by Maureen Salamon,
People with FM deal with a great amount of chronic pain resulting from muscle stiffness and soreness. This can be incapacitating, as pain can range from moderate to extreme. It is vital that people with FM learn to manage their pain in whatsoever method works best for them. Each individual will have diverse techniques to comfort and deal with pain, and it is essential to establish a routine based on what works best for individuals.
There is no cure for FM, so pain management is the most significant focus of treatment. Pain management can include exercise practices, medications, stress-relief methods, and other practices. Another kind of pain management is done through an implanted occipital nerve stimulator. This has lately been verified as advantageous for those with FM pain.
An implanted device that destroys the nerves at the nape of the neck has improved pain and quality of life for people with FM. This treatment is associated with alteration in activation patterns of the areas of the brain that produce pain response.
The technique is normally used for extreme leg pain, back pain, and headaches, but Dr. Thimineur is one of just a handful of physicians who practice nerve stimulation to treat FM, a poorly understood and hard-to-diagnose condition noticeable by widespread pain and soreness.
The Food and Drug Administration (FDA) has not approved nerve stimulation for FM. It is considered an experimental treatment and is used exclusively in people with near-disabling FM who have failed to respond to other treatments.
A Belgian scientist treated small numbers of FM patients with “occipital nerve stimulation,” which provokes the occipital nerves just underneath the skin at the back of the neck by means of an implanted device. Dr. Mark Plazier found that pain scores dropped for twenty of twenty-five patients using this device over six months and their quality of life enhanced considerably.
“There are only a few treatment options [for FM] right now and the response to treatment is far from hundred percent, which implies there are a lot of patients still looking for help to get a better life. This treatment might be an excellent option for them,” said Plazier, a neurosurgeon at University Hospital Antwerp. But, “it is tough to determine the impact of these findings on FM patients, since larger trials … are required.”
Plazier is to present his research at a meeting of the International Neuromodulation Society, in Berlin. Neuromodulation is a group of treatments that use medical devices to relieve symptoms or reestablish abilities by changing nerve system function.
Research presented at scientific conferences has not normally been peer-reviewed or published and is considered preliminary.
Plazier also presented a separate study on six FM patients using PET scan images to visualize brain alterations from occipital nerve stimulation treatment. It proposed that the nerve stimulation alters activity in the limbic system, a brain region that helps regulate pain perception.
“In FM, we understand that there is a hypervigilance to pain, so patients are extra sensitive to pain and more aware of it,” Plazier said. “They also have high scores on questionnaires about catastrophizing behavior, which suggests the high impact of pain on their lives.”
“During [occipital nerve] stimulation we see differences in brain activity on PET scans in regions involved in pain,” he added. “This all might suggest that we are influencing a cerebral system and might even turn it back to ‘normal’ perception.”
Study participants didn’t find the nerve-zapping treatment to be painful, Plazier noted. The occipital nerve stimulation device is implanted during a brief surgical procedure using general anesthesia, he said, and postoperative pain is common but not dangerous.
Nerve pain is a very huge part of FM. As patients who suffer from fibro pain know, this nerve pain causes the whole body to ache. Research indicates the pain control system in the skin, spinal cord, and brain of FM patients is overloaded, clarifying why those with fibro incline to ache all over. In particular, immune cells that usually do not cause pain contribute to the flu-like fibro symptoms that make the whole body ache.
It is expected to be many years before nerve stimulation becomes a normal treatment for FM. The way we are using nerve stimulation is more of a paradigm shift.
People with FM are constantly looking for different methods to control their pain. Nerve stimulation in an aggressive measure that can make a positive influence on those who are suffering significantly from pain.
Others choose non-invasive methods, including massage, exercise, and other. People with FM frequently receive massage, either from an expert or at home. Those who choose to see a specialized expert should notify the masseuse of the condition and be certain that the bodywork done is gentle and not painful. Massage done at home can also be helpful in decreasing pain, as it can be done every day and at a person’s convenience. At home massage can be done with a tennis ball, smoothly rolling over tight and sore muscles with gentle pressure.
Another treatment involves movement and exercise. Exercise can increase serotonin levels in the brain and can lead to positive affect. There are a few kinds of exercise that are suggested for people suffering from FM pain. Yoga is a great technique to gain flexibility, power and strength. Restorative or gentle yoga is beneficial for people who have FM, as this type of yoga moves gradually and is gentle. Tai Chi has also been recommended, as it includes steady slow movements and conscious breathing. Practicing yoga or tai chi can decrease stress levels and can be meditative for people, letting them to take a break and ease their mind and body.
Warm showers or baths can also be helpful, particularly in the morning as many people wake up with excessive stiffness in their muscles and joints. Taking a warm shower or bath will relax muscles and improve some stiffness. There are numerous different treatments for FM pain management, and individuals should consult with a physician to find the treatment program suitable for them.
Mark Plazier, M.D., neurosurgeon, University Hospital Antwerp, Belgium; Patrick Wood, M.D., director, fibromyalgia clinic, Madison River Oaks Medical Center, Canton, Miss.; June 10-12, 2013, presentations, International Neuromodulation Society meeting, Berlin