Tag Archives: FM

Fibromyalgia Diagnosis: What Is It?

 

           

Fibromyalgia in San Francisco

Fibromyalgia Diagnosis and Treatment

We have been providing natural solutions for Fibromyalgia in San Francisco for over 20 years now.

Confirming the diagnosis of fibromyalgia (FM) is challenging, as there are no blood tests to verify accuracy of the diagnosis like so many other disorders. However, blood tests are needed when FM is suspected to “rule in/out” something else that may be mimicking FM symptoms. Also, FM is often associated with other disorders that are diagnosed by blood testing, so it is still necessary to have that blood test. So what is the CURRENT recommendation for diagnosing FM?

 

            The American College of Rheumatology (ACR) developed criteria for diagnosing FM in 1990 and has updated it since then. The original 1990 criteria included the following: 1) A history of widespread (whole body) pain for three months or more; and 2) The presence of pain at 11 or more of 18 tender points which are spread out over the body. The main criticism regarding this approach has come from the poor accuracy and/or improper methods of testing the 18 tender points. As a result, this examination portion of the two main criteria has been either skipped, performed wrong, or mis-interpreted. This left the diagnosis of FM to be made based on symptoms alone. Also, since 1990, other KEY symptoms of FM have been identified that had previously been ignored including fatigue, mental fog (“cognitive symptoms”), and the extent of the body pain complaints (“somatic symptoms”).

 

            As a result, it has been reported that the original 1990 approach was too strict and inaccurate because too many patients with FM were missed – 25% to be exact – by using this method. In 2010, the diagnostic approach was modified by using two different questionnaires: 1) The “Widespread Pain Index” or (WPI), which measures the number of painful body regions; and 2) the development of a “Symptom Severity” scale (SS). The MOST brain fog” common with FM, unrefreshed sleep, fatigue, and the  number of “somatic symptoms” (other complaints). The Symptom Severity scale (SS) incorporates these four categories and is scored by adding the totals from each category.  By using both the WPI and the SS, they correctly classified 88.1% of FM cases out IMPORTANT FM diagnostic variables included the WPI score and scores of “cognitive symptoms,” which includes the “of a group of 829 previously diagnosed FM patients and non-FM controls!

 

            What’s important is that this NEW approach does NOT rely on the “old” physical exam requirement of finding at least 11 of 18 tender points. Because FM patients traditionally present with highly variable symptoms, removing the challenge of determining the diagnosis by physical examination is very important! Plus, now we can TRACK the outcomes of the FM patient to determine treatment success both during and after care. Since the 2010 approach has been released, it has been published in multiple languages and is starting to be used in primary care clinics. Recently, in July 2013, a study reported that the Modified ACR 2010 questionnaire is highly sensitive and specific for diagnosing FM, and its future use in primary care was encouraged. What is most exciting about this is that a referral to a rheumatologist may not be needed since this tool can be easily administered by primary care physicians, which include chiropractors!

 

            In past health updates, we have discussed the need for a “team” of health care providers to best manage the FM patient. This multidisciplinary approach offers the FM patient multi-dimensional treatment strategies that encompass manual therapies, physical therapies, nutritional strategies, pharmacology, exercise, and stress management, cognitive management, and behavioral management. Now, with the release of the Modified ACR 2010 criteria, we can diagnose FM more accurately, track progress of the patient, and make timely modifications to the treatment plan when progress is not occurring. This is a “win-win” for the patient, providers/health care team, and the insurer!

 

            If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

           

Altadonna Communications ©

To schedule an appointment for Fibromyalgia Treatment in San Francisco call 415-392-2225

Since 1992

                         

 

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Fibromyalgia and the Immune System: Study


Fibromyalgia pain treatment in SFWe have been providing treatment for Fibromyalgia in San Francisco for over 20 years.

 Fibromyalgia
(FM) is a condition with a polarized audience comprised of those who believe
it’s real and those who don’t. This interesting political-like conflict is, in
a large part, centered around the topic we discussed last month concerning the
causes of FM. This month’s article will focus specifically on the immune system
and its relationship to FM.

“EXTRA, EXTRA, READ ALL
ABOUT IT! New research published on 12-17-12 in BMC Clinical Pathology
describes cytokine abnormalities were found in FM patients when compared to
healthy controls.”
OK!
But what does that mean?

