What are the symptoms of Fibromyalgia?

Each individual can experience different symptoms, but the most common are:

• Fatigue that is disproportionate to the level of the individual’s activity and sleep
• Stiffness, tenderness and a high level of pain in the muscles and joints
• Anxiety, depression and possible bowel function problems
• Poor sleep patterns or waking after long bouts of sleep, but still feeling tired all day.
• Poor memory and alertness. A ‘foggy’ feeling in the brain.

The symptoms of Fibromyalgia are cyclical and each symptom can create the onset of another. The typical cycle would be:

An injury or disease leads to limited physical activity – which leads to muscular tension or stiffness – leading to stress/depression/anxiety – which leads to poor sleep – leading to pain – which leads to disease etc …and so the cycle will resume and continue. Breaking this cycle is essential to the recovery of a Fibromyalgia patient.

What are the causes of Fibromyalgia?

Far more prevalent in women than in men, there is really no known cause of this disease. It is extremely difficult to diagnose and treat, as it is neither an inflammatory, degenerative, nor an auto-immune disease.

What is known is that Fibromyalgia appears to manifest itself after:

• A stressful event like a motor accident or the death of a loved one
• A traumatic injury
• Repetitive poor sleeping patterns
• The sudden onset of an unexpected or chronic illness like Lupus or Rheumatoid arthritis

What is my best course of action?

Alleviating any of the symptoms of Fibromyalgia, even temporarily, can enable the sufferer to break the chain of symptoms and experience some relief or potentially break the cycle altogether.

Because it is difficult to diagnose and other conditions like an underactive thyroid, Vitamin D deficiency, or Rheumatoid arthritis can mimic this disease, extensive testing by a doctor or Rheumatologist may be necessary to eventually establish that you have Fibromyalgia.

Through alleviation of the pain, even for a few days, your Physiotherapist can assist you in finding, starting and maintaining comfortable and regular exercises, in addition to providing guidance on sleeping more comfortably. The combination of a reduction in pain, improved sleep and regular exercise provides a massive leap towards snowballing back in the right direction. Contact us for advice, referral to the correct specialist if necessary and positive treatment of this complex, yet but not necessarily incurable, disease. 

What are the common types of headaches treated by Physiotherapists?

Sinus, Tension, Cluster, Migraine and Cervicogenic headaches all greatly benefit from physiotherapy. All of these headaches fall under four broader categories of headaches which are:

Neck headaches

Neck headaches, also known as Cervicogenic headaches, are typically mistaken for ‘Migraine’ headaches when self diagnosed. These can often be eliminated through the successful treatment of neck disorders, with or without having experienced neck symptoms up until then. These headaches are caused by dysfunction in the musculoskeletal and neurovascular structures in your neck, including the upper three neck joints, which send a signals to the brain that are ultimately interpreted as a headache.

Migraines

Migraine pain is often described as ‘throbbing’ and can be of moderate to severe intensity. Occurring only on one side of the head, but sometimes alternating sides with different attacks, the cause of migraines is not actually know for certain. The current belief is that hormonal and blood pressure changes adversely affect the electrical impulses in the brain which leads to visual, auditory and olfactory (smell) sensitivities and/or hallucinations. One or more of these are frequently, but not always, accompanied by pain or a headache.

Tension headaches

Tension headaches are the most common type of headaches and only need to be treated if they’re constantly re-occurring or if symptoms become chronic. Generally brought on by stress, it is irritating but not necessarily debilitating.

Sinus headaches

The build-up of pressure in your sinuses can cause deep and constant pain in your cheekbones, forehead, or the bridge of your nose and the combination of these can feel like a headache. Your sinuses can also be aggravated by tension in the upper three vertebrae and therefore, what many don’t realise, is that Physiotherapists can relieve the pressure by assisting the sinuses to drain, as well as addressing any contributing factors stemming from the neck.

Can I be suffering more than one type of headache at once?

You most certainly can. We are by no means living in isolated boxes, being exposed to only one thing at a time. You may have irritated sinuses from a food allergy or pollen and be under a tremendous amount of pressure in addition to having had a bumper bashing at some point in the past. With the combined symptoms arising from a sinus headache, a tension headache and a neck headache all at once, its no wonder that I often hear individuals complaining about having a migraine – they must think that nothing else can be that debilitating! It’s all the more reason then that neck pain, discomfort, injury or headache, should be assessed by a physiotherapist, the medical experts in dealing with musculoskeletal conditions. It saves time and money to refer yourself, as we as Physiotherapists are trained to identify situations beyond our scope of practice and will refer you to the appropriate health professional to address your individual situation – This ability is what lead to physiotherapists being awarded the :First-line practitioner status”.

