Is There a Connection Between Fibromyalgia and Traumatic Stress? | Print |  E-mail
Sunday, 16 August 2009
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Question:
I'd like to ask Belleruth about the seeming correlation between trauma and fibromyalgia in women.  Has there been any research into this?

Answer:
Mary, I write about this in Invisible Heroes.  At the time of publication there were only 2 studies published, showing the link between fibromyalgia and traumatic stress – for men or women, although either condition hits more women than men.  Now there are too many studies to count, but you can start with a recent article by some Italian researchers, Stisi et al, titled Etiopathogenetic mechanisms of fibromyalgia syndrome. Robert Scaer was on to this years ago, and wrote about it in The Body Bears the Burden.  But the short answer is YES, there is a big, fat correlation.

Here is an explanatory (or at least I hope so) excerpt of the relevant material from my book (and for those of you who have the book, it’s in Chapter 5, The Physical Effects of Trauma, pages 78-80.

Chronic Pain Conditions
This constant activation of the alarm state leads to an accumulation of metabolic waste products in the muscle fibers, and the release of kinins and other chemical pain generators in the tissue, resulting in myofascial pain and the appearance of those seemingly intractable chronic conditions such as fibromyalgia, chronic fatigue, irritable bowel syndrome, chronic headache, TMJ and more.   

And because these conditions are generated in the brain stem and the motor reflex centers in the spinal column, and routed through a perturbed, automatic, arousal circuitry, peripheral forms of treatment provide only temporary relief.  Constantly activated by everyday sensory cues, normal muscle movement and spontaneous memories, symptoms grow and become more and more entrenched over time.  In other words, this is one nasty gift from the kindled feedback loop that, if not interrupted, will just keep on giving.  

Our epidemiology research has already shown us an astounding percentage of people with baffling chronic pain conditions and “functional” diseases that have no obvious causes, who have been found to have prior histories of severe trauma.  Probably if we could tease out the subset of traumatized people who experienced substantial dissociation during their trauma, and a truncated freeze response in the midst of it, we might find closer to one hundred percent suffering from posttraumatic stress.  Unfortunately for them, they are often assumed to be malingering or engaged in attention-seeking behavior for neurotic reasons, instead of suffering from a very serious, self perpetuating condition with a potentially worsening trajectory.

Included in this group of maligned and misunderstood patients would be scores of people suffering from pelvic and low back pain, orofacial and myofascial pain, genito-urinary and abdominal pain; interstitial cystitis; and the previously mentioned headache, fibromyalgia (FM), chronic fatigue syndrome (CFS), and reflex sympathetic dystrophy (RSD); irritable bowel syndrome (IBS), inflammatory bowel disorder (IBD), multiple chemical sensitivity (MCS) and migraine. 

Thanks for asking.  Too many people still don’t know about this connection.
All best,
Belleruth



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Comments (6)Add Comment
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written by Annette , August 18, 2009
My two cents: I have been on two very different types of medications over the years that have mimicked fibromyalgia symptoms.
I cannot take any anti-depressants-they give me muscular side effects. (I have taken an anxiety med that has worked well). And I was prescribed Prilosec--OTC (over the counter) by my gastroenterologist for chronic reflux and Barret's esophagus. Prilosec, its basic ingredient very common in over the counter meds, gave me even more severe muscle ache, pain, and tightness than the anti-depressants. When I looked up the drug on line, the side effects listed could be those similar to the effects of Fibromyalgia. And when I stopped taking it, those symptoms went away. It is my belief that there are alot of unknown, misunderstood conditions that arise with people that are a product of the drugs we are taking; drugs that are both purchased over the counter and prescribed by our trusted physicians, and drugs that are not tested enough and too easily approved of by the powerful pharmaceutical lobby.
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written by emily neale, August 18, 2009
i was diagnosed with ME/CFS earlier this year after having turbulent emotional and physical health for the last 6 years. My worst episodes followed very hectic and stressful times, when there have been alot of external pressures.

i would definately say that even when i was physically healthy in my mid teen years, i lived in 'fight/flight' mode due to domestic unrest.

these last years has definately felt like an accumulation of symptons building in my body, until eventually i collapsed. i think that unrecognised shock and truama from those difficult years with my family was the trigger. I do not blame my family but i do not think i dealt with the true emotions i felt at the time, all i remember is being very angry.



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written by Diane Hovey, Ph.D., August 18, 2009
The connection is very real and is something I see in many of my clients. One of the treatment modalities that produces rapid, positive results is manual lymphatic drainage. Stress and trauma cause / respond to the sympathetic nervous system (SNS). The SNS is concerned with survival and shuts down systems not directly involved with the flight or fight response. That would include digestion and the immune system (lymphatic system). The result in the tissues is a build up of cellular waste material that generates regional inflammation and pain. Manual lymphatic drainage assists in the removal of these waste products and stimulates the parasympathetic nervous system, which reduces stress, decreases pain, and stimulates the continued operation of the lymphatic system. This work coupled with emotional release for the old trauma(s) produces very gratifying results for my clients.
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written by Wendy, August 18, 2009
I was witness to a horrific Car/Train accident several years ago..the resulting terror when ever I came upon a train..in real life, on TV or even a set of train tracks ,I would seize up and the trembling wouldn't stop for hours..this lasted for 3 years or more...I have since been searching for answers to vague pains and symptoms.I have had blood work done for R.A. LUPUS, etc..and all tests have come back within "normal" limits..yet the pain and discomfort continue.....I am convinced after reading this article that my symptoms are not "in my head" and there is a scientific basis for everything I am experencing...I have some new found info to discuss with the M.D. thank you
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written by karen gorrin, ma, lmhc, August 21, 2009
100% YES!! In my professional experience in health psychology and mind-body medicine I can report that 100% of my patients/clients with FMS have a history of trauma (often childhood sexual abuse or/and neglect, and spiritual trauma in addition of physical trauma.) In fact most of my patient/clients with other autoimmune disorders and somatic complaints, digestive upsets, diffuse pain syndromes, and inflammatory conditions also share this history. I believe Imagery, biofeedback, mindful awareness, deep grief work, boundary-setting, and especially Lifespan Integration Therapy (which utilizes imagery) have the keys to healing the body's well-intentioned but maladaptive pattern of self-protection and hypervigilance. Thank you Belleruth for your valuable contribution to this inquiry.

Karen Gorrin, MA, LMHC
Bellevue, Washington
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written by Walter, August 24, 2009
Dr. Hovey and others. I am a psychotherapist and I see many people with PTSD who do not have CFS or FMS. Do you have a sense of why some trauma sufferers with PTSD get CFS/FMS and others do not?

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