Fibromyalgia and old Injuries
The past comes back to haunt you
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This idea is not new, as anyone who has suffered an injury while they are younger, is reminded of the damage when they get older and they have some "weather wise" aches and pains. But for those of us with FM, I think the concept takes on a totally different perspective due to the fact that FM is a pain amplification problem. Knowing this fact, might help us to not only understand some of our pains better, but allow us to get more effective treatments. 

Hey, one source of pain that maybe we can fix? Gotta love that idea. Alright now, why am I bringing this up ?

I am sitting here with my hip and lower back hurting and I had a flash back of when they last felt like this. I was 17 years old, nearly 9 mts pregnant and was taking a short doze on the sofa. Until I heard a crash in the kitchen. A kitchen where my niece and nephew were doing the dishes. 

Now, like any responsible adult I flew off the sofa to go investigate. In my half doze state and reacting to what seemed like an emergency, I forgot for that moment that I was very pregnant. Meaning I moved as if I had no limitations, moves that due to the pregnancy, I should NOT have attempted.

It only took one step for me to realize that something was dreadfully wrong. My hip and leg were on fire as I rushed to the kitchen that day. Diagnosis for the problem .. Sciatica, which is a nerve pinch at the hip and spine that creates pain that runs down the leg, across the hip and lower back. With the treatment that it  was given at the time, it seemed to have gone away...  it was healed, or so I thought.

Now I am told I have that same Sciatic back again, as well as lumbar radiculopathy Aka Lumbago or lock up of the lumbar spine Link. With no new injury sustained. Higher up at the neck I have Spinal Stenois and the worst area that has degenerated, are the same vertebra that sustained the most damage during a car accident at age 14 that trashed my back and gave me whiplash. Again with NO new major injury since that time.  

My left hand, is the one that suffers the most joint and muscle pain. It is the same hand that has sustained several major tendon and muscle damages, over the course of my life. I have not directly injured it in years. A knee that blew out and needed surgery in my youth, over half my lifetime ago, is the one in the most pain now. 

Then you have to add in the almost uncountable times that I have strained and sprained muscles and joints, as I have led a very active life. Not to mention that we with FM often have joint hyper mobility, which allows us to overreach and damage joints. ( see FM and joint/tendon issues on site link ) I could go on, but I think the point is made.

Now, how would cataloging old injuries... help us?  Well, for one thing, it would pin point areas that are likely to become problems, before they happen. It would also help the doctor or therapist your working with, to help you...more. Just knowing that a site that is currently being a problem, has suffered prior injury, can change how it's treated. 

Repeated studies indicate that pain from prior injuries is often an indication of incomplete or poor healing of the original injury. This is especially true if the injury happed to a joint or tendon, as such areas are naturally low in blood flow and are highly resistant to healing.  

"There are many reasons why a trauma may not heal well. Joint and connective tissue tends to heal slower due to a low perfusion of blood compared to muscle tissue. Sometimes the rate of re-injury exceeds the ability of the body to heal. This can come from overuse of the joint or simply poor health and age. Environment, nutrition and severity of the original injury also play a role. "  Fighting Arts and Bi injuries

Not to mention that it is our habit as a race to assume that when an injury stops hurting, that it is healed. So, once a thing stops hurting us so much, we return to whatever activity level we are used to. We demand that the damaged part "make it happen" long before it is healed. We do this almost to man, as in the case of joints and tendons, they can take months to heal. How many of us can take months off of work ?

The body, assuming that our survival is at stake here since we make such demands, tends to shunt off the healing process and patchs the area to allow for the demands on it. The trouble is, that it does so at the sacrifice of full function and it is now weakened due to this and we can and often do re-injure it. It tells us about the strain and pain it's suffering, often ... and if you have FM make that a super sized scream in pain, especially if the weather is about to shift.

Ever notice that when the weather is about to change, everything it seems for those of us with FM, kicks off in pain? Well, we are not alone. As nearly everyone, for as many centuries ago as we have records for, makes note of the same thing in areas with prior or even current injury or inflammation. So, are your joints a more accurate metrologist than the weather man?The short answer is... yes they are. :)

" Significant drops in air pressure usually are an indication that a storm is approaching, but people with bone or joint problems caused either by prior injuries or arthritis frequently report increases in pain that coincide with such fluctuations. Doctors have yet to understand why air pressure might trigger such pain, but theories center on nerves surrounding the joints that may be highly sensitive to drops in air pressure, according to the American Academy of Orthopedic Surgeons."

