Chronic Back Pain & Fibromyalgia Risk
It's pretty well accepted that some people with chronic spinal pain eventually develop fibromyalgia, possibly because spinal pain can lead to central sensitization and changes to the brain over time. Now, some researchers are looking into which back-pain patients go on to develop chronic widespread pain (CWP).
At a pain clinic, researchers followed up with people who were diagnosed with chronic neck or low-back pain (but didn't have CWP) 5 years before. In that 5-year period, 23% of them had developed CWP. Those people were asked to come in for a tender-point exam. Only about a quarter of them did, but of those people, 76% fit fibromyalgia diagnostic criteria.
Researchers say certain criteria appeared to predict those whose spinal pain would progress to CWP or fibromyalgia:
- Initial pain intensity
- Gender (female)
- History of abuse
- Number of pain management strategies used
- Widespread pain in family members
- Other central sensitization disorders, including:
- Irritable bowel syndrome
- Irritable bladder (interstitial cystitis)
- Migraine
- Restless legs syndrome
This isn't a surprise to me. I've had chronic back and neck pain since an accident when I was 10, and the only risk factor they found that doesn't apply to me is a history of abuse.
The most important part of this, to me, isn't that it explains why I have fibromyalgia -- it predicts what could cause my children to end up with it. They've got one huge risk factor just from having me as a mom. If I start to see other risk factors crop up in their lives (such as spinal pain), I can make sure it's treated aggressively. There's no guarantee, but hopefully that can keep their pain from becoming chronic, which can keep pain signals from making changes to their central nervous systems.
I already suspect that my son inherited my myofascial pain syndrome, since a "minor" neck injury has left behind a painful trigger point. He's reluctant to try acupuncture (he's only 7), so we're using cupping therapy, massage, topical pain creams, anti-inflammatories, and a special pillow that supports his neck well. Of course I worry about it, but I try to keep a positive outlook, reminding myself that he's getting the treatments nobody knew I needed. I just have to have faith that it'll help.
Does this set of risk factors fit your situation? Have you seen similar issues in your children? Are you taking steps to mitigate their risk? Is it discouraging to you to see abuse brought up in yet another study? Leave your comments below!
Suggested Reading:
- What Causes Fibromyalgia?
- Who Gets Fibromyalgia?
- Learning Acceptance: How it Can Help with Treatment
Photo © Don Farrall/Getty Images
Comments
I’ve had it (FM) for over 17 years now and it started after a neck injury that caused some paralysis on my left side, though the paralysis is gone it’s left me with pain that’s been flaring up on and off for years.
First–thank you so much, Adrienne, for keeping abreast of relevant news & research and passing it to us via your newsletter. This is a wonderful, selfless service. I don’t know how you do it!!
You asked: “Is it discouraging to you to see abuse brought up in yet another study?” Yes, it certainly is. Some of us were abused. So what? Plenty of us weren’t. And plenty of people who were abused have NOT developed CFIDS/fibro. The drive to associate our illness with abuse is just one piece of the determination to label us–once and for all–as neurotic hypochondriacs, not as folks with physiological disease. William Reeves, who heads the CDC’s CFS program, is at the head of this movement and he seems to be gaining traction, unfortunately.
We have to be ever vigilant (as you are, Adrienne) and use whatever energy we can muster to keep the medical and political communities focused on this as physiological, not psychological, in origin.
I have FMS and I have some spinal problems. I am being checked for a pinched nerve in my neck, and my MRI results do show some mild stenosis (according to my PCP’s interpetation). I see the neurologist on July 22nd for his feedback.
I also have a torn disk in my lumbar back.
This makes a lot of sense to me, personally, because I started having fibro symptoms in 2003 or 2004. At the time, I had been learning yoga from an exercise video and I did inversion postures (surely very incorrectly putting pressure on my neck/head/upper back!). I started having tingling/numbness in my fingers and weakness in my left hand.
BUT, also going on at the time – I was living in a terribly stressful living environment and dealing with a load of stress at my job. Things really seemed to go haywire whenever I got what seemed to be “food poisoning” (I had eaten salmon that was undercooked and later I found had not been cooked soon enough!).
What’s hard about these illnesses that it’s hard to point to one factor that’s causal. And, there are so many ‘what if’s…?” How can they narrow down a life-time of possible precipituous events. I also had abuse in my background but it happened during one school year, by a teacher. I went to the hospital and my recollection was that I had full-body pain where it hurt to be touched and my mother found me curled up in a ball on the floor in front of the kerosene heater, moaning. She hadn’t known about the abuse until I had reached that breaking point.