            Very simply, this study reports that
immune dysfunction is part of the cause of FM. The most exciting part is that
this study identified a BLOOD TEST (finally!) that, “…demonstrates value as a
FM diagnostic tool.” Looking at this closer, the researchers used multiple
methods to examine cytokine (proteins that help regulate our immune response)
blood levels in FM patients. They found the FM group had, “…considerably lower
cytokine concentration than the control group, which implies that cell-mediated
immunity is impaired in fibromyalgia.” This study’s findings of an immune
response abnormality strays from previous study findings which largely pointed
to the central nervous system (CNS – brain & spinal cord) as the origin of
the FM syndrome. This makes some sense as the study of immunology (in this
case, “neuroimmunology” – the combination of neurology and immunology) has only
been around for about 10 years, and as such, may hold some important answers as
more evidence is uncovered to further support this potential “paradigm shift”
in considering the primary cause of FM. The authors offer further excitement as
this focus could lead to a better understanding of the cause of other
neurological conditions such as multiple sclerosis (MS)! They go on by
describing how body temperature, behavior, sleep, and mood can all be
negatively affected by “pro-inflammatory cytokines” (PIC) which are released by
certain types of activated white blood cells during infection. PIC have been
found in the CNS in patients with brain injury, during viral and bacterial
infections, and in other neurodegenerative processes (like MS)!

            To further support this advance in
understanding, the National Institutes of Health (NIH) reported, “…Despite the
brain’s status as an immune privileged site, an extensive bi-directional
communication takes place between the nervous and the immune system in both
health and disease.” They describe multiple signaling pathways that exist
between the brain and the immune system that function normally throughout our
lifetime. When immune, physiological, and psychological “stressors” occur,
cytokines and other immune molecules stimulate interactions within the
endocrine (our hormone) system, nervous system and immune system. To prove
this, brain cytokine levels go up following stress exposure and similarly go
down when treatments are applied that alleviate stress. They list other conditions
such as stroke, Parkinson’s, Alzheimer’s disease, MS, pain, and AIDS-associated
dementia as being similarly affected as well. They also report that cytokines
and other neuro-chemicals play a role in our neuro-development throughout our
lifespan, help regulate brain development early in life and brain function
throughout life, and how this all changes in the aging brain. There are also
interactions of these immune chemicals that result in gender differences on
brain function and behavior.

            Needless to say, it will be very
interesting
to watch for additional developments along this line of
research as it pertains to the FM patient and future treatment recommendations!
Also, immune stimulation by chiropractic adjustments has been postulated as a
benefit and this too may be better understood using this new research approach!

            If you, a friend or family member
requires care for FM, we sincerely appreciate the trust and confidence shown by
choosing our services!

To schedule an appointment for Fibromyalgia Treatment in San Francisco call 415-392-2225

 

Altadonna Communications ©      

 

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Fibromyalgia – Where Does the Pain Come From?


Fibromyalgia relief in san francisco CAFibromyalgia
(FM) is a very strange condition. Can you think of any other condition that
creates so many symptoms and yet all the blood and imaging tests are negative?
FM symptoms include chronic fatigue, muscle aches and pains, depression, sleep
disturbance, memory affects, and more. The degree or severity of FM varies from
mild to severe, leaving some totally disabled and distraught. So, the question
of the month is, where does the pain come from?

            Since the usual markers of injury
are negative (that is, blood and other tests), we can tell you first that the
pain is NOT coming from damaged tissue such as muscle, bone, organs, and the
like. If it did, abnormal enzymes &/or inflammatory tests would result.
Rather, the origin of pain appears to be arising from within the central
nervous system. That is to say, there are portions of the brain and spinal cord
where pain signals are received and when they reach a certain level or threshold,
the sensation is felt. When the sensory input is below that level, it will not
be felt. In fact, there are MANY MORE incoming sensory signals that are NOT
felt compared to those that are. This “thermostat-like” function is vital so we
DO NOT feel everything that arrives to the brain. This is why we don’t feel the
clothes hanging from our backs or the shoes on our feet (unless the laces are
tied too tight!). It’s been said that if we DID “sense” all the incoming
signals we would, in a sense, “…short circuit.”

