Fibromyalgia, Pain & Depression. How much is due to physical misalignment?

I used to think the hu­man ‘ma­chine’ was a poor de­sign.

But I was wrong, it was poor us­age that had made life so painful.

This is my ex­pla­na­tion for chronic pain and the many pain-re­lated syn­dromes cur­rently clas­sified as idio­pathic (the cause is un­known) i.e. fibromyal­gia, restless legs, chon­dri­tis, plan­tar fasci­itis, shin splints, many “IBS” is­sues, frozen shoulder, neck cricks, ten­sion headaches etc …. a long list of symp­toms and con­di­tions that plague the mod­ern world.

This is based on:

  1. My re­cov­ery from nearly 20 years of se­vere de­pres­sion and a life­time of pain.

  2. Anatom­i­cal facts. Logic starts here: midline anatomy & the me­dian plane.

  3. My ed­u­ca­tion and ex­pe­rience in han­dling mam­malian tis­sues as a vet­eri­nary sur­geon (surgery, au­top­sies, butch­ery).

Key Points:

  • Myal­gia of phys­i­cal im­bal­ance. I did not use my main mus­cles of move­ment. I had no con­nec­tion to my Base-Line. No core pillar of strength. No in­ner refer­ence to re­set back to ‘baseline healthy’. My body was phys­i­cally mis­al­igned and im­bal­anced.

  • Phys­i­cal re­stric­tions form in “con­nec­tive tis­sue” (in re­sponse to in­flam­ma­tion and in­jury). This re­stric­tions can be thought of as “stored trauma”. Restric­tions re­duce range of move­ment in­creas­ing the im­bal­ance.

  • Phys­i­cal re­stric­tions ap­ply ten­sions through­out the body. Along “threads”.

  • Ten­sions gen­er­ate pain & weird sen­sa­tions—body-wide. The body ad­justs to avoid pain, adding to the mis­al­ign­ment.

  • Un­ex­plained pain. (of­ten di­ag­nosed as fibromyal­gia these days) that in­creases over time.

  • Self-doubt. Stress. Hypochon­dria.

  • De­pres­sion.

My Story.

I was too young to voice my pain when it started and grew up think­ing ‘stiff and sore’ was nor­mal—that the pains, spasms and weird sen­sa­tions were just a part of life.

Over the years trau­mas built up on my body, re­strict­ing my nat­u­ral range of move­ment (see be­low for ‘stored trauma’). I be­came in­creas­ingly tense and im­bal­anced. I never slept well. A long list of seem­ingly un­re­lated in­juries and symp­toms. There was always pain, and then a lot of self-doubt. De­pres­sion hit hard and en­veloped my life for many years.

My rock-bot­tom was akin to the cru­ci­a­tus curse (an ac­cept­able refer­ence on LW I pre­sume?). Stuck on the floor one morn­ing, scream­ing as the in­tense pain seared through ev­ery part of my body. I was un­able to move, any at­tempt was ter­rify­ing. I could feel my­self go­ing in to clini­cal shock. I hel­pless and I knew it but rather than send­ing me crazy, the pain forced me to sur­ren­der. I ex­pe­rienced a sud­den clar­ity that my body was say­ing “NO MORE”. Some­thing had to change.

Afraid of re­turn­ing to that level of pain and knowl­edge­able enough to know the range of drugs I had been pre­scribed (mor­phine, codeine, parac­eta­mol, naproxen, gabapentin, di­azepam would a) not mag­i­cally fix me b) fuck me right up) I started do­ing Pilates—a few ba­sic ex­er­cises at the eas­iest lev­els. Tak­ing it gen­tly and work­ing with my breath­ing. Over a few weeks, I be­gan to no­tice what mus­cles were ac­ti­vat­ing as I at­tempted to move—of how I braced my­self to do any­thing, of how much move­ment I lacked and how tense and twisted my body was. I was phys­i­cally wrecked.

The day my de­pres­sion lifted as I stood up from a roll-down was the day I knew I could get bet­ter. It was that dra­matic. Like a blan­ket be­ing pul­led from over my head—a shift, a fresh­ness, a hope. A re­lease of ten­sion that had been sup­press­ing me. It felt like a whole new world. The birth day of my Base-Line The­ory Hu­man Health and Move­ment. It wasn’t the end of my men­tal is­sues, I had a lot stored, but it was the turn­ing point to­wards bet­ter.

Re­cov­er­ing my nat­u­ral range of move­ment has been a long slog. Slowly free­ing my body and re­leas­ing all my ‘stored trau­mas’ (see be­low) - both phys­i­cal and men­tal. Im­prov­ing my pos­ture, work­ing to­wards body al­ign­ment and bal­ance by learn­ing to use the right mus­cles.

Ap­prox­i­mate time scale:

Pain ~ Life long. 4+ decades. My ear­liest mem­o­ries.

De­pres­sion ~ 17+ years. Too scared of failure to at­tempt suicide. Too scared of suicide to try an­tide­pres­sants. I hated my­self, the world, ev­ery­thing. An­gry, stressed, mis­er­able—hope­less of ever feel­ing bet­ter. I was bro­ken. I wanted it all to stop.

