Fibromyalgia, joint pain and sleep. Finding a common ground through sleep.

Anyone who has been diagnosed with Fibromyalgia, or has joint pain and achiness has also likely been challenged by problems with the quality of their sleep.  Without getting too technical, sleep disturbance is one of the symptoms of Fibromyalgia.

Earlier this week, while dining with Dr. F (A well-known local Rheumatologist who helped craft the current criteria for Fibromyalgia) and Stu Carlitz, (the president of Eclipse who manufactures Therapedic as well as other brands of mattress), we had a lively discussion about chronic pain, Fibromyalgia and how to improve the quality of sleep in these individuals through better mattress design. 

During the conversation, it was clear that Dr. F who is currently involved in a drug trial and has pioneered the use of drugs such as Lyrica had a belief that Fibromyalgia according to the latest research is a neuro-chemical problem with a likely genetic basis (pain threshold is believed to be genetic based on current research).  Apparently, Lyrica is one of the drugs of choice for chronic Fibromyalgia and according to Dr. F, in Europe it is also approved as a sleep aid.  Dr. F believes based on what he has seen clinically that if you improve sleep, reported levels of pain are markedly reduced. 

The book Cheating Mother Nature, what you need to know to beat chronic pain talks about fibromyalgia in a more functional way.  One of the criteria is the 18 tender points which are not described other than to look for them as diagnostic criteria. In the medical world, if the person has a certain number of these tender points, and sleep problems, where they do not reach the deepest levels of sleep, they can be classified as having Fibromyalgia. In the book, it shows what the tender points are, which are areas of strain from Bio implosion, a concept pioneered by Brian Rothbart DPM, who is sort of a podiatric heretic who I believe based on years of observation and practice, figured out years ago the basis for chronic pain.  If bio implosion occurs only on one side, the asymmetry distorts the pelvis  in a similar way to how a towel is twisted which strains all the joints throughout the body.  This is as described in the book the reason chronic pain exists and the problem begins at the feet and is compensated by the myofascial that surrounds the core muscles.

The reality is that long term, as chronic pain develops, more pain results in a less restful sleep from the point of view of Cheating Mother Nature.  From Dr. F’s point of view, lack of sleep causes chronic pain, and Lyrica improves sleep quality and therefore helps these people function better. Dr. F also believes that Lyrica works on the neurology behind the abnormal pain these people experience.  Current research shows the body will adapt to its situations neurologically so chronic pain accommodation can go terribly wrong.

When trying to help those who meet the Fibromyalgia criteria, are we treating a disease classification with a drug that works while they take it, or do we fix the mechanical problems that create bio implosion to fix the problem.

A third idea comes to mind.  What if the mattress design addressed the sleep issue? This is why Mr. Carlitz decided we should work with one another and this is why the conversation was so fruitful.  We all agreed on the fact that better sleep improved pain levels.  The challenge now is to design a sleep system to address it head on, with the help of Dr. F’s guidance would decrease the reliance on drugs and allow people with mechanical basis problems to feel better and more refreshed in the morning.  The result will be less pain, less reliance on medication and while many of these people can benefit from the correct biomechanical interventions such as foot orthotics, fascial release treatment and manipulation, often their mattress offers a consistency not offered on today’s healthcare system since your mileage may vary between different healthcare providers and belief systems.

At the end of dinner, I gave Dr. F a copy of my book and suggested we get together for lunch or dinner more often.  We go back quite a few years as being friends and colleagues.  I think the open exchange of ideas is important, to avoid any of us from retreating back too far into our own ideologies.  While I believe that almost all chronic pain begins from asymmetry of the musculoskeletal system, I also believe there is a time and place for medical co management as well.  Conversely, they need to see things in a similar light.  At least we can agree on the importance of sleep and how a bed may be able to affect the growing problem of chronic pain.

Cheating Mother Nature is available through Amazon.com and other booksellers.  You can check out Dr. Charschan's authors page at whypeoplehurt.com and visit his blog at http://www.backfixer1.com/blog/.

Dr. F is a well known Rhumatologist in NJ who helped craft the current Fibromyalgia criteria. He is current involved in a 20 center drug trial to help those in chronic pain.