            In the FM patient, this thermostat
is “messed up.” It is set lower than what is considered normal, and as a
result, patients do sense or feel more than they should. This “nervous system
overload,” sometimes referred to as a “sensory storm,” occurs in the FM
sufferer. A more fancy term called “central sensitization” can be searched and
you will find a LOT to read about this
interesting subject (check it out)!

            So how does this hypersensitive
situation start? Fibromyalgia is classified into two main categories – type I
and type II. In type I, or primary FM, the cause is unknown. The cause could
include one’s genetic make-up, but the bottom line is, we really don’t know. In
type II or, secondary FM, some other known condition or situation can be identified
such as irritable bowel syndrome, rheumatoid arthritis, after a trauma, or
following an illness or infection. Some also feel the lack of sleep or sleep
loss can cause FM. This is because it takes about four hours of sustained sleep
to reach deep sleep, and because of frequent sleep interruptions, the person
never reaches deep sleep. Over time, deprived of the relaxing deep sleep
benefits, the body gradually tightens up, “re-setting the thermostat” and too
much sensory information reaches the brain, resulting in overload, and a
heightened pain level is perceived. Studies have shown that when sleep is
restored, many FM patients gradually improve and function better. This focus on
sleep restoration is important in the management strategies of FM treatment. We
all know our tolerance to just about everything suffers when we are over-tired,
similar to the toddler who cries at the drop of a dime when they need a nap.

            Chiropractic adjustments, certain
nutrients like melatonin, valerian root, and vitamin B complex can facilitate
sleep restoration. Treatment for sleep apnea can also help patients with FM. As
we’ve said before, FM is usually multi-factorial and including chiropractic in
the FM treatment “team” is essential for a satisfying result!

            If you, a friend or family member
requires care for FM, we sincerely appreciate the trust and confidence shown by
choosing our services!

To schedule an appointment for Fibromyalgia Treatment in San Francisco call 415-392-2225.

                                   

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Fibromyalgia and Nutrition Recommendations

Fibromyalgia experts san francisco CAFibromyalgia
(FM) management involves many treatment approaches. As was pointed out last
month, the importance of sleep quality, hormonal balance, infection management,
nutritional supplementation, exercise and more was discussed as the “SHINE”
approach. This month, we are going to explore how important diet is in the
management of FM.

As far as Fibromyalgia and Nutrition goes…

                It’s been said that one of the
most powerful tools the FM patient has in their possession is their FORK
because, “…food becomes cells.” That is to say, the food we eat is used to
build cells, tissues, and support our organ systems. The National Fibromyalgia
Association
(NFA) has reported that all FM patients have some common
physiological abnormalities that include:

  1. Too
    much Substance P (a pain producing neurotransmitter).
  2. Too
    little tryptophan (an essential amino acid that helps make serotonin which
    helps mood and many other things).
  3. Not
    enough serotonin (a brain neurotransmitter that fights depression)..
  4. Abnormalities
    in muscle cells, especially the mitochondria that provides energy (ATP) to the
    cell.

                With the exception of substance
P, we can control ALL of the above, at least in part, with diet and eating the
right food. The following 7 nutritional recommendations can make a significant
improvement for the FM sufferer:

  1. ELIMINATE FOOD TRIGGERS: Eliminate foods
    that irritate the digestive system. The NFA reports that 40% of FM
    patients have irritable bowel problems and food sensitivities that trigger
    abdominal pain, diarrhea, and headaches. Common food triggers include:
    monosodium glutamate (MSG), caffeine, food coloring, chocolate, shrimp,
    dairy products, eggs, gluten, yeast, milk, soy, corn, citrus, sugar and
    aspartame. Regarding aspartame and MSG – a 2010 study out of France
    reported FM symptoms subsided significantly after eliminating both from
    the diet, as they found that they stimulated certain neurotransmitters.
  2. EAT MORE TURKEY! That’s because
    turkey contains tryptophan, an essential amino acid that can help combat
    chronic fatigue and depression, which are common FM symptoms. In a large
    NFA 2007 survey of 2,596 FM patients, about 40% of the group complained of
    energy loss. Tryptophan is only acquired through food as our bodies cannot
    make it or convert it from other substances. Tryptophan is needed by our
    body to make serotonin (the “happiness hormone”) which improves our mood
    and makes melatonin, the chemical that helps us sleep deeply. Hence, to
    fight fatigue, avoid the food triggers mentioned in #1 and increase
    tryptophan, which can be found in certain protein rich foods such as
    cold-water fish (salmon, tuna, anchovies, and mackerel), nuts and seeds,
    soy (soymilk, tofu, and soybeans), turkey, and yogurt. Many of these foods
    also contain tyrosine, which increases levels of brain neurotransmitters
    dopamine and norepinephrine. These brain neurotransmitters help with cell
    messaging, alertness, and reduce cognitive “fog,” often described by FM
    sufferers. Also consider taking melatonin if sleep is an issue.
  3. EAT MORE SARDINES! Okay, turkey is
    more “palatable,” but sardines have the ability to reduce muscle pain, of
    which, according to the NFA survey, 63% of FM sufferers experience. This
    is thought to be due to coenzyme Q10 (CoQ10) deficiency, essential for
    muscle function and found in sardines and organ meats. Of course, if these
    natural food approaches don’t appeal to you, a CoQ10 supplement may be
    easier. In two studies, FM patients were found to be 40% deficient in
    CoQ10, and 30% experienced less muscle pain and fatigue after taking
    300mg/day for 9 months.

If
you, a friend or family member requires care for FM, we sincerely appreciate
the trust and confidence shown by choosing our services!

To schedule an appointment with one of our Fibromyalgia Treatment in San Francisco call 415-392-2225 and ask for a complimentary consultation.

 

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Fibromyalgia Treatment and “SHINE”

Fibromyalgia pain treatment san franciscoWe have been providing natural solutions for Fibromyalgia in San Francisco for over 20 years.

Fibromyalgia
(FM) management can be as difficult as making a definitive diagnosis.  FM is characterized by generalized body aches
and feeling exhausted, and yet, in spite of the exhaustion, the inability to
sleep is a “classic” FM complaint. Some have referred to FM as “blowing a fuse”
or as an “energy crisis,” as more energy is expended than what’s being made. FM
sufferers, as well as the caregivers, know how physically and mentally
difficult it is to manage this controversial condition. Many management
strategies that have been published; SHINE is one approach. SHINE stands for
Sleep, Hormones, Infections, Nutritional supplements, and Exercise. By focusing
treatment strategies on these 5 areas, significant benefits can be achieved.

            SLEEP:
Some feel this is the most important problem to manage in order to gain control
of FM. If we cannot reach “deep sleep,” (which is the sleep stage that is
usually reached after about the 4th hour into sleep) then the body cannot fully
rest. When discussing sleep problems with the FM patient, it is common to hear
them say, “…I wake up every 1-2 hours and can’t get back to sleep for at least
15-30 minutes.” This results in NEVER getting to the deep sleep stage and eventually,
because the body hasn’t fully relaxed often for years, everything starts
hurting. This is the hallmark of FM. Some “tips” to help us get to sleep and
stay sleeping include: keeping the bedroom cool (such as 65°), taking a hot
bath before sleep to relax your tight muscles, spraying the pillow with
lavender oil (helps promote sleep), taking 75-150mg of magnesium, avoiding
caffeine (especially later in the day), the use of Valarian Root (a muscle
relaxing herb) and/or melatonin (an amino acid that promotes sleep) can also
help. The goal is to try to get 8-9 hours of sleep a night. Establish a routine
in the evenings and go to bed at the same time or close to it.

            HORMONES:
These chemicals are produced by our endocrine glands (pituitary, thyroid, parathyroid,
adrenals, ovaries/testes, and part of our pancreas. They are in balance with
each other, and somehow, in FM they often fall out of balance. Have your health
care provider perform tests (usually blood and/or urine) to determine your
hormone levels and get them balanced!

            INFECTION: The lack of sleep lowers our immune
function, and infections can occur more readily. In addition to treatments,
there are nutritionally based approaches to improve immune function, and if
recurrent illnesses are part of your FM profile PLEASE consult with us
regarding ways to boost your immune system!