Rock-bot­tom un­til the day my de­pres­sion lifted ~ 14 weeks. My fear of pain and my sup­port net­work were both strong al­low­ing full time con­sid­er­a­tion of how I was us­ing my body.

Re­cov­ery ~ 4+ years of hard slog. Us­ing my sense of pro­pri­o­cep­tion to slowly my full range of nat­u­ral move­ment. Re­liv­ing and re­leas­ing all the pains and ten­sion I had been car­ry­ing around bring­ing a new sense of bal­ance and calm.

My ear­liest symp­toms were of mus­cle pain = myal­gia.

Myal­gia (from Greek) myomus­cle + al­gos pain.

Ac­cord­ing to:

Base-Line The­ory of hu­man Health and move­ment (Part 3):

BLTH Part 1 , 2

The 5 main mus­cles of move­ment should be un­der full vol­un­tary con­trol for op­ti­mal func­tion­ing of the body.

Op­ti­mal Func­tion­ing—Strong, Balanced and Pain-free.

The body func­tions at op­ti­mum when it is dy­nam­i­cally bal­anced and al­igned i.e. it is free of phys­i­cal re­stric­tions (see be­low) and the main mus­cles are fully util­ised so an ideal pos­ture can be achieved.

Move­ment is smooth and con­trol­led, un­re­stricted through a full range of nat­u­ral move­ment. The head and limbs can all be moved in­de­pen­dently with­out pain or ten­sion whilst the rest of the body re­mains sta­ble.

The midline lin­ear anatomy can be felt to be in al­ign­ment. The Base-Line mus­cles (pelvic floor, rec­tus ab­do­mi­nis) pro­vid­ing the core sup­port from where the rest of the body ex­tends.

We are bal­anced, we are al­igned. A strong con­nec­tion be­tween mus­cles and mind.

I be­lieve this ca­pac­ity is what so many dis­ci­plines are try­ing to demon­strate. (yoga asanas, Tai chi, the in­ter­nal mar­tial arts …)

The 5 (paired) key mus­cles to fo­cus on to im­prove phys­i­cal con­di­tion.
The 5 main mus­cles—cen­tral to healthy move­ment. pelvic floor, rec­tus ab­do­mi­nis, glu­teus max­i­mus, rec­tus fe­moris, trapez­ius­

An ideal pos­ture can­not be main­tained if any of the main mus­cles of move­ment are not fully func­tional or our range of move­ment is re­stricted. Dy­namic al­ign­ment and bal­ance are eas­ily lost—the body be­comes im­bal­anced and we suffer PAIN.

Im­bal­ance, Mimic Mus­cles & Myal­gia.

A func­tional pos­ture is main­tained by the ac­ti­va­tion of parts of other mus­cles (the ‘wrong mus­cles’) in an at­tempt to mimic the ac­tion of the main mus­cles, but stresses are dis­tributed less effi­ciently—ei­ther side of ideal—adding to im­bal­ance. The lo­ca­tion and dis­tri­bu­tion of these ar­eas of ‘mimic’ mus­cle varies, de­pen­dant on:

  • The body’s cur­rent po­si­tion and ac­tion. Stand­ing, sit­ting, bend­ing, walk­ing, climb­ing etc.

  • Ex­ter­nal stresses. Push­ing, pul­ling, lift­ing, hug­ging, throw­ing etc.

  • Phys­i­cal re­stric­tions that are pre­sent. (see be­low)

  • Habits that have formed. e.g. an­ti­ci­pa­tory pos­tures re­cruit­ing mimic mus­cles rather than the main mus­cles.

  • Skewed body map in the mind. Mo­tor sig­nals from the brain in­struct­ing which mus­cle ar­eas to ac­ti­vate fol­low a ‘pat­tern’ but are not over­laid onto the body cor­rectly. (‘pat­terns’ to be ex­panded on in later posts)

  • Other. Any­thing I’ve not thought of yet.

I be­came aware of when mimic mus­cles would ac­ti­vate. The ‘wrong’ mus­cles, ac­ti­vated via mo­tor path­ways that need to be re­pro­grammed to the ‘right pat­tern’ by con­sciously en­gag­ing with the ‘right’ mus­cles.

Mimic mus­cles can­not tol­er­ate the same bur­den as the main mus­cles of move­ment. The mus­cle tis­sue is quicker to fa­tigue and more prone to spasms and strains, re­sult­ing in myal­gia. When ar­eas of mus­cle be­come painful, ‘fresh’ ar­eas of mimic mus­cle are then used. More and more ar­eas be­come stressed and sore as the bur­den shifts around, the body ad­just­ing its pos­ture in an at­tempt to avoid/​min­imise the pain.

If not cor­rected ⇒ im­bal­ance leads to fur­ther im­bal­ance.

Wide­spread myal­gia oc­curs with an im­bal­anced body.

