Chronic Pain

Fibromyalgia: Symptoms, Causes, Pain Management


Do You Have Fibromyalgia? Learn About Your Pain Management Options Do you have chronic muscle pain, especially abdominal and back pain? What about overwhelming fatigue? Numbness or tingling in your extremities? Stiffness? Insomnia? Headaches? Anxiety? Do these symptoms constantly shift Read more

7 Negative Effects of Poor Posture


Poor posture is more than just a pain in the neck. Poor posture can affect the body in a number of odd and unexpected ways. Other than the well-known cases of backaches and the serious unnatural spinal curvature, here Read more

What Different Kinds of Back Pain Are There?


Back pain seems like it should be a fairly simple concept—your back hurts, you want it to not hurt, you go to a professional where they fix you up and send you on your way. Except, like with most Read more

Fibromyalgia: Symptoms, Causes, Pain Management

Dr. Leo Potetti Chronic Pain , , , ,

Do You Have Fibromyalgia? Learn About Your Pain Management Options

Do you have chronic muscle pain, especially abdominal and back pain? What about overwhelming fatigue? Numbness or tingling in your extremities? Stiffness? Insomnia? Headaches? Anxiety? Do these symptoms constantly shift and come and go?

As much as all of that might seem unrelated and you may just consider yourself to be always in poor health for some reason or another, it may all be symptomatic of the same one condition: fibromyalgia.

This affliction affects about 5 million Americans aged 18 and older, 80-90% of whom are women. And yet, with its wide range of symptoms, inconsistent intensity, and unknown root causes, fibromyalgia remains poorly understood by patients and medical professionals alike.

So, what do we know? Let’s go through the symptoms and potential causes, as well as the treatment options for pain management.

Symptoms of FibromyalgiaPain Management for Fibromyalgia

One of the things that makes fibromyalgia such a difficult condition to live with is how broad the range of symptoms is.

The symptoms that most define fibromyalgia, though, are chronic widespread pain and fatigue.

By chronic widespread pain, what is meant is a dull, constant, aching pain that affects both sides of the body, as well as both above and below the waist, continuing for longer than three months.

People with fibromyalgia also typically feel a constant fatigue, and report feeling it when they first wake up regardless of how long they’ve slept. Their sleep is also often disrupted by factors including pain, restless leg syndrome, and sleep apnea. As a result, many fibromyalgia patients experience chronic insomnia.

These and other factors can additionally contribute to a set of cognitive difficulties known as “fibro fog”. This involves difficulty with being able to remember things, pay attention, stay focused, concentrate on simple mental tasks, etc.

There’s a long list of other potential symptoms as well though, including:

  • Muscle spasms and/or tightness
  • Stiffness when you first wake up or stay in the same position too long
  • Irritable bowel syndrome—abdominal pain, nausea, bloating, alternating constipation and diarrhea
  • Migraine or tension headaches
  • Tenderness of the jaw or face
  • Numbness or tingling of the face, arms, legs, hands, or feet
  • Sensitivity to noise, bright lights, cold, odors, certain foods, or medication
  • Anxiety and depression
  • Irritable bladder—increased frequency or urgency of urination
  • Reduced ability to tolerate exercise, and muscle pain following exercise
  • Feeling of swelling in hands and feet without actual swelling present

These symptoms can come and go, all together or switching out for one another, from month to month. This is why it’s hard for a patient to realize that these symptoms can all be connected, and why medical professionals have trouble making a confident fibromyalgia diagnosis.

So, what could be the cause of a condition with such a diverse range of symptoms?

Possible Causes of Fibromyalgia

The truth is, we don’t really know. Just like with many other forms of chronic pain, there isn’t an identifiable anatomical cause for the symptoms which together characterize fibromyalgia.

There are theories, though.

Researchers believe that the pain associated with fibromyalgia stems from repeated stimulation of the nerves, which leads to a change in how the brain interprets, experiences, and reacts to pain. An abnormal increase in the neurotransmitters that signal pain, increased sensitivity of pain receptors, and decrease in the brain’s pain management through natural painkilling endorphins are all possible factors.

Lowered serotonin levels in particular are associated with fibromyalgia. Serotonin is a big factor in pain management. It has the effect of calming and reducing anxiety, and a reduction in its levels leads to a lowered pain threshold similar to that of fibromyalgia patients. Men produce serotonin 50% faster than women, so this may explain why women are so much more likely to suffer from fibromyalgia than men.

But how does this happen? Well, some believe that because fibromyalgia appears to run in families, the problem is at least partly genetic. This in itself wouldn’t directly cause the condition, but would make you more sensitive to environmental factors that do.

Those environmental factors include infections and traumatic physical injuries that can damage the spinal cord or other parts of nervous system, like severe car accidents. However, some researchers also believe that factors like sleep disorders, stress, and depression may also lead to lowered serotonin levels, and can similarly trigger fibromyalgia.