            NUTRITIONAL
SUPPLEMENTS:
This topic is related to the last as there are MANY supplement
recommendations that have been found to boost immune function, increase energy,
enhance sleep quality, and more. This is an area of FM management that is
largely overlooked by traditional medical management approaches. Remember, a
“team” of providers offers the FM sufferer the best way to manage this
challenging to treat condition. Look for health care providers who are willing
to work together as a team on your behalf.

            EXERCISE:
This is a MUST! For example, in a 2010 Oregon Health &
Sciences University

study, women with FM who practiced yoga for 8 weeks had a 24% pain reduction,
30% fatigue reduction, and 42% depression reduction.

            If you, a friend or family member
requires care for FM, we sincerely appreciate the trust and confidence shown by
choosing our services!

To schedule an appointment with a Fibromyalgia doctor in San Francisco call 415-392-2225.

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Fibromyalgia and Neurotransmission

Fibromyalgia therapy in san francisco, CAWe have been providing treatment for Fibromyalgia (FM) in San Francisco since 1992.

Neurotransmission
is the method by which nerves “speak” to each other so impulses can be sent
from one part of your body to the brain and back. For example, when you touch a
hot plate by accident, it doesn’t take long before you quickly let go of the
plate. The reason you let go quickly is because of neurotransmission. Certain
types of neurons or nerves (called afferents) bring information to the central
nervous system where the information is processed and then signals are
transferred back to the target site (such as your hand touching the hot plate)
by different nerves (called efferents) telling you to immediately let go of
that hot object. It’s like the flow of traffic into a city during rush hour.
People work all day and then drive in the opposite direction on their way home
(afferents in the morning going in the city or “brain” and efferents in the
evening bringing new information home). This “give and take” process of
information coming in, being processed and going out helps coordinate our
bodily functions. This allows us to constantly adapt to surrounding changes in
temperature, stress, noise, and so on.

            Each neuron has as many as 1500
connections from other neurons, but they don’t actually touch one another.
Rather, there are “synapses” where nerve impulses stimulate the release of
calcium and neurotransmitters, which either inhibit or excite another neuron
and each neuron may be connected to many other neurons. If the total excitatory
stimuli are greater than the inhibitory stimuli, that neuron will “fire” and
create a new connection resulting in an action (like dropping the hot plate).

            Okay, sorry for the enthusiastic
description and details of neurotransmission. More importantly, how does all
this relate to fibromyalgia?  A new study
(published May 14, 2012 in NATURE by scientists at Weill Cornell
Medical College
)
discovered that a single protein (alpha 2 delta), “…exerts a spigot-like
function controlling the volume of neurotransmitters and other chemicals that
flow between the synapses of brain neurons.” This study shows how brain cells
“talk to each other” through these synapses relaying feelings, thoughts, and
actions and how this powerful protein plays a crucial role in regulating
effective communication in the brain. They found that if they added or
decreased this single protein (alpha 2 delta), then the speed of
neurotransmission increased or decreased by opening or closing the calcium
channels that trigger neurotransmission release.

            The relationship between calcium and
neurotransmission has been known for 50 years, but how to “turn on or off” the
volume is a new discovery. They hope this finding will help in the design of
new medications that will help regulate the neurotransmission in the brain,
thus help reduce the increased pain perception found in people suffering from
fibromyalgia.

            Our aim in sharing this information
with you is to keep you informed with what is on the cutting edge of research
as we’ve said many times before, a “team” of health care provision is the BEST
way to manage FM including chiropractic and primary care!

            If you, a friend or family member
requires care for FM, we sincerely appreciate the trust and confidence shown by
choosing our services!

To schedule an appointment with one of our Fibromyalgia Doctors in San Francisco call 415-392-2225.

Serving local 94111 for over 20 years.

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Fibromyalgia and Sleeping Problems

Treatment for fibromyalgia pain in san franciscoFibromyalgia
(FM) and sleep dysfunction seem to go hand in hand. In fact, most people who
have FM complain of problems associated with sleeping. Sleep problems can
include difficulty falling asleep with or without waking up one to multiple
times a night. Also, the inability to reach “deep sleep” results in waking up
un-restored. People with fibromyalgia frequently state, “… I feel exhausted
when I wake up; I have no energy.” They often feel more tired in the morning,
and many go back to sleep during the day to ease their fatigue. Another common
FM complaint is having great difficulty concentrating during the day, often
referred to as, “…fibro fog.” Other sleep disorders such as sleep
apnea and restless leg syndrome are also often associated with FM.