There is a ten­dency to­wards a pat­tern of dis­tri­bu­tion of mimic mus­cle ar­eas and the as­so­ci­ated adap­ta­tions (see be­low) of the body, which are what I be­lieve are the ba­sis of the “ten­der points” as­so­ci­ated with a ‘di­ag­no­sis’ of fibromyal­gia (see be­low) are.

lo­ca­tion of some of the ten­der points tra­di­tion­ally as­so­ci­ated with fibromyal­gia.

From per­sonal ex­pe­rience I say these doc­u­mented ten­der points are the early in­di­ca­tors of an im­bal­anced body and many more ten­der points de­velop (just about ev­ery­where even­tu­ally!) if the un­der­ly­ing is­sue of im­bal­ance and mis­al­ign­ment is not rec­tified.

- - -- ---

(in­ter­lude ….)

Some Thoughts on Bones and Joints.

His­tor­i­cally, the skele­tal sys­tem has been con­sid­ered the ba­sis of the body. Bones re­main, long af­ter we have gone, but it is our main mus­cles that ‘do the work’ - that cre­ate our pos­ture. That al­low us to move.

Stressed mus­cles ‘pull’ on the bones they at­tach to, caus­ing pain that is of­ten mis­in­ter­preted and mis­di­ag­nosed as a prob­lem with a joint.

Bone Imag­ing.

Ra­dio­graphs provide clear images of bone in liv­ing pa­tients.  It has be­come ha­bit­ual to fo­cus on bones and joints be­cause we can see them on an X-ray and ‘di­ag­nose’ a prob­lem.   Mus­cles and con­nec­tive tis­sue are not so eas­ily imaged and con­se­quen­tially, not so con­sid­ered.

Changes to the sur­face of a bone (rough­en­ing, re­mod­el­ling, os­teo­phyte spurs etc.) provide a vi­sual ab­nor­mal­ity for doc­tor and pa­tient to fo­cus on. But WHY have they oc­curred?  Bone is a com­par­a­tively in­ert body tis­sue (bone mar­row is ac­tive) and these changes take time to de­velop.  Although they may be­come clini­cally sig­nifi­cant, bony changes should be con­sid­ered a symp­tom of a prob­lem not the pri­mary is­sue, and should not be used to ‘ex­plain the pain’ with­out sup­port­ing ev­i­dence.

♢ “Trac­tion spur” os­teo­phytes oc­cur where mus­cles at­tach to bone. They in­di­cate a long-term prob­lem where a mus­cle (via its con­nec­tive tis­sue at­tach­ment) is pul­ling on its pe­ri­osteal at­tach­ment caus­ing the pe­ri­os­teum to re­act.

♢ Os­teo­chon­drophytes oc­cur at the car­tilage-bone junc­tion, in re­sponse car­tilage dam­age. This can be due to acute trauma, but more com­monly is “wear and tear” (de­gen­er­a­tive joint dis­ease, os­teoarthri­tis). Are os­teo­chon­drophytes also due to long-term mi­susage of the main mus­cles of move­ment?

An MRI af­ter rock-bot­tom was com­fort­ing. A sense of re­lief at hav­ing ev­i­dence of phys­i­cal dam­age and that the pain wasn’t just all in my head but when I eval­u­ated my MRI I could see the pathol­ogy was old—I’d been liv­ing it with for years. It was not an ex­pla­na­tion for all the pain.

Back Pain.

Stud­ies have shown there is lit­tle cor­re­la­tion be­tween pain lev­els and find­ings on imag­ing the spine (I ex­clude acute trauma and nerve im­p­inge­ment).

Fur­ther read­ing:

Clini­cal guidelines lower back pain—in­cludes refer­ences to var­i­ous stud­ies.

MRI and X-Ray Often Worse than Use­less for Back Pain—An ar­ti­cle worth skim­ming through.

With “back-pain” our at­ten­tion is drawn to the spinal column (ver­te­brae) be­cause:

Fear of the con­se­quences of spinal cord dam­age.

Imag­ing of­ten pro­vides some­thing to look at.

Our ver­te­brae are there to pro­tect the spinal cord. They are NOT a stack of blocks that keep us up­right.

I’ve seen back pain at­tributed to the “rapid” evolu­tion of hu­mans—the sug­ges­tion that our abil­ity to walk on two legs de­vel­oped too fast and our body didn’t adapt it­self to bipedal move­ment.

A face-palm thought now that I un­der­stand the im­por­tance of the ‘five main mus­cles of move­ment’!

Non-spe­cific Lo­ca­tion of Pain.

We tend to use our joints as refer­ence when talk­ing about pain, um­brella terms cov­er­ing a sec­tion of body. ”Oh, it’s my knee.” or “It’s my shoulder.”

But where is the pain? The joint it­self, or the sur­round­ing con­nec­tive tis­sue and mus­cles?

Is the pain always in the same place? Or does the ex­act lo­ca­tion shift around? Even if it’s still your ‘knee’, or your ‘shoulder’? Ex­am­ine your pain.

Get to know your body bet­ter.

Base-Line The­ory of Hu­man Health and Move­ment (Part 4):

Phys­i­cal re­stric­tions in the body:

  • Re­duce range of move­ment.

  • Cause stiff­ness.

