Fibromyalgia and tender points

What are tender points?
Tender points are pain points or localized areas of tenderness around joints, but not the joints themselves. These tender points hurt when pressed with a finger.

Tender points are often not deep areas of pain. Instead, they are superficial areas seemingly under the surface of the skin, such as the area over the elbow or shoulder.

Are tender points large areas of pain?
No. The actual size of the point of most tenderness is usually very small, about the size of a penny. These areas are much more sensitive than other nearby areas. In fact, pressure on one of the tender points with a finger will cause pain that makes the person flinch or pull back. Tender points are scattered over the neck, back, chest, elbows, hips, buttocks, and knees.

What causes tender points?
The cause of these pressure points is not known. Even though it would seem these areas might be inflamed, researchers have not found particular signs of inflammation when examining the tissue. What is known is that the locations of tender points are not random. They occur in predictable places on the body. That means many people with fibromyalgia experience similar symptoms with tender points.


Can my doctor diagnose fibromyalgia from the tender points?
Your doctor can test the painful tender points during an examination.Yet even with tender points, you need to tell your doctor about the exact pain you feel in those areas. You also need to tell the doctor about your other symptoms of fibromyalgia, such as deep muscle pain, fatigue, sleep problems, depression, irritable bowel syndrome, and more.

When a doctor tests tender points for pain, he or she will also check “control” points or other non-tender points on your body to make sure you don’t react to these as well.

For a diagnosis of fibromyalgia, the symptom of widespread pain must have been present for three months.

Is there a prescription medication that eases the pain of tender points?
Pain management for tender points with fibromyalgia involves a multifaceted treatment program that employs both conventional and alternative therapies. While the reason is not entirely clear, fibromyalgia pain and fatigue sometimes respond to low doses of antidepressants. However, the treatment for fibromyalgia and tender points involves medications, daily stress management, exercise, hydrotherapy using heat and ice, and rest. Other remedies for symptoms may also be used.

What at-home treatments might help in managing tender point pain?
Alternative treatments or home remedies are important in managing fibromyalgia and the pain of tender points. As an example, therapeutic massage can manipulate the muscles and soft tissues of the body to help ease pain, muscle tension, spasms, and stress.

Twice daily moist heat applications are also helpful in easing the deep muscle pain and stiffness. To benefit from moist heat, you can use a moist heating pad, warm shower, or a heat “cozy” that you warm in the microwave. You can also relax in a Jacuzzi.

With fibromyalgia, it’s extremely important to manage your schedule and to control your level of stress. Be sure to block time each day to rest and relax. Avoid making too many commitments that can increase stress and fatigue. In addition, you can do relaxation exercises such as guided imagery, deep-breathing exercises, or the relaxation response to manage how you respond to stress.

Staying on a regular bedtime routine is also important. Doing so allows your body to rest and repair itself. In addition, regular exercise is vital to managing the pain, depression, and other symptoms of fibromyalgia.

A number of factors can make fibromyalgia symptoms worse. They include:

  • Anxiety
  • Changes in weather — for example, cold or humidity
  • Depression
  • Fatigue
  • Hormonal fluctuations such as PMS
  • Infections
  • Lack of sleep or restless sleep
  • Periods of emotional stress
  • Physical exhaustion
  • Sedentary lifestyle

Fibromyalgia and Fatigue

Persistent and chronic fatigue is one of the most common symptoms of fibromyalgia, second only to the deep muscle pain and body aches. But unlike normal fatigue, the feelings of fatigue, weakness, and exhaustion that come with fibromyalgia can often lead to unending social isolation, even depression.

What Is Fatigue With Fibromyalgia?
Fatigue with fibromyalgia is described as crippling, exhausting, and flu-like. You may experience fatigue on arising, even after hours of bed rest. And many people with fibromyalgia have disturbances in deep-level or restful sleep, so the fatigue they feel is not easy to treat.

The fatigue with fibromyalgia syndrome (FMS) often coincides with mood disturbances, anxiety, or depression. People with fibromyalgia may describe their sleep as unrefreshing or light. Some people with fibromyalgia have pain and achiness around the joints in the neck, shoulder, back, and hips. This makes it even more difficult to sleep and worsens their daytime feelings of sleepiness and fatigue.

Experts theorize that there are similarities between fibromyalgia and chronic fatigue syndrome, which is a condition primarily characterized by ongoing, debilitating fatigue. Often, people with fibromyalgia describe the fatigue they feel as “brain fatigue.” They report a total loss of energy and difficulty concentrating, a condition called “fibro fog.”

Fibromyalgia can cause signs and feelings similar to what people experience with osteoarthritis, bursitis, and tendinitis. But unlike the localized pain with bursitis or tendinitis, the feelings of pain and stiffness with fibromyalgia are widespread.


Do Daytime Naps Help Fatigue With Fibromyalgia?
On good days, the fatigue with fibromyalgia may be tolerable with daytime napping. However, on bad days, when fibromyalgia symptoms flare, dealing with fatigue can be quite difficult for both individuals with fibromyalgia and their loved ones. Even multiple rest periods throughout the day may fail to provide relief from the chronic achiness, fatigue, and exhaustion.