None of this is entirely proven, however, and medical professionals continue to research and speculate.

Pain Management for Fibromyalgia Patients

Since fibromyalgia can’t be cured, treatment revolves around minimizing the pain and fatigue that it causes. And since bed rest doesn’t seem to alleviate the fatigue, and the pain is often what keeps sleep from being restful, pain management is the real focus.

In this regard, the treatments of fibromyalgia are similar to those for most other chronic pain conditions.

The first option which many practitioners push is the use of drugs. There are many kinds that are used to try and treat fibromyalgia, but none that stand out as particularly effective at pain management. Some of these drugs include antidepressants like duloxetine (Cymbalta), as well as the anticonvulsant pregabalin (Lyrica).

However, like all drugs, these chemicals have consequences in the form of side effects: nausea, dry mouth, and constipation, insomnia, and dizziness for Cymbalta, and dizziness, sleepiness, swelling, weight gain, and impaired ability to drive for Lyrica.

Many other more natural treatment methods provide pain management for fibromyalgia patients and don’t carry the negative side effects that drugs do.

Exercise for example is a great pain management option. It increases endorphins which reduce pain and boost mood. However, those suffering from fibromyalgia often feel intensified pain after working out, and avoid it. So exercise is something that has to be slowly worked toward, and there are initial barriers that have to be passed before a fibromyalgia patient can enjoy exercise without pain.

As a result, other methods provide better starting points for pain management. These include:

  • Chiropractic, which can reduce pain and increase range of motion
  • Acupuncture, which can stimulate the nerves to alter brain chemistry and improve pain tolerance
  • Biofeedback, which helps people learn to control their stress responses and minimize their pain
  • Deep-tissue massage and neuromuscular massage, which help reduce muscular and soft-tissue pain
  • Physical therapy, which can reduce muscular pain and stiffness and improve posture and confidence of movement
  • Meditation, which can reduce stress and anxiety and produce a calming effect
  • Tai Chi and qi gong, which have evidence of helping with pain in fibromyalgia patients

To figure out which of these might be right for you, you should consult with a professional who can examine your condition and recommend which treatment options might work best. Back in Shape Chiropractic has been helping patients with pain management in Gurnee, IL for decades, and is licensed to provide quality chiropractic, acupuncture, and other health services.

So if you’re suffering from chronic pain and fatigue, give us a call at (847) 249-2225—we’ll do our best to find a solution and get you Back in Shape!
Back in Shape Chiropractic
4673 Old Grand Ave
Gurnee, IL 60031


Is Chiropractic Care Safer than Opioids for Pain Management?

Dr. Leo Potetti Chronic Pain , , , , , ,

When you think of healthcare, and particularly when you think of pain management, as an American one of the first things that inevitably comes to mind is the image of a bunch of pills. American conceptions of treatment are dominated by pharmacology—medicines like antidepressants, sedatives, and painkillers generate billions every year for pharmaceutical companies, are the primary method of treatment for hundreds upon hundreds of distinct illnesses, and are at the forefront of every U.S. citizen’s imagination when they picture medical care.

And among the pain management options offered to patients with chronic pain conditions, none is pushed so hard and prescribed so widely as the family of drugs called opioids, with sales of prescription opioids nearly quadrupling from 1999 to 2014 despite there being no real change in how much pain Americans report.

On the other hand, chiropractic care has traditionally been regarded with suspicion and skepticism. Is it safe? Is it proven? Is that what my doctor knows is best for me?

Yet despite this all, it’s becoming increasingly common for not only regular Americans but even institutions within the industry to question whether chiropractic might in fact be a far safer alternative to opioids for the treatment of chronic and acute pain. And with America caught in an increasingly alarming epidemic of prescription opioid abuse, we have a duty to openly and honestly examine the existing research around each treatment method and discuss whether a change is necessary.

Doing so could be a matter of life and death for thousands.

America’s Opioid Addiction

Currently, opioids are the primary method of pain management in the U.S. But what are they?Pills for Pain Management

Opioids are defined by how they function, in that they are a family of drugs with morphine-like effects. They include several subgroups. Opiates are the naturally-occurring compounds found within the Asian opium poppy plant’s seed pods. In addition to morphine, they include codeine and thebaine. Semi-synthetic opioids are derived from these opiates and include not only illicit street drugs like heroin but also pharmaceuticals like hydrocodone, oxycodone, hydromorphone, and oxycodone. Synthetic opioids created without opiates include methadone, fentanyl, and buprenorphine.

Most Americans are more familiar with the listed pharmaceuticals by the brand names they’re sold under—hydrocodone is Vicodin and oxycodone is OxyContin, with each also being sold under other names as well. All of these drugs relieve pain and dull emotion by affecting opioid receptors in the brain, blocking pain signals from the nervous system.

