What Treatments Help Me with Fibromyalgia: As Tested During Lock-down

Here I share eight treatments that help me with fibromyalgia and myofascial pain syndrome. There is nothing like a challenge for a treatment that we think helps to ensure it works. The pandemic has been a good time to test all of my coping mechanisms.

Being at home with three small, high energy boys, much of the time alone, while trying to work 20 hours and manage my health has been a massive challenge.

But here’s the thing. Despite my neck and back being harder to manage -average pain levels went from mild to moderate – I had only one neck migraine attack and that was the first weekend. So what treatments help? What have I been doing?

what treatments help me with fibromyalgia during the lockdown

Here are the treatments that help me the most

Electric heat pad

This has been my best purchase of 2020. Instead of dragging myself out of bed, standing in front of the microwave for the heat pack to warm and then trying to get it in the right spot – I just press a button and have whole back and neck warmth. It’s been the best help.

Physiotherapy

I knew this helped my neck but man it helps my back too. After more than two months without being able to see my physio my entire back and neck were flaring. I also had trigger points in my chest, arms and legs. The acupuncture needles in the neck, shoulders and upper back had flow on effects. So did the ultrasound the physio did on the middle and lower back while the needles were in the top. That feeling of all my back ribs forming a cage on my back muscles and drawing tighter came back. My lower back, glutes and upper legs were tight. Surprisingly, my neck coped alright without the needles. I thought this was a guaranteed truth. So this was a mixed finding and I’m not sure what to do with this.

what treatments are helping me most with fibromyalgia

Self-trigger point work

Following from the above point, my self-trigger point work helped me manage so much better than I thought. With the additional computer work with my new job I was needing to manage trigger points in my SCM. This one I tilt my head to the side and rub down, pressuring trigger point I find on that tight wire like muscle. My upper trapezius trigger poibts required a lot of work between my hands and theracane massager.

Regular dynamic stretches

These have been the best learning ever. After years of static stretching doing little for my neck, my dynamic stretches for my neck are so useful for keeping those neck trigger points in check. It also helped me notice where the trigger points are restricting range of movement so I can tackle them first.

Yoga, meditation and breathing (three treatments that help in one)

When we first went into lock-down my chest was constantly heavy and tight – not from being sick, from the anxiety of the situation. Take the ability to plan from a person who uses strict planning to survive and you get the perfect breeding ground for anxiety. My breathing practices got me through this.

Each day, after lunch, I have done my guided meditation. I have had about 45 minutes of decent rest and relaxation. It has helped a ton. It is my favourite tool.

My yoga practice hasn’t really looked like a class. It’s looked like cat and cow whenever I need it and some puppy thrown in for some upper body tightness. It’s looked like doing downward dog, cat and cow and forward bend with an 18 month old climbing under me. I have used these tools and used them well.

Want to give yoga a go? Join my free challenge! Yoga for Fibromyalgia: Five Minutes a Day for Five Days.

yoga for fibromyalgia challenge

Avoiding white flour

Oh how this is something that works for my tummy. In the beginning of lockdown here we were limited to two breads per shop and there was no flour. So I found a 20kg bag of white flour. And proceeded to bake to my son’s heart’s content. And ended up with a very bloated sore tummy. I stopped eating it and was fine again!

Gentle walking

We have managed to start taking a walk everyday. It feels so good to be able to. I feel strong and so happy to now walk for 30-45 minutes. With no hangover pain (stretching afterward). It helps to be outside and to move these muscles and gentle walking has always been soothing to my upper body trigger points (don’t ask me how).

Sleep

I have always said sleep is king and I will continue to do so. We cannot be well and continuously sleep poorly. My sleep hygiene routines, walks, yoga, meditation, breathing, low dose naltrexone and magnesium all help me sleep. Even when my neck is interrupting me multiple times a night I am sleeping in blocks of a few hours which makes all the difference.

You will note that many of these are reactionary to trigger points – the trigger points are related to mechanical things like using the computer but they are also worsened by things like the central nervous system flaring (hello stress). Many of these also target more than one symptom, I am nothing if not efficient, which is why I adore yoga and sleep.

Share with us- what treatments help you? What have you confirmed over this time?

