain and discomfort. The spine, particularly the neck, mid-back, and low back, plays a significant role in pain generation, with deep spinal muscles causing nerve entrapment syndromes.

The underlying cause of fibromyalgia pain is often a combination of nerve and muscle dysfunction. Deep spinal muscles may induce minor or major nerve entrapment syndromes, leading to pain that radiates into the limbs, head, and body at large. Furthermore, as individuals transition into adulthood, skeletal muscles naturally shorten due to factors such as exercise, injury, and hormonal changes, particularly a decrease in growth hormone levels. This shortening process, compounded by injuries sustained during work and exacerbated during periods of rest, contributes to joint compression, stiffness, and eventual osteoarthritis development. While the progression of muscle and nerve dysfunction in fibromyalgia may unfold gradually over months or years, its impact is profound and far-reaching. Recognizing these underlying principles is essential in devising holistic treatment approaches that address the multifaceted nature of fibromyalgia and empower individuals to regain control over their health and well-being.

Spine-Muscle Connection

The spine serves as the cornerstone of our body's structural integrity, influencing everything from mobility to overall well-being. In the realm of fibromyalgia, understanding the intricate relationship between spinal health and muscle function is important to unraveling the mysteries of this complex condition.

Picture the resilience of a child's spine—able to run and play for hours on end without fatigue or discomfort, bouncing back effortlessly day after day. Yet, as we age, the wear and tear on our spines become increasingly evident. Some adults over thirty find themselves struggling to engage in even the simplest physical activities. Muscles play a pivotal role in supporting spinal health, but when they persistently remain spastic or shortened, they can wreak havoc on our bodies.

This chronic spasticity may lead to scar tissue formation, resulting in abnormal joint movement and compression. Over time, this may culminate in disc compression, herniation, arthritis, and misalignments of the spine, exacerbating pain and discomfort. Additionally, these muscle imbalances can trigger joint compression in the limbs, leading to abnormal wear patterns and osteoarthritis.

Delving deeper into the anatomy of the spine, we find three deep layers of muscles, each with its unique role in maintaining spinal stability. Among these, the deep muscles—such as the multifidus and rotator brevis and longus muscles—emerge as unsung heroes, providing structural support and preventing spinal collapse. However, despite their strength, these deep muscles are not immune to injury and strain over time, leading to tightness and scarring that can compromise spinal integrity.

Nerve and Muscle Interplay

Furthermore, neuropathy—a term encompassing nerve diseases or injuries—adds another layer of complexity to the fibromyalgia puzzle. Pinched nerves, often stemming from compression within the deep spinal muscles, are a common manifestation of neuropathic dysfunction. These pinched nerves contribute significantly to the pain experienced by individuals with fibromyalgia, amplifying their discomfort and reducing their quality of life. In the realm of fibromyalgia management, there is no one-size-fits-all solution. However, many individuals find relief through a multifaceted approach that includes chiropractic care, physiotherapy, exercise, and nutritional supplementation. While some may not achieve complete cure, these therapies can significantly alleviate symptoms and enhance overall well-being, offering hope and respite to those navigating the challenges of fibromyalgia.

Associated Factors

Fibromyalgia intertwines pain, sleep disturbances, and anxiety in a relentless cycle. Severe pain disrupts sleep patterns, leading to increased anxiety and exacerbation of muscle pain. Conversely, heightened anxiety further disrupts sleep, perpetuating the cycle of discomfort and distress. It's a vicious loop where aggravations to sleep worsen muscle shortening, compounding the symptoms of fibromyalgia. In addition to its elusive nature, fibromyalgia faces controversy regarding its diagnostic criteria.

Fibromyalgia spans multiple boundaries, affecting individuals worldwide and spanning across demographics. While more prevalent in women, it also impacts men, children, and young people. Numerous factors contribute to fibromyalgia, including age, repetitive work, accidents, joint deformities, hormonal fluctuations, stress levels, types of activities, and drug effects on muscles. Understanding the multifaceted nature of fibromyalgia is essential in developing effective treatment strategies. By addressing the interconnected components of pain, sleep, and anxiety, individuals can begin to break free from the grip of this debilitating condition and reclaim their quality of life.

Treatment Approaches

Managing fibromyalgia requires a multifaceted approach tailored to individual needs. Conventional treatments typically involve medication and lifestyle interventions, such as antidepressants, anti-seizure drugs, exercise, and cognitive-behavioral therapy. However, recent advancements have introduced alternative modalities like light therapy, specifically photobiomodulation (PBM), as promising options.

Photobiomodulation and the Only FDA Cleared Non-invasive Device Therapy

PBM uses painless and non-invasive near-infrared light to regenerate, heal, and stimulate damaged tissue. In sports, PBM has been used for years to improve performance and recovery by increasing muscle strength, speed of muscle adaptation, ventilation rate, and time to exhaustion. It can also decrease inflammation, oxidative stress, blood lactate levels, and muscle fatigue. PBM can be applied before exercise (pre-conditioning) or after exercise.

FibroLux is a handheld, cordless laser therapy device that provides temporary pain relief for fibromyalgia patients. By addressing several of the underlying mechanisms of fibromyalgia, PBM can offer promising options as a non-invasive therapeutic approach. It is the first therapeutic laser to be cleared by the FDA for this purpose. The FibroLux uses low-level laser therapy technology to deliver light to cells, increase energy production, and heal cells. This unique PBM uses low-level lasers or light-emitting diodes to emit specific wavelengths of light that penetrate the skin without causing heat or injury. The process is believed to stimulate cellular repair and reduce inflammation, leading to pain relief and enhanced tissue healing.

The FibroLux laser has shown impressive results in clinical trials, including a 52% reduction in tender points, a 53% decrease in pain, and a 45% reduction in Fibromyalgia Impact Questionnaire scores. The FibroLux is a handheld, cordless laser therapy device with built-in protocols that guide clinicians to apply the therapy to affected tender points on the body. The FDA has granted 510(k) clearance to the FibroLux laser for temporary relief of pain associated with fibromyalgia.