But they also all are extremely addictive, all listed under various “Substance-Control Schedules” in the Uniform Controlled Substances Act. Combine this with the fact that they’re prescribed for everything from surgery-related pain to coughs and diarrhea, and it’s easy to see how an addiction epidemic can form.

As sales of prescription opioids has doubled, so has the number of overdoses linked to them, with more than 165,000 lives lost to prescription opioid overdoses from 1999 to 2014. In 2014 alone there were 72 deaths from opioid abuse a day, about three every hour. More than half of these were from prescription opioids, and overdoses on popular painkillers like Vicodin now claim more lives than heroin and cocaine combined.

Not only that, but prescription opioid abuse is a stepping stone to heroin abuse, with almost half of young heroin users reporting that they started abusing opioids first and switched to heroin because it’s cheaper and easier to obtain while offering a similar high.

The problem is driven in part by healthcare providers’ overenthusiasm for prescribing these drugs. A National Safety Council (NSC) survey this year found that 99 percent of medical doctors prescribe opioids, often for longer than the Center for Disease Control’s (CDC) recommended three-day period; 23 percent reported they prescribe a month’s worth of opioids or more at a time. In addition to all this, over 70 percent of doctors wrongly believe opioids are the most effective treatment for pain and prescribe them for back pain, despite the NSC not considering them an ideal treatment.

But Do Opioids Work?

With how addictive and dangerous they can be, you would hope at the very least that prescription opioids are doing their job. But as the previous statement about the NSC indicates, this isn’t the case, and the research doesn’t quite add up either.

Meta-analysis of many studies about opioid effectiveness turn up murky results, with the increases in risks for abuse and other side effects far outweighing any apparent benefits. Other systematic reviews of the evidence conclude that the evidence in favor of opioids’ ability to provide long-term pain management and improvement in function is “weak,” “unclear,” “limited,” or missing.

The problem with long-term opioid treatment is that, as with many drugs, the body soon builds up a tolerance. While the first prescription might provide a patient relief, they almost immediately find that this relief is extremely short-lived and that the same dose won’t keep providing the same amount of it. As the old dosage doesn’t do it anymore, they push the doctors for more and more, and the doctors, pushed into a corner by patient demands and complaints about the pain, oblige, increasing dosage.

But dosage can only be increased so much before entering dangerous levels. At that point, either the patient will be receiving debilitating amounts of the drug, impairing their daily function, or the doctor will cut them off, offering no further increases. If the patient hasn’t yet turned to obtaining more opioids illicitly, they’ll certainly consider it then.

Chiropractic for Pain Management

As the country has woken up to this epidemic, alternatives are beginning to receive the attention they deserve, and chiropractic care is at the forefront of those alternatives.

In March the CDC released groundbreaking new guidelines for healthcare providers on the prescription of opioids, offering very clear and specific guidance on what drugs to prescribe, when, and in what amounts. Above all, they urge doctors to avoid prescribing opioids unless absolutely necessary as a last resort, and to look for non-pharmacological (non-drug) treatment options instead.

In response, the Foundation for Chiropractic Progress published a whitepaper applauding these new guidelines and advocating for chiropractic as the drug-free therapy option that the CDC recommends. The American Chiropractic Association has also lauded the new guidelines, and many chiropractors are now offering themselves up as resources to educate and provide nondrug treatment options for pain management.

This could mean a big shift towards chiropractic and medical professionals working more closely together in treating patients with pain, and thus greater availability of chiropractic care.

Chiropractic care, which has high reported patient satisfaction and carries none of the risks of opioids, could be the solution to the opioid epidemic, curbing prescriptions that lead to overuse, abuse, and addiction.

But industry shifts can take a while, and in the meantime you still may have pain. It’s up to you to take charge of your own health. If you have chronic or acute pain in your back or anywhere else and you’d like to discuss non-drug pain management, contact the professionals at Back in Shape Chiropractic in Gurnee by simply calling (847) 249-2225. We’ve been treating conditions just like yours for nearly thirty years, and we have just the expertise you need to get back in shape—with no risk of addiction or overdose included.
Back in Shape Chiropractic
4673 Old Grand Ave
Gurnee, IL 60031
(847) 249-2225


How Treating Your Stress Can Alleviate Your Chronic Pain

Dr. Leo Potetti Chronic Pain , , , , ,

Your back aches. Your joints ache. Your head aches. Your neck is sore. Your feet hurt. Any combination of these can be present in people who suffer from chronic pain, whether the root cause is fibromyalgia or regional pain caused by a car accident or other injury. But while this may seem like a purely physical issue, an affliction of your body, did you know your mental state can have a profound influence on your chronic pain as well? This isn’t some new-age belief—scientific study after scientific study has shown repeatedly over decades of research that mental stress has a significant direct impact on chronic pain.