Can I Continue to Work With Fibromyalgia and Fatigue?
Some people with fibromyalgia say they experience great stress on the job. Some say they fear they may be let go and be replaced by healthier, more qualified workers. Others are concerned because they are not able to perform the way they used to. Employers also report concern over the output of chronically ill patients. They cite reduced productivity, increased absenteeism, poor work quality, and increased workplace accidents. But if you stay mentally and physically able to handle your job responsibilities, you can continue to be a productive employee, even with fibromyalgia and fatigue.

Symptoms of fibromyalgia may wax and wane over time. You may, however, continue to experience muscle pain and fatigue. That doesn’t mean there is nothing you can do. Here are actions you can take to help keep fatigue at bay:

  • If your employer will allow it, put a cot in your office or workroom. Then allow yourself to take rest periods throughout the day, especially when symptoms flare and you are fatigued.
  • Try to allow more time during the day to complete your responsibilities.
  • Budget your time carefully to avoid procrastinating. Procrastination can increase your stress level when deadlines come around.
  • Make daily “To Do” lists to remind yourself of the responsibilities you need to complete.
  • Limit outside commitments on work days.
  • Ask for help from coworkers when pain and fatigue are overwhelming. Pay them back with your assistance on days you feel better.
  • Take periodic breaks to avoid getting overly tired or stressed during busy workdays.
  • If appropriate. listen to music during your workday to help keep your stress levels minimal.

What is Fibromyalgia and it’s symptoms

Fibromyalgia Overview

Fibromyalgia syndrome affects the muscles and soft tissue. Symptoms include chronic muscle pain, fatigue, sleep problems, and painful tender points or trigger points, which can be relieved through medications, lifestyle changes and stress management.

Symptoms of Fibromyalgia

Symptoms of fibromyalgia include:

  • Chronic muscle pain, muscle spasms, or tightness
  • Moderate or severe fatigue and decreased energy
  • Insomnia or waking up feeling just as tired as when you went to sleep
  • Stiffness upon waking or after staying in one position for too long
  • Difficulty remembering, concentrating, and performing simple mental tasks (“fibro fog”)
  • Abdominal pain, bloating, nausea, and constipation alternating with diarrhea (irritable bowel syndrome)
  • Tension or migraine headaches
  • Jaw and facial tenderness
  • Sensitivity to one or more of the following: odors, noise, bright lights, medications, certain foods, and cold
  • Feeling anxious or depressed
  • Numbness or tingling in the face, arms, hands, legs, or feet
  • Increase in urinary urgency or frequency (irritable bladder)
  • Reduced tolerance for exercise and muscle pain after exercise
  • A feeling of swelling (without actual swelling) in the hands and feet

    Fibromyalgia symptoms may intensify depending on the time of day — morning, late afternoon, and evening tend to be the worst times. Symptoms may also get worse with fatigue, tension, inactivity, changes in the weather, cold or drafty conditions, overexertion, hormonal fluctuations (such as just before your period or during menopause), stress, depression, or other emotional factors.

If the condition is not diagnosed and treated early, symptoms can go on indefinitely, or they may disappear for months and then recur.

What is restless leg syndrome and what causes it?

Restless legs syndrome (RLS) also known as Willis-Ekbom disease (WED) or Wittmaack-Ekbom syndrome, is a neurological disorder characterized by an irresistible urge to move one’s body to stop uncomfortable or odd sensations. It most commonly affects the legs, but can affect the arms, torso, head, and even phantom limbs. Moving the affected body part modulates the sensations, providing temporary relief. WED/RLS sensations range from pain or an aching in the muscles, to an itch you can’t scratch, an unpleasant tickle that won’t stop, or even a crawling feeling.

While the exact cause of RLS (Restless Leg Syndrome) is still elusive to researchers, many consider these reasons contribute to the cause:

  • Diabetes
  • Kidney Failure
  • Hereditary Gene
  • Iron Deficiencies
  • Parkinson’s Disease
  • Peripheral Neuropathy
  • Pregnancy
  • Rheumatoid Arthritis


Diabetes and RLS

Changes in the blood sugar levels and can damage small capillaries and nerve endings in all parts of your body with the fingers and toes being the first to be affected.

The nerve signals to the brain are interrupted and can contribute to the twitching and/or involuntary jerking of the legs of Restless Leg Syndrome symptoms.

Kidney Failure and RLS

The Kidneys help to clean and balance the chemical makeup of the blood. The kidneys help remove toxins and wastes from the body by constantly filtering the blood.

If the kidneys have been damaged or diseased some of the Restless Leg Syndrome symptoms of itching, numbness, tingling and muscle cramps.

Family Heritage and RLS

Restless Leg Syndrome has a tendency to run in families. Inherited RLS shows up in 60% of cases. Most often an individual will not start to show symptoms until their 30’s or 40’s but the condition can show up in children too.