  • Ap­ply ten­sion.

  • Gen­er­ate sen­sory feed­back → pain and weird sen­sa­tions.

  • Add to im­bal­ance.

  • In­crease mis­al­ign­ment.

  • Affect the way we move and act.

  • Are ‘stored trauma’ .

  • Can be pal­pated in sub­cu­ta­neous con­nec­tive tis­sues when large enough. (Felt be­low the skin). Lumps, bands, thick­en­ings.

Many oth­ers have noted phys­i­cal re­stric­tions on the body us­ing var­i­ous ter­minol­ogy (‘fas­cia’ is pop­u­lar). I use the cov­er­ing term ‘con­nec­tive tis­sue’ (see notes be­low).

Con­nec­tive tis­sue: The stuff that sur­rounds and links all the other bits of us.

Phys­i­cal re­stric­tions form in ‘con­nec­tive tis­sue’ be­cause of:

1) Trauma, In­flam­ma­tion & Tis­sue Re­pair.

The in­volve­ment of ‘con­nec­tive tis­sue’ in in­flam­ma­tion and the heal­ing pro­cess are well doc­u­mented (but still sub­ject to re­search). The heal­ing pro­cess is com­plex (fibro­pla­sia, gran­u­la­tion, col­la­gen de­po­si­tion etc.), in­volv­ing the cre­ation and cross-link­ing of col­la­gen fibres the main com­po­nent of con­nec­tive tis­sue. (see notes be­low).

Trau­matic in­jury causes af­fected tis­sues to get ‘sticky’. Tear­ing of tis­sues/​vas­cu­lar dam­age, leak­age, in­flam­ma­tory fac­tors etc. Wounds “con­tract”. Phys­i­cal re­stric­tions form e.g. scar tis­sue, sur­gi­cal ad­he­sions.

Main in­juries (what­ever’s bleed­ing or bro­ken) are treated, but the effects of trauma can be wide­spread. e.g. an im­pact shock ra­di­ates through­out the body—micro-tears and micro-re­stric­tions leave an ‘im­print’ of the ‘max-stressed po­si­tion’, effec­tively ‘stor­ing the trauma’ on the body.

The body tries to avoid pain (sig­nals say­ing: watch it! pro­tect!) by mak­ing ad­just­ments above and be­low the in­jury—twists, kinks, tilts and com­pres­sions. This main­tains a ‘func­tional pos­ture’ but in­creases the body’s mis­al­ign­ment and im­bal­ance.

In­flam­ma­tion is a topic too com­pli­cated for me to cover in de­tail. (Here’s one ar­ti­cle as a starter). In­flam­ma­tion can be caused by many things—in­fec­tion (viral, bac­te­rial etc), auto-im­mune (aller­gies etc.), tox­ins etc. but what­ever the cause:

In­flam­ma­tion causes con­nec­tive tis­sue gets sticky = phys­i­cal re­stric­tions in the body.

Ad­den­dum : Novem­ber 2020. Ex­clud­ing recog­nised dam­age to or­gans (lungs, kid­neys etc.), how many of the clini­cal signs of “long covid” are the re­sult of body-wide in­flam­ma­tion and changes in con­nec­tive tis­sue? There is a lot of over-lap with fibromyal­gia (see be­low).

2) Restric­tions as the Body Adapts to Im­bal­ance.

If the main mus­cles of move­ment are not ad­e­quately func­tion­ing the body lacks their cen­tral sup­port. In an at­tempt to com­pen­sate, phys­i­cal re­stric­tions form in con­nec­tive tis­sue, ‘re­in­forc­ing’ ar­eas un­der stress.

Phys­i­cal re­stric­tions may not be no­ticed at first. Like a few loose sticky plas­ters all over, then maybe a few tacks up and down the body, then ropes and glue and nails …

If im­bal­ance is not cor­rected, more and more re­stric­tions de­velop, form­ing chains of mis­al­ign­ments spread through­out the body. The body stiffens.

Micro-re­stric­tions be­come macro and range of move­ment severely limited as con­nec­tive tis­sue be­comes a re­stric­tive scaf­fold.

If not re­leased, phys­i­cal re­stric­tions = stored trauma.

Ten­sions, Pain and Weird Sen­sa­tions.

Along with the myal­gia of im­bal­ance, ten­sions from the phys­i­cal re­stric­tions gen­er­ate sen­sory feed­back re­sult­ing wide­spread pain and weird sen­sa­tions that can oc­cur from head to fingers to toes, along af­fected ‘pat­terns’.

pain comes in many forms.

Body Threads & Pat­terns.

Imag­ine a unique multi-threaded ‘pat­tern’ for ev­ery pos­si­ble po­si­tion of the body. (On what scale? - Ar­range­ment of mus­cle and col­la­gen fibres (see be­low).) Each pat­tern con­sists of threads run­ning to the arms, legs and head con­nected via a cen­tral ‘con­trol board’ - the rec­tus ab­do­mi­nis mus­cles.

When the body has a full range of nat­u­ral move­ment all threads of each pat­tern are free to fully ex­tend and can be perfectly over­laid onto the body map in our mind.