The last poster had a valid statement. I WAS abused, yet my first recognizable fibro flare wasn’t until much later in life. Did this lay dormant for 20+ years because I was abused?!? Abuse may be a possibility but there just has to be more substantial evidence to determine this was a causal factor. Where are the studies? Was the person abused and developed fibro during the time of abuse or years, years later? How can we be sure the so-called ‘relationship’ isn’t anecdotal?!
I too would like to Thank You for the
newsletter.It has contains some of the best information I have found!
I have suffered from migraines since 14.(I endured a lot of abuse growing up and after my divorced managed to get into a couple of abusive relationships, did this affect me I can’t say b/c I suffered from clinical depression and we all know fatigue and pain can go hand in hand with that)
In 2005 I started having wide spread pain and neck pain, tingling and numbness. In Dec I was told I had DDD and a herniated disc in c-spine. Tried everything but ended up having Anterior Discectomy with Inter-body Fusion in April 06. Before my 3 month check-up my neck pain was worse and MRI showed 2 herniated disc one above and one below repair,( yes, I knew this was a risk when surgery was done) I lived with it on medication, physical therapy, a lot of tears, Oct. 07 I had another surgery and one disc was fused. After that it was like the fatigue and pain intensified ten-fold! Some days it is all I can do to get out of bed. I say God blessed me with Dakota, he is 3 1/2 and my reason to get out of bed even when I don’t want to! If it wasn’t for him I think I would have given up but instead I find myself looking at all the info I can find…trying different things to see if they help and hoping one day there will be an answer! May we all find one and may our children NEVER have to endure this condition!
Does this set of risk factors fit your situation? Yes~but the abuse part is shaky footing.
Have you seen similar issues in your children? Yes, but thank God no Abuse.
Are you taking steps to mitigate their risk? Yes, She does not have the same dxs I have, but if I had not pursued, we would not have found out she had Mono (age 5) and Hashimoto (still getting under conrol. She also reports neck problems.
Is it discouraging to you to see abuse brought up in yet another study? Leave your comments below! I am not sure of the contect of the abuse in the study, but I do think it is an easy “target” statistic. What kind of abuse do they mean? Rape, incest, verbal abuse, physical abuse, witnessing abuse? I mean really, I would like to know the percentage of the population that does NOT experience these things. I never brought up my case of abuse until a therapist treating me told me that often CFS/FMS had like a 500% rate of abuse. I had not thought about it till then.
So, unless they draw a darker line connecting the things they mean about abuse that are physically making us suffer now, it is useless and quite derogator toward the sufferer of these syndromes.
I also wanted to comment that I have two herniated disks in my lower spine, L5 and L5. They are “dry” in appearance. I have not experience any pain in that area for a while.
Right now I am having an odd “symptom”. It is Iliac Crest Pain or referred to as Iliac Crest Syndrome. I have pain on the iliac crest of my hip. Very, very weird. Used to be one hip and now I have it in two. I do not know if it is related to my dis injuries.
I am unable to find out much about it. If anyone knows, please let Adrienne know so she can let me know!!!!! My Dr.’s are stumped.
Have you all visited http://www.nfra.net WOW it has unraveled my lifetime of suffering…I have Chiari and Congenital stenosis and unfortunately my 20 year old son has been diagnosed also… We are both heading in for surgery in a few months. I will keep you all posted.
Thank you for the informative article. The prediction criteria describe my situation to a ‘T’. I had a serious neck injury at 7, developed ‘nervous stomach’ (colitis) at 9, had a grandma who lived with us who had widespread, chronic pain (arthritis & rheumatism), I have had migraines off and on since childhood, have had several other significant back and jaw injuries including 4 slipped lumbar discs. I learned in my 20’s that colitis and other forms of bowel irritability are often linked with harsh and/or pre-mature toilet training. As well, a history of abuse need not include physical abuse. Harsh, critical parenting, lack of emotional availability, and neglect are also considered as abusive. As a psychotherapist I see many people with chronic widespread pain who had to take responsibility for themselves and/or others very early in life, and I wonder whether another potential risk factor might be early, continuous over-utilization of the back and other parts of the body.
Has anyone tried LDN as a treatment for Fibromyalgia
Stewart,
LDN is spreading as a fibromyalgia treatment. Here’s more information for those who aren’t familiar with it:
Low-Dose Naltrexone for Fibromyalgia