Want unlimited access to yoga made for fibro bodies? Join Yoga for the Chronic Life virtual studio!

yoga and meditation for fibromyalgia

Myofascial Pain Syndrome, Trigger Points and Fibromyalgia: Definition, Diagnosis, Triggers and Treatment Options

Myofascial Pain Syndrome (MPS) is a term I came across in 2017, when a physiotherapist finally explained that this is what was causing my severe neck issues. In this post we go through what it is, examine if it’s part of Fibromyalgia, and my at-home treatments.

Remember: I bring together research, resources and my personal experience as a STARTING point for your own consideration. Please always check in with your medical team. We are all so different in what works and doesn’t work that other people’s experiences are helpful but not going to be a template for you.

Also it is worth noting that a healthy person with trigger points is a much different proposition than someone with fibromyalgia. With the fibromyalgia we need to factor in the central sensitization and central nervous system overactivation. It’s complex!

myofascial pain syndrome, trigger points and fibromyalgia

Definition of Myofascial Pain Syndrome

A good definition of Myofascial Pain Syndrome that I have come across explains it as: “hyper irritable spots, usually within a taut band of skeletal muscle or in the muscle’s fascia that is painful on compression and can give rise to characteristic referred pain, tenderness, and autonomic phenomena” 1

Are Trigger Points Part of Fibromyalgia?

There is often confusion between the tender points characteristic of Fibromyalgia and trigger points. This article discusses the differences and similarities and provides a chart for distinguishing between the two.

The propensity for medical professionals to throw every symptom into the Fibromyalgia basket set me back for a decade. If they had realised prior to 2017 that my neck pain was really caused by trigger points, then we could have begun working on them sooner. These tiny hyper irritable spots have caused me over ten years of sleepless nights and 24/7 pain that nothing completely relieved.

Whether or not one wants to accept trigger points as part of Fibromyalgia or separate, research has noted that where trigger points are present in those with Fibromyalgia, the treatment of trigger points relieves the Fibromyalgia symptoms associated – such as pain in that area and fatigue.

Diagnostic Criteria and Prevalence for Myofascial Pain Syndrome

MPS does not have universally accepted diagnostic criteria, so it also does not have reliable statistics as to the prevalence. An estimate, using data around musculoskeletal pain in general puts estimates of myofascial pain as a patient’s primary complaint at 30%. 2

However the presence of a trigger point in the muscle that causes referred pain (and often secondary symptoms) is often enough for a physical therapist to treat these.

Other posts you may like:

Tools to Fight Fibromyalgia
My Top Three Treatments to Fight Fibromyalgia
9 Inexpensive Items I Use to Fight Fibromyalgia (including items I use to treat trigger points)

Causes or Contributing Factors for Trigger Points

  • Fibromyalgia or other conditions, especially inflammatory ones
  • Sleep deprivation
  • Postural (including bad ergonomics at the computer)
  • Trauma to the area
  • Excessive or lack of exercise
  • Emotional stress
  • Fatigue
  • Nutritional deficiencies
  • Excess weight

Treatment for Trigger Points

The above quoted literature review (2) discusses general treatments for MPS: aside from eliminating as many aggravators of the condition as possible (like proper ergonomic posture at computers), treating any other present diseases, the treatment usually includes NSAIDS (usually stated as unhelpful for Fibromyalgia), heat pack, and acupuncture applied by a specific methodology.

In my case, I found that placing acupuncture needles into the trigger point (gently, without aiming for muscle reactions like in dry needling) and leaving them in for 10-15 minutes followed by neck mobilisations and tractions, provides the best relief I have found. By going to a physiotherapist to do this every three weeks, in addition to my home treatment plan, is the best way to treat the trigger points. But they always come back. We have made some progress over the past year, but they are always there and re-triggered rather easily.

Whatever may work for you, it is likely to be multi modal – involving a few treatment options, including pharmacologic and alternative approaches.