Ok then, what to do about all this since we have no control over the weather or other triggers that is making things scream? According to most body workers, Orthopedics and therapists, the trick is to heal the "casting" that the body created over the injury. 

Casting is the bodies automatic defense that happens when we have an injury. The body sends out fibroblasts to the injured site and welds it in place, while it heals. The problem with this, is the fact that unlike when we were kids and hurt ourselves, such casts of scar tissue do not dissolve in adulthood.

This is further complicated by the fact that such fibrous casts, often become a case of over kill, thanks to the demands we make. We do this so often that the area that was injured, is now stuck to the areas around it. A process called adhesion. The more demands we make, the more adhesions form, as we re-injure it. 

This is why it hurts. As you are asking an area that is supposed to slide, to move. However it cannot move due to the excessive scaring, so with every move you make, you are yanking on tissue that is welded in place. Just thinking about that hurts.

This creates some very bad body movement habits, as since that area or areas, does not move as it should, it hurts and we develop some very twisted body movements as the body tries to avoid more pain. We limp, we "guard" the area in pain etc. Which in turn, creates problems for the rest of the body that is now under stress, being yanked and twisted in abnormal ways, as it tries to compensate.

We can have such injuries, all over the body as we stress and strain muscles and tendons, rather often. Many of which, thanks to FM, we are not aware of. Things being in pain for no apparent reason is so commonplace, we just assume it is the FM and we do not treat what is in fact, an injury.

If you bring this matter up to most doctors, the first thing you will be told is the traditional R.I.C.E. treatment (rest, ice, compress and elevate)  along with medications for pain, inflammation etc, which will make it feel better, but if it is due to prior injury, it does not treat the problem.  

As despite the signs that are presented, inflammation is often not at issue, or at least it is secondary to the real reason the area hurts. As pain by itself can create inflammation, as the body "pads" the area in pain and tries to immobilize it with fluids.

"If inflammation isn't responsible for chronic conditions like tennis elbow and iliotibial band syndrome, what is? There's a good chance it's scar tissue. Repeated or sustained muscular contractions in any athletic endeavor increases tension on soft tissues (muscles, tendons, fascia and nerves) which in turn decreases blood and oxygen supply to the area. With muscles, nerves and fascia, the result is a build-up of scar tissue. In tendons, decreased oxygen leads to degeneration. Scar tissue and degeneration are the common cause of chronic overuse injuries..."  Link

Surgery is generally not considered, other than in cases of gross deformity. Surgery by its invasive nature, creates more scar tissue and can therefore recreate the problem while trying to solve it.  Arthroscopic surgery, which is minimally invasive, could be an option in some cases. But do not assume that a surgical fix, will be the first option for treatment for this kind of problem.

The sooner the better when it comes to treatment, as any joint that is not moving normally is not only going to hurt, it will start to degenerate which equals abnormal and accelerated wear and tear. However, do not assume that just because the injury is many years old, that it cannot be treated. As it can, it will just take longer to restore. 

Ok, what are possible options?

Rofling and deep tissue massage is one answer Sandpoint Wellness Council   as such massage, done over time, can release the adhesions allowing the area to move. Electro simulation is another, bringing more blood to the area and forcing micro movement at the site of the injury. Ultrasound is yet another, to break up the scar tissue. Active Release Technique (ART) is yet another from. 

As over all, scar tissue IS generally the problem with prior injuries. Adjustment of the entire body, via chiropractic alignment is recommended here, due to the guarding movements we have been making, but only after the tissue is freed and able to move. Otherwise you will continue to do the same guarding movements that twists and strains other areas of the body and pull the body back out of alignment.

In short  any action that makes the area move, as the body does not like this idea of stuck down anymore than you do, is a help. Any improvement is a good thing, so do not be afraid to try any of the treatment modes, or self help. ( Carpel tunnel etc ) As with all pains with FM, any that we can ease, gives the FM that much less pain to amplify.