Last Updated on February 15, 2024 by melissanreynolds
It’s widely believed that fibromyalgia pain is caused by messages from the brain/nervous system making us think we are in pain, with no damage to the muscles or joints. Newer research is finding good reasons for the pain at the muscular level. Intramuscular Pressure.
In this study, Intramuscular Pressure Is Almost Three Times Higher in Fibromyalgia Patients: A Possible Mechanism for Understanding the Muscle Pain and Tenderness in The Journal of Rheumatology in 2021 researchers found that the intramuscular pressure in the trapezius muscles (muscles that run in a diamond shape across the neck, shoulders and toward the middle back) was three times higher in fibromyalgia patients.
They concluded, “Therefore, FMS as a disorder of exclusively central pain processing should be revisited. Therapeutically, the reduction of muscle pressure may change the clinical picture significantly.”
This should be revolutionizing the understanding of what causes pain in fibromyalgia and how we treat it.
Instead, patients are still getting, some version of, “it’s fibromyalgia, there’s nothing wrong with your muscles, try exercise.”
Muscle Tension, Intramuscular Pressure and Fibromyalgia
In an article What if pain in fibromyalgia is primarily due to increased muscle tension? discussing their findings, the authors say, “When observing the neck x-ray of a patient with fibromyalgia, a loss of the usual lordotic curve without other radiographic abnormalities can typically be found. Instead of a reverse C, the neck looks straight, a potential effect of the high muscle pressure found in patients with FMS.” (my bold)
This is what x rays showed on my intake with the chiropractor, my neck does not have a regular curve. After 20 years of questions, I finally have a concrete looking answer.
After finding these articles, I searched to see if the lead author had contributed to any newer papers on fibromyalgia and found one from 2023.
In a follow up study, published in the same journal (mentioned above) in 2023 they said, “A straight neck without other radiographic abnormalities may be a major anatomical abnormality in fibromyalgia that has gone unnoticed. It may assist in the diagnosis, as well as suggest increased muscle tension/pressure as a possible etiology.” The Vast Majority of Patients With Fibromyalgia Have a Straight Neck Observed on a Lateral View Radiograph of the Cervical Spine: An Aid in the Diagnosis of Fibromyalgia and a Possible Clue to the Etiology (My bold.)
This post comes from a chapter in my next book, it was too important not to share here right now. If you’d like to support me with writing my book and sharing this work, join the launch team and preorder the book.
What does this mean?
Finding abnormalities associated with fibromyalgia feels like a vindication. Especially after chronic, disabling neck pain that has impacted my life, day and night, since I was a teenager. Not to mention the rest of the tight muscles my body harbors.
This has not fully been worked through. Doctor Ginevra has discussed it in some excellent videos on her YouTube channel (you can type in her name and you’ll find her channel). Essentially if muscular tension is a major issue in fibromyalgia, is the central nervous system overactivation then the chicken, the egg or the cohabitating factor. In other words does an overactive nervous system cause the muscular tension, does it simply respond to it and then worsen it or is it a byproduct.
In other words does an overactive nervous system cause the muscular tension, does it simply respond to it and then worsen it or is it a byproduct.
It gives me some understanding of my muscles as well. I can well imagine the pain and fatigue generated by consistently being three times tighter than they are supposed to be. How damaging and exhausting.
It feels exciting to have these findings. If they can find causes of problems, then it’s easier to find answers. Of course it doesn’t change much yet. Except that we can stop throwing the medications currently prescribed for fibromyalgia that doesn’t target muscle pain. We can look after our tense muscles.
My approach for now
My working theory, right now, is that I need to both nurture my nervous system and my muscles. At this point there is no proven way to release that intramuscular pressure.
I’ve done intramuscular needling for several years with a physiotherapist and that is only a short-term answer.
Hot baths, mindful stretching, and gentle chiropractic care seem to help my muscles. But then so does Yoga Nidra guided meditation, calming my nervous system and my body.
Mindfulness of movement, self massage and working on your stress levels can only support.
I’m watching the research, and follow Dr Ginevra’s channel because I know the answers will come.
The lead researcher on the above papers, also a practicing rheumatologist, said he treats patients with muscle relaxants and medicines that calm the central nervous system. So one could consider researching and discussing muscle relaxants with their medical team.
This post comes from a chapter in my next book, it was too important not to share here right now. If you’d like to support me with writing my book and sharing this work, please join the book support crew to be the first to receive a digital copy of the book when it’s complete and extra bonuses.
