CURRENT THOUGHT ON PAIN REDUCTION IN MYOFASCIAL PAIN SYNDROMES (Part 6)

How Does This All Work?

Impressive sub-title, huh? The reality is that we don’t really know how it all works. Right now, research is snapping at the edges of what promises to be a very complex set of conditions. This is one good reason for legitimate scientific research funding from governments. Certainly, there is good and valuable research funded by private enterprise and non-governmental organizations (NGOs) but those entities often have specific agendas regarding the directions and results of research they fund. Those organizations, as the old adage states, “…have a dog in the race.” Their profits and/or organizational values are foremost in any decision to fund research. This profoundly affects the questions put forth in the investigation and in how the study is constructed.

Also, to dredge up another old adage, “When your only tool is a hammer, all problems begin to look like nails.” At risk of belaboring the point, let me explain. Private enterprise is most interested in research that promotes whatever product the company manufactures or sells. NGOs want to support investigations whose results closely align with their values. For example, pharmaceutical manufacturers want results that prove a recently developed drug is the best treatment for a problem and any solution other than use of that drug 2nd best. A NGO may want to prove the best solution to a problem is to follow the specific course of action advocated by the organization. Other, possibly better, solutions are ignored because the NGO wants to impose it’s value system on the target population to the exclusion of more efficient approaches.

Governmental support of basic science or health research is less likely to attempt to influence the direction of that investigation. As a result, much of the technological and scientific advancements that placed the United States at the vanguard of innumerable fields have come from government support of basic research. Many of these investigations offered no immediate benefit, only the opportunity to advance the general knowledge base of society. One example is the space program, out of which entire industries were created that did not exist even 30 years ago.

To say that we don’t know how it all works is true. But we have a pretty good idea how some of it works. There are a number of conditions or circumstances that seem to contribute to myofascial pain syndromes.

Sleep disorders may be closely associated with MPS. If you wake in the morning feeling that you are still tired, you may have a sleep disorder. Your body needs a particular sleep cycle sequence in order to heal and resupply with necessary hormones, biochemicals and anti-bodies. If your sleep cycle is disrupted, these critical tasks are not accomplished. Sleep is loosely divided between a phase called Rapid Eye Movement (REM) and Non-Rapid Eye Movement (NREM). REM sleep is also considered the dreaming phase of sleep and its importance is not understood. This may be when memories are moved from short-term to long-term storage but that is only a guess. NREM sleep is more cogent to our discussion because it is during this phase that synthesis of necessary chemicals is done as is much of the healing and repair required to keep your body functioning.

Studies have shown that sleep disorders and MPS are closely associated. In fact, 70% of MPS patients recognize that poor sleep makes their symptoms significantly worse. This is an area that should be pursued by MPS patients in a complete approach to reducing symptoms.

Depression is also found in many MPS patients. Again, the specifics of this connection are not defined. Some believe there is a direct and intimate relationship between the two while others are firm that any depression in MPS patients is primarily due to sleep deprivation. Pharmaceutical solutions to sleep disorders and depression are not a cure. In fact, neither sleep disorders nor depression have shown to respond particularly well to drug treatment alone. Both, however, seem to diminish with an appropriate regimen of exercise, dietary modification and stress management. (I recommend discussing your desires and goals with your physician and working out a suitable program together.)

Cognitive Dysfunction is a decreased ability to think, learn, remember or reason. This is a common problem with MPS and may actually cause more trouble than any other symptom. I’ve seen this referred to as “fibro-fog” and is due to alterations in various types of memory storage and reasoning systems in your brain. Obviously, with moderate to severe cognitive dysfunction your school, career, personal relationships, emotional well-being and even your physical safety can be impaired.

CNS Imbalances, as mentioned in an earlier post, document a number of chemicals and neurotransmitters that can have a detrimental affect on your ability to think, do your job and even increase your perceived pain levels.

Physical and Emotional Stresses can have the unfortunate affect of making symptoms worse and then, as your functional abilities decrease, cause misunderstandings with your co-workers, friends and family. This, of course, further increases those same stressors, thus creating a vicious cycle that feeds on itself.

The last few parts of this topic have touched on a few aspects of MPS but I haven’t discussed much about what can be don to alleviate your symptoms. The next section (part 7) “Some Things That Seem To Help”, will address a few treatment considerations I have found helpful over the years.