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Fibromyalgia

Fibromyalgia syndrome (FM) is one of the three most common conditions seen by rheumatologists. It is a complex, chronic condition of unknown cause affecting an estimated three to six million Americans. It is 10 times more common in women than in men. Most patients are women between the ages of 30 and 60.

Patients typically complain that their muscles and joints ache all over. A large number of other symptoms are often present including fatigue or pain, (ranging from a dull aching, flu-like discomfort to more severe discomfort). Other symptoms may include body stiffness in the morning, after prolonged periods of sitting or standing in one position, or with changes in temperature or relative humidity. When FM patients try to avoid pain, they can complicate the condition with compensatory movement patterns.

Patients may complain of sleep disturbances or cognitive difficulties such as difficulty concentrating, "spaciness," memory lapses, and being overwhelmed easily. Some patients develop irritable bowel or bladder, digestive disturbances, abdominal pain, bloating, constipation and/or diarrhea. It is not unusual to have swelling, numbness or tingling of fingers or toes, cold hands or feet, itchy, dry or blotchy skin.

Patients may experience headaches, TMJ or facial pain, depression or anxiety. On examination, areas of tenderness called "tender points" can be seen in characteristic locations. Most patients can be helped quite a bit with manual therapy.

Fibromyalgia has been called soft-tissue rheumatism because it primarily affects muscles. Unlike arthritis, fibromyalgia does not cause pain or swelling in the joints. Rather, it produces pain in the soft tissues, around joints and throughout the body. Severity of pain varies from day to day and can change location. Pain may become more severe in parts of the body that are used the most (the neck, shoulders and feet.) In some people, the pain can be intense enough to interfere with daily tasks, while in others it causes only mild discomfort.

It has been suggested that the pain of FM is related to micro-trauma in deconditioned muscles and that exercise works by conditioning these muscles (Bennett, 1989). However, some tender points are not over muscles or tendons, such as those over the inside fat pad of the knees (Smythe 1989).

It has also been suggested that FM may be due to non-restorative deep sleep (Moldofsky 1975, 1993). Patients with FM often report insomnia, trouble staying asleep or light sleep, with an increase in symptoms after disturbed sleep (Campbell 1983). Despite sufficient amounts of sleep some nights, FM patients may awaken feeling unrefreshed, as if they have barely slept. Controlled research trials have confirmed the value of aerobic exercise in the treatment of FM (McCain 1988). Exercise appears to increases time spent in deep sleep (Hobson 1968), which may be a mechanism for its therapeutic effect.

Development of the syndrome may involve a predisposing (possibly inherited) factor. There may also be a precipitating factor, such as trauma (accident, fall or injury), illness, disease, infection, emotional stress or sleep disruption that acts as a trigger. In order to make a diagnosis of Fibromyalgia, the following symptoms are required:

  1. Widespread pain lasting a minimum of three months.
  2. Pain located in at least 11 of 18 specified tender points around the neck, shoulders, chest, hips, knees, and elbows.

Treatment modalities that have proven effective include manual soft tissue therapy such as the work we perform at Clear Passage Therapies, medications, whirlpool, hot or cold packs, relaxation techniques. Yoga, acupuncture and daily, gentle, low impact aerobic exercise have also been effective for some patients. Patients should start out with just 3 to 5 minutes of exercise every day and gradually increase as tolerated, up to 30 minutes a day.

Almost 45 million people in the United States live with frequent headaches. About seven million people get debilitating headaches that last for hours at a time, at least every two days. It is estimated that 157 million workdays are lost due to headaches. Two billion dollars are spent on over-the-counter painkillers to treat headache symptoms each year.

Fibromyalgia Treatment:

Therapy Without Surgery or Drugs

Treatment methods for fibromyalgia vary significantly. Many people do not obtain pain resolution after conservative treatment such as traditional physical therapy and medications. AtClear Passage, we have been successful helping many people who have been unable to find pain relief with other methods.

We treat difficult, persistent fibromyalgia pain with unique treatment methods. From your first visit, we use a "hands-on" approach to treat your symptoms and discover the cause of your pain. We begin by treating tight and dysfunctional areas in your body.