A phys­i­cal re­stric­tion on a thread may ex­ert ten­sion any­where on the whole pat­tern. Move­ment of one part of the body af­fects other parts—pul­ling on a thread and ap­ply­ing ten­sion. This gen­er­ates pain /​ weird sen­sa­tions any­where along an as­so­ci­ated thread and at the ends of the pat­tern—a stab­bing pain, a sud­den itch­ing, tin­ni­tus. Wide­spread symp­toms—a bunch of threads “gen­er­al­ised pat­tern” to lo­cal­ised—threads (acupunc­ture points?).

my­ofas­cial meri­di­ans.

Re­gain­ing a full range of nat­u­ral move­ment is de-kink­ing all the threads through­out the body from cen­ter to ends. The body is a bun­dle of threads. Are they tan­gled, knot­ted or free to fully ex­tend?

The rele­vant sec­tion of the rec­tus ab­do­mi­nis needs to be en­gaged to sup­port the ‘shak­ing out’ of the body, re­leas­ing re­stricted tis­sues. From mid­dle outto work to­wards an ideal pat­tern—ideal pos­ture.

Re­leas­ing Restric­tions.

When an in­jury has healed the body should re­gain a full range of nat­u­ral move­ment by re­leas­ing re­stricted tis­sues and ‘re­set­ting back to baseline healthy’, if not then cu­mu­la­tive dam­age = trauma stored on the body.

I’ve come across var­i­ous ther­a­pies that re­lease phys­i­cal re­stric­tions—“my­ofas­cial re­lease” ap­pears to be the com­mon­est term these days.

Self heal­ing is pos­si­ble.

I worked though and re­leased the phys­i­cal re­stric­tions by:

  • Work­ing from my Base-Line mus­cles.

  • Devel­op­ing my sense of con­scious pro­pri­o­cep­tion.

  • In­stinc­tively feel­ing how to move through and re­lease the phys­i­cal re­stric­tions.

  • Con­stantly mov­ing, work­ing through the ten­sions to re­gain my full range of nat­u­ral move­ment.

  • Let­ting go. Re­lax­ing. Let­ting the ten­sions work their way out.

  • Work­ing to­wards al­ign­ing my body. Imag­ing a rib­bon from pelvic floor to back of the head. Full ex­ten­sion, smooth rib­bon is al­ign­ment.

Phys­i­cal re­stric­tions: I have felt ‘re­leases’ - pops, cracks, krup­pals all over. I have seen them, I have heard them. Work­ing through the pain and ten­sion. Slowly re­gain­ing my nat­u­ral range of move­ment, guided by my Base-Line.

The sounds and sen­sa­tions of re­leas­ing re­stric­tions might be scary at first—a noise, a twinge, a shock—but they FEEL RIGHT. Never force any­thing.

As I re­leased phys­i­cal re­stric­tions I had men­tal re­leases too. A ses­sion of move­ment, us­ing the roll down, work­ing from my Base-Line and mov­ing as felt good. Ex­pe­rienc­ing the phys­i­cal re­leases, then feel­ing a build up of stress, flashes of trauma—mem­o­ries and emo­tions that also needed to be re­leased --> a melt-down, cry­ing, scream­ing, feel­ing my face writhe as the ten­sions worked them­selves out. The deep sob­bing ex­tend­ing my Base-Line, my body un­wind­ing and some stress be­ing re­leased. (phys­i­cal re­stric­tions a com­po­nent of PTSD? ‘phys­i­cal mem­o­ries’). anger, fear, self-loathing … Ex­pe­rienc­ing my is­sues and then the de­tails were gone, his­tory. A sense of calm af­ter­wards. Learn­ing to let the re­leases hap­pen then let them go. No longer em­bar­rassed or ashamed of be­ing a mess. Know­ing I was mak­ing progress..

The mind-body wants to heal and re­turn to a state of bal­ance and al­ign­ment. Made pos­si­ble when the cen­tral frame­work of the main mus­cles of move­ment is ac­tive.

Heal­ing in­volves re­leas­ing the re­stricted tis­sues and re­gain­ing a full range of move­ment—in­clud­ing re­turn­ing to po­si­tion­ing of trauma. Re­live to re­lease, work­ing from Base-Line to al­ign­ment.

Idio­pathic Pain Con­di­tions.

Idio­pathic: “De­scribing a dis­ease or con­di­tion the cause of which is not known or that arises spon­ta­neously”

Fibromyal­gia is the cur­rent favourite la­bel for pain-re­lated symp­toms that are idio­pathic, but “fibromyal­gia” is just a la­bel for a col­lec­tion of clini­cal signs—it is not a di­ag­no­sis or an an ex­pla­na­tion of the pain

No known cause = No known cure.

Cur­rent Re­search into Idio­pathic Pain Con­di­tions.

Modern re­search tends to fo­cus on break­ing things down into smaller and smaller parts. We have gained a lot of knowl­edge (and con­fi­dence) by tak­ing this ap­proach.

