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Fibromyalgia

If you have been diagnosed with Fibromyalgia (FM) by a physician, neurologist, internist, or pain management specialist, it probably surprised you to land on our dental site. Please read on!

Fibromyalgia is a common syndrome in which a person has long term, body wide pain and tenderness in the joints, muscles, tendons, and other soft tissues. The cause is unknown.

Fibromyalgia is a diagnosis of exclusion.

  1. Blood and urine tests are usually normal. Tests may be done to rule out other conditions. Mild to severe pain is the main symptom of fibromyalgia.
  2. Painful areas are called tender points. Tender points are found in the soft tissue on the back of the neck, shoulders, chest, lower back, hips, shins, elbows, and knees. The pain then spreads out from these areas.
  3. The pain may feel like a deep ache, or a shooting, burning pain. The joints are not affected, although the pain may feel like it is coming from the joints.
  4. These ‘tender points’ are sore and painful areas in the muscles themselves rather than from the joints as in arthritis.
  5. Pain may get worse with activity, cold or damp weather, anxiety, and stress.
  6. To be diagnosed with fibromyalgia, you must have had at least 3 months of widespread pain, and pain and tenderness in at least 11 of 18 areas (tender points), including:
  • Arms (elbows)
  • Buttocks
  • Chest
  • Knees
  • Lower back
  • Neck
  • Rib cage
  • Shoulders
  • Thighs

How does this relate to TMD?

10 out of these 18 tender points for Fibromyalgia diagnosis are in head and neck area and are many of the same muscles used for positive diagnosis of TMD. These TMD diagnostic points in dentistry are called trigger points.

A misaligned jaw causes an improper head and neck posture which often results in postural compensations down the postural chain to the feet. When the shoulders and hips are not level, the muscles of the legs and back have to work non-stop to make up for that imbalance. Is it not conceivable that FM patients are just TMD patients with one or more of the “other 8” tender points below the head and neck? That is all that would be needed for a FM diagnosis.

Fibromyalgia Treatment

  1. The goal of treatment is to help relieve pain and other symptoms, and to help a person cope with the symptoms.
  2. The first type of treatment may involve physical therapy, an exercise and fitness program, and stress-relief methods, including light massage and relaxation techniques.
  3. Many medications are used to treat the condition including:
  • Anti-seizure drugs
  • Other antidepressants
  • Muscle relaxants
  • Pain relievers
  • Sleeping aids

Expectations (Prognosis)

Fibromyalgia is a long-term disorder. Sometimes the symptoms improve, but often the pain gets worse and continues for months or years.

Unfortunately, I have yet to see Fibromyalgia patients completely resolve their pain after Neuromuscular TMD Therapy allowing them to entirely eliminate their medications and reclaim their lives. What I have seen though, are great improvements so that I am convinced Fibromyalgia is a group of symptoms resulting from a musculoskeletal system that exceeded its adaptive capacity due to the imbalances throughout the postural chain, that are in some way influenced by jaw alignment. The jaw alignment could play a primary role or be one of the imbalances in the cascade of events that result in Fibromyalgia. Neuromuscular TMD therapy could stop the progression of the symptoms and/or start slow regeneration in the damaged systems.