            Restless legs syndrome (RLS) is a
neurologic disorder that is characterized by an overwhelming urge to move the
legs at rest, thus interfering with sleep. Restless legs syndrome is more
common among those who have fibromyalgia. Patients with RLS describe this as an
unpleasant sensation in their legs and sometimes their arms or other parts of
the body accompanied by the irresistible urge to move the legs in attempt to
relieve the sensation. The terms, “itchy” or “pins and needles” or “creepy
crawly” are frequently used when describing the sensations and can range from
mild to intolerable. Symptoms are typically worse at rest, especially when
lying or sitting and frequently results in sleep deprivation and stress. The
intensity of the symptoms can vary, frequently worse in the nighttime, better
in the morning. RLS may affect up to 10% of the population in the United States,
especially women, and can affect both young and old, even young children. The
severe cases usually affect the middle-aged or older and account for about 2-3%
of the 10% incident rate. The diagnosis is often delayed, sometimes for 10-20
years. Although the cause is not clearly described, genetics seems to play a
role given about 50% of those affected have a family member with the condition.

            Other conditions often associated
with RLS include iron deficiency, Parkinson’s disease, kidney failure, iron
deficiency, diabetes and peripheral neuropathy. Treatment applied to these
conditions often indirectly helps RLS resulting in sleep quality improvement.
Medications such as anti-nausea drugs, antipsychotic drugs, some
anti-depressants, and cold/allergy medications that contain antihistamines can
worsen symptoms. Pregnancy can also trigger RLS, especially in the last
trimester. It commonly takes about 3-4 weeks for the symptoms to quiet down
after delivery. Other factors that affect RLS include alcohol intake and sleep
deprivation itself. Improving sleep and/or eliminating alcohol can be quite
effective treatment strategies. There are no medical tests that confirm the
diagnosis of RLS, but blood tests can at least rule out other conditions, and
when all the tests are negative, the diagnosis is made based on a patient’s
symptoms, family history, medication use, the presence of an interrupted sleep
pattern with daytime fatigue, and knowledge about the condition.

            Treatment utilizing chiropractic
management has been reported to be effective in managing RLS associated
symptoms including the use of spinal manipulation, muscle release techniques,
exercise training, and at times, physical therapy modalities. Nutritional
approaches that emphasize muscle relaxation have also been reportedly helpful.

            If you, a friend or family member
requires care for FM, we sincerely appreciate the trust and confidence shown by
choosing our services!

To schedule an appointment with one of our San Francisco Fibromyalgia Doctors call 415-392-2225. Mention this article for a complimentary consultation.

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Fibromyalgia Nutrition Tips

Fibromyalgia doctor downtown SFWe have been providing treatment for Fibromyalgia in San Francisco for over 20 years.

Fibromyalgia
(FM) is a disorder that affects everyone a little differently. Therefore,
promoting a one diet approach for every FM patient doesn’t make a lot of sense.
However, according to Ginevra Liptan, MD, medical director of the Frida Center
for FM in Portland, OR, it is clear that what is included in a diet vs. what is
eliminated makes a big difference for many FM patients. It has been reported
that 42% of FM patients surveyed indicated their symptoms worsened after eating
certain foods. Here are some recommendations about diet to consider:

  1. Pay attention to how food makes YOU feel. Many FM patients
    have sensitivities to particular foods, but this is highly variable from
    person to person. Sensitivity to MSG, certain preservatives, eggs, gluten,
    and dairy are quite common. Keep a daily food journal for at least 2 weeks
    and write down the foods eaten and any associated symptoms like headaches,
    indigestion (irritable bowel syndrome irritation – IBS), or fatigue.
  2. Try Eliminating Certain Foods. Many FM patients
    have irritable bowel symptoms, and using an elimination diet can help
    determine which foods to cut out. Try it out for no less than 6-8 weeks in
    order to get the best results. Then, add it back into your diet and pay
    attention to how it makes you feel. The most commonly eliminated foods are
    dairy and gluten and the most common improvement is in fatigue reduction
    and reduced IBS symptoms like bloating and constipation.
  3. If you think you might have food sensitivities
    or allergies, talk with us.
    Sometimes it is best to obtain an
    evaluation from an allergist for food allergy testing. Dietitians can also
    assist in assuring that you don’t eliminate essential nutrients when foods
    are eliminated from the diet.
  4. Make it easier to Eat Healthy. Everyone,
    including the FM sufferer, should try to eat fruits, vegetables, whole
    grains (if not gluten sensitive), and lean meats or protein. A well
    balanced diet will give you more energy, which in turn, can improve your
    overall health. When pain and exhaustion are present, choose healthy foods
    that do not require a lot of preparation such as buying pre-washed
    vegetables, or purchase pre-prepared foods like beet salad and quinoa.
  5. Use Food to Help Fight Fatigue. Consume foods in a
    way that increases energy levels and prevent fatigue. Anecdotally, FM
    patients have reported that eating small meals frequently vs. restricting
    themselves to 3 meals a day can keep blood sugar levels more even and
    prevent the “hypoglycemic lows.” A snack high in protein around 3pm can
    prevent mid-day fatigue.  Make sure
    your breakfast includes some protein and whole grains (again, assuming
    there is no gluten sensitivity). Focus on getting enough sleep and staying
    active during the day as these can also prevent fatigue during the day.
  6. Check on Your Supplements. Some supplements
    have significant side effects and can interact with medications. Talk to
    the prescribing doctor or pharmacist about this. For example,
    antidepressants and certain supplements can interact.
  7. Focus on Your Overall Well-Being. A multiple
    approach to managing FM symptoms works better than a single approach.
    Things like yoga, massage, and deep breathing exercises, as well as
    routine chiropractic treatments can improve the overall quality of life.
    Increasing the quality of life is the ultimate goal for managing the FM
    patient. Going to bed at a consistent time, not eating too late, and
    exercising regularly are key components.

Our Chiropractors are experts when it comes to providing natural solutions for FM. To schedule an appointment with one of our San Francisco Fibromyalgia Doctors call 415-392-2225.

Serving zip code 94111 since 1992

 

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Fibromyalgia Basics You Should Know

Fibromyalgia san francisco
Fibromyalgia
(FM) is a disorder that includes widespread musculoskeletal pain along with
fatigue, sleep disturbance, memory changes, mood changes and more. Studies show
that FM amplifies or increases painful sensations by changing the way the brain
processes pain signals. FM is NOT a psychological disorder that only people
with a troubled past or present acquire. Nor is it due to being inactive or
lazy. If ANY doctor suggests that, PLEASE find a different doctor who
understands the pathogenesis of FM. Unfortunately, this can be a challenge!

                FM symptoms can begin after a
physical trauma, surgery, an infection and/or after a significant stress
experience. It can also just gradually appear over time without an obvious
triggering event. Women are more vulnerable to acquire FM than men. Many FM
patients have other conditions that may be associated with FM including (but
not limited to) headache, TMJ, irritable bowel syndrome, anxiety, depression,
thyroid/hormonal imbalances, endometriosis, and more.

                Though the cause of FM may not
be clearly identified, studies suggest there are a variety of factors that work
together resulting in FM. Some of these include genetics, infections and
physical and/or emotional trauma. Because FM tends to run in families, there
may be certain genes or genetic mutations (changes that occur to genes) that
make one more susceptible to developing FM. Infections appear to be a trigger for
developing or aggravating FM. Post-traumatic stress disorder and less obvious
physical or psychological trauma has been linked to the development of FM.  The amplified or heightened pain response has
been termed, “central sensitization,” meaning, increased sensitivity to normal
pain stimulation in the central nervous system (brain and spinal cord). Because
of this heightened nervous system response, what normally isn’t processed as
pain in the non-FM person, does reach and exceed the pain threshold in the FM
patient (sort of like when amputation of a limb occurs and the brain still
“thinks” there is a limb and “phantom pain” is felt). Studies show that
repeated pain signals result in an abnormal increase in certain brain chemicals
(called neurotransmitters). As a result, the brain’s pain receptors seem to develop
a “memory” of the pain and become “sensitized” or they overreact to the pain
signal input and pain is felt at an increased intensity. Certain risk factors
come into play with developing FM, some of which include: your sex (female),
family history (increased risk if other family members have FM), and rheumatic
diseases such as rheumatoid arthritis and lupus.