A good un­der­stand­ing of cel­lu­lar func­tion and the chem­istry of our bod­ies has al­lowed the de­vel­op­ment of effec­tive treat­ments for many con­di­tions.

The abil­ity to find small differ­ences in our DNA is an amaz­ing feat of hu­man in­no­va­tion and tech­nol­ogy, con­tinu­ally ad­vanc­ing our un­der­stand­ing of ge­netic con­di­tions.

We look deeper and deeper into micro-lev­els of how our body works (the physics of biol­ogy and chem­istry) look­ing for an ex­pla­na­tion for all the pain—try­ing to find ‘ab­nor­mal’ phys­iolog­i­cal com­mon­al­ities be­tween pa­tients in pain, and then find­ing a chem­i­cal that will change them. But look­ing for sub­tle bio­chem­i­cal changes or nerve dys­func­tions to ex­plain fibromyal­gia and other (cur­rently clas­sified as) idio­pathic pain syn­dromes will not be suc­cess­ful in my opinion.

We should con­sider the whole.

We are in­ter­con­nected from head to fingers to toes.

Macro-dys­func­tions.

When the body be­comes un­bal­anced and mis­al­igned it is a “macro-dys­func­tion”—a prob­lem with the whole. Which, with­out cor­rec­tion, will con­tinue to worsen.

Some­where sore, stressed, in­jured --> pain --> dam­aged tis­sues --> phys­i­cal re­stric­tions --> re­duced move­ment --> ten­sion --> im­bal­ance --> mis­al­ign­ment -->sen­sory feed­back say­ing “prob­lem” --> pain --> weird sen­sa­tions --> fear --> re­stric­tion --> stiff­ness --> ten­sion --> pain --> fear --> anx­iety --> de­pres­sion.

I be­lieve only when the main mus­cles of move­ment are fully util­ised and the body is dy­nam­i­cally al­igned can the­myal­gia of im­bal­ance and ten­sions of phys­i­cal re­stric­tions be ruled out as the cause of oth­er­wise un­ex­plained pain. But how does an im­bal­anced body and phys­i­cal re­stric­tions in con­nec­tive tis­sues ex­plain the myr­iad of weird sen­sa­tions and pain-re­lated symp­toms—differ­ent for ev­ery in­di­vi­d­ual sufferer but with com­mon­al­ities that can be grouped into pro­gres­sive stages of dys­func­tion and pat­terns of symp­toms?

In­di­vi­d­ual Trauma Im­prints & Stored Trauma.

Where phys­i­cal re­stric­tions form is di­rectly in­fluenced by what a body has been sub­jected to. An in­di­vi­d­ual’s life ex­pe­riences. A phys­i­cal record of what the body suffered, cre­at­ing our unique ‘in­di­vi­d­ual trauma im­print’ and with it a unique col­lec­tion of pain-re­lated symp­toms.

Every trauma (in­jury, in­flam­ma­tion, stress) leaves an im­print in con­nec­tive tis­sue (scar tis­sue, sur­gi­cal ad­he­sions are well known ex­am­ples). This al­ter­a­tion to con­nec­tive tis­sue causes a re­stric­tion -a stiffen­ing, a re­duc­tion in move­ment (may be on a microscale so not no­ticed—the body is very adapt­able).

A trauma im­print is re­leased if a body re­turns to a full range of move­ment, oth­er­wise it be­comes ‘stored trauma’.

Stored trauma ap­plies ten­sion along the spe­cific pat­tern the body was in at the time of trauma. e.g. an im­pact shock ra­di­ates through­out the body—micro-tears and micro-re­stric­tions leave an ‘im­print’ of the ‘max-stressed po­si­tion’, effec­tively stor­ing the trauma on the body. (?com­po­nent of PTSD) “mem­ory of the stress”.

As the body adapts to the effects of mis­al­ign­ment it be­comes more re­stricted—im­bal­ance leads to fur­ther im­bal­ance. A grow­ing list of nig­gles, aches and pains. Resi­d­ual effects from old in­juries, a grow­ing list of com­plaints over time. ‘Pat­terns’ of symp­toms de­velop ac­cord­ing the gross pat­terns most af­fected by phys­i­cal re­stric­tions (my­ofas­cial meri­di­ans etc.)

My Ex­pe­rience of ‘Fibromyal­gia’.

From:

(New Latin) fibro ≃ of fibrous tis­sue + (Greek) myo ≃ mus­cle + al­gos ≃ pain

The pain and ten­sion of an im­bal­anced and re­stricted body?

Con­stant pain. A whole list of things that are poorly ex­plained. Symp­toms that come and go and then come back again. Worse and worse over time.

The foot spasms, shin splints, sore knees, pul­led ham­strings, pelvic pains, chronic ‘bad back’, ab­dom­i­nal pains, sore ribs, burn­ing shoulder, stiff neck, crunch­ing jaw, headaches … The ran­dom shocks, spasms, sud­den in­tense itch­ing, stab­bing, bit­ing and gnaw­ing sen­sa­tions.   The chest palpi­ta­tions, ab­dom­i­nal ‘puls­ing’, restless legs, eye twitches, white fingers, numb­ness, sud­den ex­treme fa­tigue feel­ing and pins and nee­dles in my arms and legs.