So how does stress affect pain? And how can tackling stress factor into your strategy for managing your chronic pain? Read on to learn about this crucial relationship.

How Stress Intensifies Chronic Pain

Studies have shown that there are several ways in which stress worsens the symptoms of chronic pain.

The first affects your body itself. When you experience stress, it triggers a response in your nervous system, releasing hormones that makes your muscles tense up. This occurs most commonly in the back, shoulders, neck, forehead, and jaw. Over time, this can lead to chronic muscle tension, which results in spasms, aching, and heightened pain sensitivity. This, of course, heightens the pain suffered by patients with chronic pain.

Another way that stress increases pain is how it affects the way that the nervous system, in particular the brain, processes pain. Nerves throughout the body receive sensory information, which travels up the spinal cord to the brain, where it is processed to create the experience of pain. Typically, the brain softens these pain signals so that we can still function. But a person who is often stressed puts strain on this system, and the brain becomes increasingly sensitive to pain, requiring less and less stimuli to trigger a pain response.

Recent research suggests that cortisol, known as the “stress hormone,” is responsible for this process. A study conducted at the Institut universitaire de gériatrie de Montréal (IUGM) and published by the Oxford University Press found that elevated levels of cortisol are associated with stronger stress responses, increased pain sensitivity, and possibly increased risk of developing chronic pain.

So stress both creates painful muscle tension, and also increases our experience of pain by making our brain process it with greater sensitivity.

Stress Management for Chronic Pain Reduction

chronic pain meter

Since stress can increase the intensity of your chronic pain, it follows that an effective method for alleviating some of your pain may be to address the stress you’re experiencing in your life.

There are many ways to treat your stress, some more general and some targeting the specific causes of your stress. Of course, the obvious first step is to try to arrange your life to be less stressful. Try changing up your daily routines to create a more balanced schedule with more room for the leisure activities that help you relieve stress.

To combat the stress you do feel, there’s a wide variety of strategies available that can help. Exercise is one such strategy. When you exercise, whether it’s a half hour on the treadmill at home or visiting the gym every other day, your brain releases endorphins. This hormone is not only your body’s natural painkiller, which helps you directly combat chronic pain, but also reduces your stress. If, however, your condition is such that exercise would be too strenuous or might negatively affect your pain, you may want to consult with your healthcare provider and consider alternative ways to get exercise like pool therapy or walking.

There are plenty of other ways of relieving stress as well. You can start with daily breathing exercises like foursquare breathing, in which you inhale to the count of four, hold to the count of four, exhale to the count of four, and so on and so forth for ten repetitions.

Once you’re ready for more involved exercises, you can move onto things like guided imagery. This is where you spend five to ten minutes each day visualizing yourself in a relaxing, tranquil scene incorporating all the senses including sights, sounds, and even feelings and smells.

Going further, you might try meditation. Mindfulness meditation involves spending twenty minutes noticing your breathing but not controlling it, noticing pain or thoughts but letting them pass like a cloud rather than pushing them away.

Beyond that, if your stress stems from a larger issue like relationship issues, insomnia, depression, anxiety, or mental illness of some other sort, it may be wise to address those causes. Getting professional help in the form of relationship counseling, sleep aids, or mental health treatment may be the right move to not only address those problems themselves, but also by extension alleviate your stress and thus your chronic pain.

Stress Management for Making Pain Tolerable

It should be noted though that many of those sources of stress can themselves stem from your chronic pain. It may hinder your ability to be sexually and emotionally intimate with your significant other, or keep you from being able to work full-time or do the things around the house you used to, or keep your from your leisure activities, or keep you awake at night. All of this can result in depression and insomnia which translates to more stress and, in turn, more pain. You can see how this becomes a cycle.

Since chronic pain is incurable, the best we can hope to accomplish is to minimize the symptoms, and one way of doing that is by breaking this cycle. Reducing stress may not remove your chronic pain, but it can soften it and mitigate the consequences so that the pain doesn’t control your life.

If your pain is making you sleep poorly, and your sleep deprivation is stressing you out and making your pain worse, then addressing your sleep issues may not cure you of chronic pain but it can keep it from getting worse and also make your pain more tolerable, because at least it isn’t also making you tired all the time. In short, treating causes of stress can minimize the grip that chronic pain has on your life.

If you have chronic pain and you’re interested in learning more about potential treatments that might be right for you, or about stress management, you should consult with a healthcare professional that’s experienced in dealing with such issues. Back in Shape Chiropractic has been serving northern Illinois for nearly thirty years, and is well-equipped to handle your questions and concerns. Simply give us a call at (847) 249-2225 and we’ll make you an appointment so you can receive the professional attention you need and deserve.
Back in Shape Chiropractic
4673 Old Grand Ave
Gurnee, IL 60031
(847) 249-2225