                 Tests to establish the diagnosis
of FM are few. In 1990, the American
College of Rheumatology

established 2 criteria for diagnosing FM. The first is widespread pain lasting
at least 3 months, and the second is the presence of at least 11 out of 18
positive tender points. Since then, less emphasis has been placed on the exact
number of tender points, while ruling out other possible underlying conditions
that might be causing the pain is now utilized. There is no lab test to confirm
a diagnosis of FM, but blood tests including a complete blood count, an ESR,
and thyroid function tests are commonly done to rule out other conditions that
have similar symptoms. Treatment is best approached by a “team effort”
combining the skills from multiple disciplines including a primary care doctor
who “believes in FM” and is willing to work with chiropractors, and others.
Exercising, pacing yourself, accepting your limitations, yoga, psychological
counseling, nutritional counseling, and having strong family/friend support are
all important in the management of FM.

                If you, a friend or family
member requires care for FM, we sincerely appreciate the trust and confidence
shown by choosing our services!

To schedule an appointment with a Fibromyalgia Doctor in San Francisco call 415-392-2225.

 

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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How Do You Know If It’s Fibromyalgia?

Fibromyalgia therapy san franciscoFibromyalgia (FM) symptoms are characterized by chronic generalized pain, and can include debilitating fatigue, sleep disturbance, joint stiffness, numbness or tingling, bowel/bladder dysfunction, and sometimes effects our ability to process thought clearly (cognitive dysfunction).  It can come on fast, almost overnight, or, develop very slowly over years of time. This highly variable onset makes establishing a diagnosis very challenging, and can also sometimes take years before the diagnosis is firmly established. In fact, the term “fibromyalgia” was not formally recognized as a diagnosis by the American College of Rheumatology and American Medical Association until 1987, and it remains a diagnosis made by excluding other diseases!

POPULAR MYTHS

MYTH: “Your symptoms are all in your head.” TRUTH: FM is a “MEDICAL DISORDER” where the nervous system’s ability to process pain is different when compared to those who don’t have FM. Why there is a difference between individuals is the big question. Some research suggests these brain processing differences may be the result of childhood stress, or prolonged or severe stress.

MYTH: “Only lazy, inactive people get fibromyalgia.” TRUTH: Research shows this not to be the case. In fact, most people with FM are focused and driven, and that stress associated with that intense drive may play a significant role in the development of FM symptoms.

MYTH: “There are no effective fibro treatments.” TRUTH: The good news is that as more studies on FM arise, we are beginning to understand more about FM, resulting in more effective treatments. The “catch” is that what works for one individual may not work for another making it essential to find a “good doctor” (or rather, a good team of health care providers) who is willing to listen and continually try different approaches until an effective management approach is found.

COEXISTING CONDITIONS

                There are some specific conditions that go hand in hand with FM, and though it’s not clear which comes first (FM or the condition), a clear relationship has been established. Some of these co-existing conditions include irritable bowel syndrome, arthritis (several different types can be associated), chronic fatigue syndrome, various sleep disorders, post-traumatic stress syndrome, anxiety, depression, and others. Often, blood and other lab tests come back negative and hence, the diagnosis is made by excluding those other conditions. What is MOST important is that to feel your best, these other conditions also need to be managed.

TREATMENT

                As stated above, the management of FM is aimed at all the condition(s) affecting the person with FM. This is why a multidiscipline “team” of health care providers is so important, as we all have our own emphasis and perspective on what to do for patients. Options include: a clinical psychologist to manage the chemical and hormonal imbalances, a primary care doctor whom “believes in FM,” and a chiropractor to manage the musculoskeletal issues of FM. Other alternative approaches such as massage therapy, Yoga classes, and acupuncture can also provide significant relief. Nutritional counseling is also highly effective in the management strategy of FM. Most important is the fact that coordination between these various approaches be supervised. Since we deal with the whole person, chiropractors are the PERFECT CANDIDATE for that job!

                If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

To schedule an appointment with a fibromyalgia doctor in San Francisco call 415-392-2225

 

 

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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