*Possible Risk Factors for Fibromyalgia

Did you ever wonder why fibromyalgia or chronic pain might occur?  A recent study in the Journal of Pain has shown possible links between regional neck and back pain and the later development of fibromyalgia and chronic widespread pain (CWP). 

 The study looked at 550 subjects with back or neck pain.  The researchers compared questionnaires filled out in 2001/ 2002 and then again in 2007 to see how many people had developed chronic widespread pain.  They found that nearly a quarter of these people had developed chronic widespread pain in the 5-6 year period.  The diagnosis of CWP was made if the person indicated pain in three out of four body quadrants (left and right, arm and leg).

 They found seven factors that increased the likelihood of developing CWP from regional neck or back pain.  They are:

• Moderate or severe pain intensity
• Female gender
• History of family abuse
• Family history of chronic widespread pain
• Interference with general activity
• Having one or more other conditions (irritable bowel syndrome, irritable bladder syndrome, restless legs syndrome, and/or migraines)
• Using more pain management strategies.

 Interestingly, they did NOT find a link with the following (although obesity and depressive symptoms were found to be almost significant):

• Number of depressive symptoms
• Pain duration
• Age
• BMI (body mass index- an indicator of obesity)
• Number of medications used
• Receipt of disability benefits

Out of all of the traits linked to development of CWP, they found the strongest predictor to be increased initial pain severity.   They stated that current research supports the theory of painful input (neck or back injury) causing changes in the nervous system leading to the development of more widespread pain. 

It is important to understand this study did not look at all people in general, but started with people who already had neck or back pain. It also does not mean that neck or back pain is the only cause of development of CWP.  The researchers also pointed out possible limitations to their findings in the use of questionnaires and the low subject response rate (24.4%) due to subjects moving in the 5-6 yr time span of the study. 

Fibromyalgia and chronic pain are not easy conditions to understand.  While this research does not give us immediate answers, it does present some useful information.  It gives clinicians or future research a place to start looking for ways to prevent the transition into fibromyalgia and more long term pain. 

*Physical Therapy Saves Back Pain Health Care Dollars

By offering physical therapy as a first-line treatment in back pain, Starbucks has saved a lot of real bucks in treatment of injured workers.  As reported by the Washington Post, July 26, 2009,   the coffee company teamed with a local hospital to overhaul the health care process.  They were able to reduce the number of expensive tests such as MRI’s and workers were able to return to work in approximately 48 hours versus 66 days. 

Physical therapists are able to effectively work with back injuries to restore pain- free function quickly. 

*Pregnancy-pelvic joint separation painful condition during pregnancy

Pelvic joint separation or pubic symphysis separation can occur during pregnancy due to the circulating hormones that relax the joints of the pelvis. This joint is at the front of the body at the pubic area. Separation may be more likely in future pregnancies. Early intervention during pregnancy can help prevent the potentially severe debilitating pain and loss of function that can occur with a separation.

It is important to avoid certain activities such as lunging that stress this joint. A Physical Therapist specializing in women’s health can help teach a woman positions to avoid and ways to strengthen the muscles that support the pelvis. Posture and safer ways to lift and get in and out of bed can also help prevent more problems.