Word of warning

If the headaches you have been suffering from are new or very severe in nature they should be examined and diagnosed as soon as possible. There may be no be cause for alarm, but your health professional needs to rule out any sinister or progressive conditions to ensure that you are able to bounce back quickly or receive the appropriate treatment to address the condition as soon as possible.

Should you like to speak to us about your particular situation, feel free to give us call.

The more common types of musculoskeletal pain are lower back pain (LBP), whiplash, headaches, tendonitis (tendon inflammation), myalgia (muscle pain) and fractures. These could result from trauma, repeated movements, sports/exercise, poor posture or being immobilised (keeping still) for a prolonged period of time.

The symptoms differ from person to person and depend greatly on the cause and the duration of the injury. Common symptoms include: Pain that is aggravated by movement and remains after movement; Stiffness or aching with or without any movement; Sharp, stabbing pain with movement that resolves greatly after movement; Fatigue, Sleep disturbances or the inability to get comfortable; Burning sensations and Twitching.

My rule of thumb for any musculoskeletal pain is to have an assessment and treatment done by a Physiotherapist if you have not seen a drastic improvement within 3 days of the onset of the pain. Patients commonly try to cope by using medication and only turn to Physiotherapy after a few months having tried numerous remedies (or trying to ignore the pain). The problem here is that even an acute injury has then become chronic. The muscles have tightened more, the joints have sustained further damage while moving differently (in an attempt to avoid the pain during function) and the medication has not only cost a lot (while simply hiding your symptoms), but they have usually also started damaging your stomach lining.

The effect of all this is that you may have problems with ulcers, you have spent money and you have had no actual healing of the injury. In fact, the injury has most probably progressed and the number of treatments you may need to help the injury heal is now substantially more.

Very few people know just how simple it could be to rid you of the niggles you deal with on a daily basis. AND in South Africa, you do not even need a referral from your GP as Physiotherapists are first-line practitioners which means that we can assess, diagnose and treat the problem while being fully aware of other possible conditions outside the scope of Physiotherapy for which we will refer you to the relevant practitioner if need be.

Treatments for musculoskeletal pain may include splinting, rest, heat or icing, myofacial release, joint mobilisations or manipulations, dry needling, strengthening/conditioning/stretching exercises and anti-inflammatory/muscle relaxing medications. These treatments will vary depending on the findings on assessment, your diagnosis and the nature of the condition.

What causes TMD?

One of the important and most common causes of TMD dysfunction is the prolonged opening of the mouth during a dental procedure, like that experienced in the removal of wisdom teeth, which can cause severe jaw pain. Other causes include:

• An over or under bite.
• Displacement of the articular disc within the joint.
• Arthritis of the TMJ.
• Grinding of the teeth in your sleep.
• Dysfunction or a biomechanical imbalance of the chewing muscles.
• Poor neck posture.
• Stress, whiplash and a blow to the jaw, are amongst many contributing causes.

What are the symptoms of TMD?

Pain is not always experienced with TMD, but prolonged jaw pain after the removal of wisdom teeth, for example, would be one possible symptom and ear and neck pain can also be experienced. Other symptoms would include:

• Clicking, popping or grinding of the jaw
• An inability to fully open or fully clench the jaw
• Teeth grinding and clenching
• Headaches and dizziness
• An inability to properly eat, talk or sing and sometimes even Tinnitus or ringing in the ears can be a sign of possible TMD.

What should I do if I experience the symptoms of TMD?

You can directly contact your Physiotherapist who will clinically assess the joint condition and start with corrective treatments or refer you to a relevant health professional if warranted. Although your Dentist may be consulted for additional input on using an assistive device during the rehabilitation process, a TMJ trained Physiotherapist will be competent in the recovery and rehabilitation of the pain from wisdom teeth removal and most other forms of TMD. There are several treatments and exercises that your Physiotherapist may recommend, so contact us to start on a recovery program today, to ensure this bothersome and often debilitating disorder can be appropriately addressed and your TMJ functions restored.