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Is There a Connection Between Fibromyalgia and Traumatic Stress?

16 Aug

Question:
I'd like to ask Belleruth about the seeming correlation between trauma and fibromyalgia in women.  Has there been any research into this?

Answer:
Mary, I write about this in Invisible Heroes.  At the time of publication there were only 2 studies published, showing the link between fibromyalgia and traumatic stress – for men or women, although either condition hits more women than men.  Now there are too many studies to count, but you can start with a recent article by some Italian researchers, Stisi et al, titled Etiopathogenetic mechanisms of fibromyalgia syndrome. Robert Scaer was on to this years ago, and wrote about it in The Body Bears the Burden.  But the short answer is YES, there is a big, fat correlation.

Here is an explanatory (or at least I hope so) excerpt of the relevant material from my book (and for those of you who have the book, it’s in Chapter 5, The Physical Effects of Trauma, pages 78-80.

Chronic Pain Conditions
This constant activation of the alarm state leads to an accumulation of metabolic waste products in the muscle fibers, and the release of kinins and other chemical pain generators in the tissue, resulting in myofascial pain and the appearance of those seemingly intractable chronic conditions such as fibromyalgia, chronic fatigue, irritable bowel syndrome, chronic headache, TMJ and more.   

And because these conditions are generated in the brain stem and the motor reflex centers in the spinal column, and routed through a perturbed, automatic, arousal circuitry, peripheral forms of treatment provide only temporary relief.  Constantly activated by everyday sensory cues, normal muscle movement and spontaneous memories, symptoms grow and become more and more entrenched over time.  In other words, this is one nasty gift from the kindled feedback loop that, if not interrupted, will just keep on giving.  

Our epidemiology research has already shown us an astounding percentage of people with baffling chronic pain conditions and “functional” diseases that have no obvious causes, who have been found to have prior histories of severe trauma.  Probably if we could tease out the subset of traumatized people who experienced substantial dissociation during their trauma, and a truncated freeze response in the midst of it, we might find closer to one hundred percent suffering from posttraumatic stress.  Unfortunately for them, they are often assumed to be malingering or engaged in attention-seeking behavior for neurotic reasons, instead of suffering from a very serious, self perpetuating condition with a potentially worsening trajectory.

Included in this group of maligned and misunderstood patients would be scores of people suffering from pelvic and low back pain, orofacial and myofascial pain, genito-urinary and abdominal pain; interstitial cystitis; and the previously mentioned headache, fibromyalgia (FM), chronic fatigue syndrome (CFS), and reflex sympathetic dystrophy (RSD); irritable bowel syndrome (IBS), inflammatory bowel disorder (IBD), multiple chemical sensitivity (MCS) and migraine. 

Thanks for asking.  Too many people still don’t know about this connection.
All best,
Belleruth

Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award