I had no idea how stiff and re­stricted my body was. No idea the phys­i­cal pain was the cause of my de­pres­sion and emo­tional is­sues. They had always felt like a fault with “me”, that I was a failure. I doubted my pain, my­self, my abil­ities. I shut­down, I hid. My emo­tional is­sues have been re­leased dur­ing my phys­i­cal re­cov­ery. Stored trau­mas—fi­nally healed.

My Com­ments on Fibromyal­gia.

To those with ‘fibro’:

  • A di­ag­no­sis of fibromyal­gia may be a recog­ni­tion of your suffer­ing, but it is a la­bel—not an ex­pla­na­tion.

  • Med­i­ca­tions may mask some symp­toms but won’t cure the pain.

  • Im­bal­ance is a phys­i­cal prob­lem that af­fects body and mind.

Ask your­self:

  • How is your range of move­ment?

  • Do you feel bal­anced, al­igned?

  • Is there ten­sion on your body?

What to do:

Find your Base-Line and de­velop your sense of con­scious pro­pri­o­cep­tionFeel how to heal .

  • Get to know your body. Keep notes. Look for pat­terns. Ac­knowl­edge your pain.

  • Don’t ex­pect some­one else to fix you. They won’t.

  • This is a do-it-your­self ap­proach.

  • Keep mov­ing. Move­ment and re­leas­ing of phys­i­cal re­stric­tions is why tai chi, yoga, and other ex­er­cises do help -when you are us­ing the right mus­cles.

To clini­ci­ans:

Look for im­bal­ance. The body mis­al­igned, tense, re­stricted and in pain. A holis­tic ap­proach to a macro-dys­func­tion.

The clini­cal pre­sen­ta­tion of myal­gia due to im­bal­ance is vari­able, in­fluenced by:

  • The suffer­ers biggest con­cerns—what they are cur­rently most wor­ried about. The pri­mary com­plaint/​s ver­sus symp­toms that get ig­nored, clas­sified as not so se­ri­ous or are so chronic they are barely men­tioned. Peo­ple can get used to a lot of pain.

  • Du­ra­tion of dys­func­tion. Symp­toms will only spread and worsen over time if the body is im­bal­anced.

  • An in­di­vi­d­ual’s trauma im­print—what the body has been through. The stored trauma of a pa­tient’s life-ex­pe­rience. (see above for more de­tails)

  • The qual­ity of his­tory-tak­ing and clini­cal exam performed.

As a start­ing ex­am­ple: The nuchal lig­a­ment is an easy ac­cessed piece of midline anatomy - ‘our sec­ondary guide for al­ign­ment’ but an easy first check for al­ign­ment. The nuchal lig­a­ment should be eas­ily pal­pated when the trapez­ius mus­cles are free to fully move. If not—the body is im­bal­anced. How many clini­ci­ans give the nuchal lig­a­ment much/​any con­sid­er­a­tion?

The end of main sec­tions, the fol­low­ing is ….

Some Notes On:

[Sim­ple notes to main­tain my san­ity. There’s much more in­for­ma­tion out there if you are will­ing to go down the rab­bit hole of re­search and if any­one has thoughts to add I would love to hear.]

Con­nec­tive Tis­sue.

Con­nec­tive tis­sue sur­rounds and con­nects mus­cles and bones, sus­pends in­ter­nal or­gans, runs through those or­gans and wraps around in­di­vi­d­ual cells—it’s ev­ery­where!

A body-wide web of fibres through­out the body.

There are many types of con­nec­tive tis­sue—vary­ing in com­po­si­tion, or­gani­sa­tion and scale. The differ­en­ti­a­tion and delineation be­tween ‘con­nec­tive tis­sues’ isn’t always clear. I in­clude the ex­tra­cel­lu­lar ma­trix (see be­low) in my thoughts.

Con­nec­tive tis­sue:

A spec­trum of fibres, cells, wa­ter -

from solid and tough

to fuzzy and goo.

For ex­am­ple, con­nec­tive tis­sue runs through and around ev­ery mus­cle:

  • Every sin­gle mus­cle cell (mus­cle fibre) is sur­rounded by con­nec­tive tis­sue called en­domy­sium.

  • Mus­cle fibres are grouped into bun­dles sur­rounded by con­nec­tive tis­sue called per­imy­sium.

  • Then the whole mus­cle is sur­rounded by more con­nec­tive tis­sue called the epimy­sium.

Bone:

  • Bones are sur­rounded by a mem­brane of dense ir­reg­u­lar con­nec­tive tis­sue called pe­ri­os­teum.

  • Bone ma­trix is a col­la­gen scaf­fold for the de­po­si­tion of bone min­er­als.

Soft tis­sues:

  • reti­c­ulin is the sup­port­ing mesh­work in soft tis­sues such as the liver and bone mar­row. Formed from the cross-link­ing of col­la­gen III fibrils (fibrils see be­low) named ‘retic­u­lar fibres’ .