A few minutes into your first treatment, our therapists will be providing a gentle stretch for a sustained period of time to areas of your body where we feel abnormal tensions. This has been very effective in decreasing and frequently resolving pain symptoms. Goals of treatment include restoring alignment, balance and mobility to the pelvis, sacrum, thoracic and lumbar spines. We address headaches, neck, back and hip symptoms. We will treat the affected connective tissues, and abdominopelvic organs. Other treatment goals focus on decreasing pain and restoring range of motion. We work with you to improve your function and your tolerance for physical activity to return you to an active, productive lifestyle.

For several years, Clear Passage therapists have instructed physicians, doctors and dentists of the prestigious American Academy of Head, Neck, Facial Pain and TMJ Orthopaedics in a "whole body approach" for treating head and neck pain associated with this condition. Many of these physicians feel that the "missing link" in physical therapy for treatment of fibromyalgia is to address the structural, full body component. If the pelvis, spine, neck and fascial support structures of the head, neck and jaw are under stress and out of balanced alignment, body pains and headaches will frequently occur as a result.

Our treatment is unique, and designed to complement your physician’s care. We use a "hands-on" approach to treat your symptoms and to discover and treat the causes of your pain. We examine and treat all affected areas. We may begin with the lower back and pelvis to create a stable foundation for your spine. This will indirectly affect the joint mobility, tissue tension and ranges of motion of the back and neck tissues and structures. Then, we work to restore alignment, balance and mobility to the head, jaws, neck and shoulder girdle (including connections to the upper rib cage and thoracic spine), muscles, connective tissues, and organs. We provide a gentle stretch for a sustained period of time to areas of the body where we feel abnormal tension. This generally reduces or resolves pain symptoms . Goals of treatment include decreasing pain, increasing range of motion, improving function and tolerance for physical activity with return to productive lifestyles.

Our directors spent years studying techniques and developing protocols to restore patients’ bodies to a state of balance, harmony and increased function. Treatment sessions are individualized and last approximately one hour based on individual needs. Treatment is one-on-one, and is in private treatment rooms. From your first visit, we use a "hands-on" approach to treat your symptoms and discover the causes of your pain. We begin by treating tight and dysfunctional areas in your body.

What should I expect from treatment?

The best way to determine if this work will help you is to schedule two or three visits. After three visits, most patients find their pain level noticeably improved. After six visits, they begin to notice significant structural and functional improvement in their bodies. Our goal is to help you achieve a pain free, more functional and productive life, with all your goals met.

If you have questions, we can schedule a personal consultation in one of our clinics or over the telephone. If treatment appears indicated, we will send you all necessary paperwork including a medical history questionnaire and release of medical records. We may request clearance from your physician for the very few conditions which would prevent us from treating you. These include diseases such as HIV and active cancer which could possibly worsen with treatment. Other contraindications are hemophilia, abnormal cysts and active infection.

Your treatment is always conducted in a lovely, private room. The first treatment includes an initial evaluation, and lasts up to 1½ hours. Thereafter, treatment sessions are generally 45 minutes of uninterrupted manual therapy. As manual therapists who often work on delicate areas, we are sensitive to your physical and emotional comfort level. We feel you should be fully informed in every step of treatment. We take the time to explain our theories and techniques while we are working with you. Your personal privacy is respected. Patient gowns are available each session for those who would like to use them.

Treatment feels similar to massage but calling our work massage is like calling the space shuttle an airplane. Our work is a very "site specific" slow and deep body work to the soft tissues of your body. We use our hands to locate abnormal tensions in and around the organs, muscles, connective tissues and support structures of the body. We then apply gentle, specific sustained manual forces designed to reduce adhesions and encourage normal mobility, tone and function. Most patients say they find treatment sessions interesting, informative and relaxing. Most patients with pain complaints usually begin to notice pain reduction or relief after the first two or three sessions.

Therapist Qualification

Therapist qualifications are a significant part of your comfort level. We invite you to visit our "About Us" page. Belinda Wurn is a physical therapist with more than 20 years experience. Larry Wurn is a massage therapist with more than 10 years experience. Both are nationally certified body workers who have performed literally thousands of manual therapy treatments. They are therapists trained and licensed to practice manual ("hands-on") therapy in Florida in their respective fields of physical therapy and massage therapy.

Following licensure, they both attended extensive continuing education courses, as well as many courses on manual pelvic, urogenital and abdominal therapy treatment in America. They furthered their education by studying manual urogenital therapy at an osteopathic medical school in France. Their goal is to provide a quality and level of service which is unavailable anywhere in our area. Clear Passage Therapies’ staff is committed to give our patients the finest one-on-one treatment available, in a relaxed and healing setting.