  • Avoid perpetuating factors (this is huge)
  • Hit the actual trigger points manually
    • Dry needling
    • Self-trigger point work
  • Heat (to help the pain and muscle)
  • Medicine (again for the pain and muscle)
  • Stretching (I find dynamic stretching more valuable than static)
  • Gentle exercise (to keep muscles healthy and moving)
  • Isometric exercises
  • Ultrasound¬†
  • Frequency-specific microcurrent therapy

My At-home Treatments for Trigger Points and Muscle Pain from Them:

  • Heat: heat pack, hot bath or shower
  • Topical creams: Essential oil blended pain cream, Deep Heat
  • Trigger Point Massager cane for self-trigger point activation (you can use your fingers or thumbs but mine get too sore for the level of pressure needed)
  • Rest/pacing
  • Stretching/yoga
  • Limiting computer time and using good ergonomic set up
  • Medicines: Brufen, when they get to spasm level then a muscle relaxant

This post is available as a full, downloadable toolkit in the exclusive members library for the Melissa vs Fibromyalgia Inner Circle Membership. You can join in here.

Yoga and Trigger Points

I find dynamic stretching the most useful for me. A lot of people love yoga and a lot of people say it doesn’t work at all for them. This is because what works for one doesn’t necessarily work for another. Also, one should delve into how you know if yoga helps. How have you tried it? Have you tried the different options on offer? If you have tried a class in a studio or a random YouTube class not designed for chronic pain then you likely haven’t tried the right yoga for you.

For chronic pain and fatigue we generally look at gentle, mindful movement with breath front and center. My trigger points seem to respond better to dynamic stretching, not long static holds with any weight bearing. So crow pose (a pose where you balance your body on your arms) really flares up my trigger points. But child’s pose (a supported, relaxing pose) makes me feel so much better.

Restorative yoga is a great, passive practice good for bringing the central nervous system down and helping the body to relax.

Slow flow yoga is a gentle practice where you mindfully move through a couple of poses. Like cat and cow pose together (I love this for my neck and back).

For us, a “class” can mean a two pose flow for a couple of minutes. Or a yoga nidra guided meditation for 30 minutes in the middle of the day. Or one 15 minute surrender into supported child’s pose.

But if yoga is not your cup of tea, check out the other ideas.

Your Trigger Point Toolkit

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the trigger point book

The Little Book of Self Care Trigger Points: Use the Power of Touch to Live Life Pain-Free is the best book I’ve found explaining trigger points, what they do and how to treat them yourself. I highly recommend getting a copy of this book. There are clear pictures of what to do and how to do it.

The Trigger Point Therapy Workbook – this is a much more detailed (like a textbook) book about trigger points, perpetuating factors and how to treat. This is the gold standard of information, but it is trickier to understand. Highly worth getting into if you really want to tackle trigger points.

The Theracane Trigger Point Massager – this is my favourite tool for managing trigger points. My fingers get too sore to hold the pressure required to treat trigger points.

Foam roller – I have a small, firm foam roller which I like to use on the bigger muscles like glutes, legs and back.

Heat pack – this is one of the top five pain management mechanisms I use. I use my heat pack every single day. It is recommended to warm up the muscle you are treating before you try trigger point release. Afterward you can stretch and then reapply heat.

Deep heat cream – I use this on my neck, shoulders and back trigger points all the time. The heat infused cream combined with gentle massage is so good.

Yoga for Chronic Pain and Fatigue – here is my free five minutes a day for five days challenge for you to gently incorporate some yoga, stretching and breathing into your day. My focus is on dynamic stretching rather than long, static stretches but also in showing you how to find what feels best for you.

Your turn: Do you have trigger points too? How do you treat them?

  1. Travell, JG, Simons, DG. Myofascial Pain and Dysfunction. The Trigger Point Manual: Upper Half of Body, 2nd edition. Lippincott, Williams & Wilkins, Baltimore 1988.
  2. Overview of soft tissue rheumatic disorders Author:Irving Kushner, MDSection Editor:Zacharia Isaac, MDDeputy Editor:Monica Ramirez Curtis, MD, MPH Literature review current through: Mar 2018. | This topic last updated: May 12, 2017. on UptoDate.com

myofascial pain syndrome trigger points and fibromyalgia


For more information:

Do you like the work I do here ensuring that people with fibromyalgia receive the tools, education and support they deserve? Then consider joining the Melissa vs Fibromyalgia Inner Circle Membership group and get access to the exclusive members library. It’s a pay what you can model starting at just $5 per month. This post is available as a downloadable toolkit with a worksheet to help you work through your perpetuating factors and your treatment plan.