The broad clas­sifi­ca­tion cat­e­gories for con­nec­tive tis­sue are:

Dense or loose—Solid or soft. Depend­ing on the amount and type of col­la­gen.

Reg­u­lar or ir­reg­u­larwhether the col­la­gen fibres ar­ranged in par­allel or not.

  • Ir­reg­u­lar con­nec­tive tis­sue (loose and dense) is found mostly lay­ers of the der­mis (skin) and adi­pose (fatty) tis­sue—sur­round­ing and en­velop­ing the rest of the body.

  • Spe­cial­ised con­nec­tive tis­sue in­cludes ten­dons, lig­a­ments, aponeu­roses, car­tilage, fas­cia, bone, teeth, meninges, pleura, per­i­toneum, per­i­cardium etc.

The linea alba, nuchal and supraspinous lig­a­ments—our midline lin­ear guides for al­ign­ment—are con­nec­tive tis­sue.

Ex­am­ples of con­nec­tive tis­sue—this is a tough, thin sheet known as an aponeu­ro­sis.

Con­nec­tive tis­sue runs through the body grossly or­ganised in myo-fas­cial meri­di­ans. Well illus­trated by the “anatomy trains” se­ries of pub­li­ca­tions (go-oogle images to see these lay­ers of the body illus­trated—fas­ci­nat­ing stuff if you’ve not thought about how you are put to­gether be­fore.)

Con­nec­tive tis­sue struc­tures are com­pli­cated—and very prone to pain. For in­stance the pelvic re­gion. The image be­low shows the pelvic floor mus­cles and sur­round­ing con­nec­tive tis­sues. Much of the con­nec­tive tis­sue at­taches to the sacrum and lum­bar spine (not shown). Pain in this re­gion is com­mon, both in the mus­cles and form con­nec­tive tis­sues.

Con­nec­tive tis­sue struc­tures of the pelvic re­gion. (Some com­pli­cated anatomy prone to pain and strain).

Con­nec­tive tis­sue can be thought of as a body-wide web of col­la­gen fibres.

Col­la­gen—some notes.

Col­la­gen is the most abun­dant pro­tein in the body. 25-35% (figures vary be­tween sources) of the body’s pro­tein is col­la­gen.

a ma­jor struc­tural pro­tein … pro­tect­ing and sup­port­ing the softer tis­sues and con­nect­ing them with the skele­ton. Twenty-eight differ­ent types of col­la­gen have been iden­ti­fied in ver­te­brates. Source.

Col­la­gen is the ma­jor in­sol­u­ble fibrous pro­tein in the ex­tra­cel­lu­lar ma­trix and in con­nec­tive tis­sue. 80 – 90 per­cent of the col­la­gen in the body con­sists of types I, II, and III. Source. (Out of date on the num­ber of col­la­gen types but a good ground­ing in col­la­gen.)

Col­la­gen con­sists of

col­la­gen fibres which are ‘ropes’ made from co­va­lently bonded strings of

col­la­gen fibrils which are bun­dles of

col­la­gen molecules which are triple-he­lices of

polypep­tides (α chains) which strings of a re­peat­ing se­quence of 3

amino acids ‘twisted’ around each other.

. ​

The 3 amino acids (the build­ing blocks of pro­teins) de­ter­mine the type of col­la­gen. Most col­la­gen in the hu­man body is type I where the amino acids are ‘glycine-pro­line-hy­drox­ypro­line’ that form a tight triple-he­lix that form ‘straight’ fibrils that bond well to cre­ate strong col­la­gen fibres.

Ex­tra-Cel­lu­lar Ma­trix (ECM).

Links to : con­cepts of ECM , khan video—com­plex­ity and re­search re­gard­ing ECM.

Col­la­gen is the most abun­dant fibrous pro­tein within the in­ter­sti­tial ECM … Elastin and Fibronectin source—stiffen­ing etc.....

Micro-Com­po­nents of Po­si­tion­ing.

mus­cle fibre = my­ocyte = a sin­gle mus­cle cell: Di­ame­ter 10 to 100 µm (microme­tre) source. And what is the width of an in­tra-cel­lu­lar fila­ment in a mus­cle cell? IDK

The width of a col­la­gen fibre: Di­ame­ter 1 to 20 μm (microme­tre) source.

Threads—fibres—to be straight­ened and al­igned on the ideal pat­tern of the body.

The ar­range­ment of mus­cle fibres, col­la­gen fibres. are they al­igned for a full range of nat­u­ral move­ment. The width of a col­la­gen fibril. A col­la­gen molecule. How small to go?

Not so ran­dom last words—if you’ve made it this far—thank you—I’m just not sure what to do with the fol­low­ing:

Restric­tions: Protein fibres. Bond­ing, cross-link­ing, like velcro?

ar­range­ment of col­la­gen, elastin, fibronectin … Align­ment of fibres...

Pro­teo­gly­cans—Large molecules con­sist­ing of a core pro­tein with one or more co­va­lently at­tached gly­cosamino­gly­cans (GAG).

Are you bal­anced and al­igned?

Phys­i­cally and men­tally?