Friday, June 15, 2012

Fibromyalgia: Advanced Techniques for the Treatment of Pain

Fibromylagia (FM) is a condition that has proven to be very elusive and challenging to the medical community, clinicians, and more importantly to those who suffer the symptomatic pain and discomfort.  I initially started my investigation into Fibromyalgia in August of 2011, however it took me by surprise how many different perspectives, theories, and central belief systems are currently in the Fibromyalgia landscape.  Therefore I took a significant amount of extra time to absorb and examine...which also lead to some more evolutions in my initial strategy for interventions in pain management.  The subject of this post is to present a blend of current concepts with another innovative concept in an effort to maximize the ability to effectively reduce the constant discomfort and often debilitating pain that can affect quality of daily life and profoundly reduce overall homeostasis.  More importantly, this post examines the mounting current research that suggests the fascia / connective tissue system plays a fundamental role in both the ¨problem¨ and the ¨solution¨.

Fibromyalgia disorder is characterized by wide-spread muscle pain and tenderness at specific soft-tissue trigger points.  Recent studies in the pain processing mechanism have resulted in some significant advances in the understanding of Fibromyalgia.  Although there has not been any definitive evidence of muscle patholgy found in FM, there is growing evidence for dysfunction of the intramuscular connective tissue (or fascia). I have embedded a previously posted article of one of these studies below.


Fascia is richly innervated, and the major cell of the fascia, the fibroblast, has been shown
to secrete pro-inflammatory cytokines, particularly IL-6, in response to strain. Recent biopsy
studies using immuno-histochemical staining techniques have found increased levels of
collagen and inflammatory mediators in the connective tissue surrounding the muscle cells
in Fibromyalgia patients.

There is a significant amount of scientific and physiological details and explanation behind this, however I will save that discussion for another (more comprehensive) post.  This brief introduction is to outline the evidence of a connective tissue / inflammatory contribution to pain in FM.  Therefore, a more practical and focused presentation of the specific strategy to reduce pain is the next step.  

Trans-Fascial Viscoelastic Stimulation
As stated in my previous FM post, massage is a well known and accepted intervention in the treatment of symptomatic pain...therefore any improvements to the delivery, absorption, and effective range of massage is an obvious (and immediate) benefit. One of the most innovative (and effective) evolutions in massage is called Trans-Fascial Viscoelastic Stimulation (TFVES).  Also known as Soft Ball Rolling Massage, this technique was developed by Mr. Leonid Blyum for the specific challenges faced by children with Cerebral Palsy and other disorders of movement and posture.  Using various stress-transfer mediums, the practitioner is able to access the connective tissue / fascia at all levels including the very deepest visceral / core level.  

TFVES is a very comprehensive set of skills, applications, guidelines, and targets that require an extensive process of learning and development...however the overwhelming scientific and clinical evidence shows that is produces extraordinary benefit and contribution to the improvement of connective tissue strength, health, integrity, and homeostasis...therefore reducing fascial dysfunction and the reduction of abnormal pain signalling. 


The complement to the TFVES technique is the implementation of specific kinesiotaping applications.  My 2 previous posts explain in detail about the mechanical and physiological benefits of therapeutic taping, however it is within a different context.  I will introduce some of the same explanation in this post to ensure an adequate link to FM.  

 Kinesio Taping alleviates pain and facilitates lymphatic drainage by lifting the skin. The taped portion forms convolutions in the skin thus increasing interstitial space. The result is that pressure and irritation are taken off the neural/sensory receptors. Then, slowly, pressure is taken off the lymphatic system allowing it to drain more freely.

Not only does this technique stand alone, but in combination with TFVES, the opportunity to effectively reduce pain is significant.  In addition, the scientific evidence shows that TFVES over the long term strengthens the connective tissue system and therefore contributes to long-term reduction of the symptomatic challenges. I highly recommend that you refer to the previous post to get a more in-depth understanding of the physiological benefits.  http://www.thescienceofphysicalrehabilitation.blogspot.com.ar/2012/06/complimentary-strategies-in-cerebral.html 

In summary, the adoption and blending of these 2 specific techniques can generate powerful results.  More importantly, they are skills that can be acquired and therefore can be implemented in a home-based environment.  The One Giant Leap Initiative is designed to provide responsible strategies and systems that can co-exist with most treatment strategies and provide an opportunity for care-seekers to contribute to their own health and well-being.

I have kept this post relatively short, however I will be formulating more comprehensive explanations and descriptions, as well as generating some practical technical demonstrations in the Miscellaneous Toolbox that can be of immediate use.  Any and all specific inquiries, comments, and feedback are welcome.

Happy rolling!

Fibromyalgia and the Fascia Effect

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