The severity of the condition will vary but most individuals will experience the symptoms on and off for the rest of their life.

Why Are Nitric Oxide Levels Important?

Nitric Oxide was first discovered by Dr. Robert Furchgott in 1980 as a vasodilating substance produced by the cells lining our blood vessels, or endothelial cells.
Dr. Furchgott was awarded the Nobel Prize in 1998 along with 2 other scientists for the discovery of the critical cardiovascular role of nitric oxide.  The American Heart Association noted in an interview that “the discovery of nitric oxide and its function is one of the most important in the history of cardiovascular medicine.”

Nitric Oxide is a signaling molecule.  When it’s created and released, this gas easily and quickly penetrates nearby membranes and cells, sending its signals.  In less than a second, NO(nitric oxide) signals arteries to relax and expand, immune cells to kill bacterial and cancer cells, and brain cells to communicate with each other.

When we are young and healthy, our artery cells produce NO through L-arginine efficiently.  People over 40 years of age probably don’t create enough NO  and it creates 50% loss in endothelial function in normal healthy adults who have no other cardiovascular risk except being over 40.  Testing your nitric oxide levels are available now and supplementation using L-arginine, NEO 40 daily product and/or Organic Greens & Reds can boost nitric oxide levels in the body.  Keeping adequate levels of nitric oxide levels will prevent high blood pressure, keep arteries young and flexible, prevent slow or reverse buildup of artery-clogging arterial plaques, help stop the formation of artery-clogging blood clots and reduce inflammation.  Nitric Oxide has also been linked to improving sexual function in both men and women, reduce risk of diabetes and conditions related to diabetes such as foot and leg ulcers, blindness and amputations.  As well as swelling and pain of arthritis, inflammation of ashthma, protect bones from osteoporosis, assist the immune system in killing bacteria.



  • Nitric Oxide (L-Arginine): Amino acid that supports Nitric Oxide formation which dilates blood vessels thereby increasing blood flow and circulation.
  • EPA/DHA (Fish Oils):  Cardiovascular benefits are numerous. Benefits include increasing blood flow, enhance the immune system, and lowers blood pressure.
  • Cal/Mg(Calcium and Magnesium): Reduces muscle spasms, regulates the body’s calcium magnesium pump. Slows digestion to aid in a healthy GI tract, more nutrient absorption and healthy glycemic control.
  • Vitamin D : Essential for everyone in the Pacific Northwest due to a lack of sun exposure. Promotes healthy teeth, bone growth and hormonal balance. Increases resistance to germs by supporting the immune system.
  • Vitamin B12: Helps to form and produce new red blood cells.
  • PhytoMulti: Provides antioxidants and factors for the maintenance of good health.  Provides phytonutrients from vegetables and fruit.
  • Ultra Flora Plus DF: Helps maintain a healthy balance of intestinal flora and is designed to provide intestinal support on multiple levels.  Supports a healthy immune system.  Helps reduce pain and inflammation.
  • Co Q10 St 200 (CoEnzyme Q10): Nutritional support designed to improve cardiovascular health. This helps with the damage from the STATIN DRUGS and is a powerful antioxidant.
  • Meta Lipoate 300- Nutritional support designed to decrease inflammation and promote healthy glucose metabolism.
  • Acetyl-L-Carnitine- Nutritional support designed to reduce physical and mental fatigue and enhance cognitive function. Helps regenerate the nerves and is a powerful antioxidant

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Wellness Coach® Spine Clinic

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What is Peripheral Neuropathy and What causes it?

Peripheral Neuropathy (PN) Occurs when nerves are damaged or destroyed and can’t send messages to the muscles, skin, brain and other parts. Peripheral nerves run from the brain and spinal cord to the arms, hands, legs, and feet. When damage occurs, numbness and pain in these areas may occur. It can affect multiple nerves (polyneuropathy) or only one nerve or nerve group (mononeuropathy) due to trauma, injury, local compression, prolonged pressure, or inflammation.  It starts with numbness, prickling or tingling in the toes or fingers. It may spread up the feet or hands and cause burning, freezing, throbbing and/or shooting pains. It is often worse at night. Sometimes it is constant or periodic and usually the pain is felt equally in both hands or in both feet. It can develop suddenly, while others progress more slowly over many years.

The majority of people, however, suffer from polyneuropathy, an umbrella term for damage involving many nerves at the same time. The body’s nervous system is made up of two parts. The central nervous system (CNS) includes the brain and the spinal cord. The peripheral nervous system (PNS) connects the nerves running from the brain and spinal cord to the rest of the body – the arms and hands, legs and feet, internal organs, joints and the mouth, eyes, ears, nose, and skin. Polyneuropathy can be caused by a number of different things such as:.disease, diabetes, smoking, chemotherapy treatments, organ transplants, exposure to toxins such as pesticides/herbicides, chemical exposures, statin drugs, surgeries, hormonal imbalances, vitamin deficencies and alcoholism, vascular damage, connective tissue disorders, benign tumors, repetitive stress, infections and autoimmune disorders, lyme disease and diphtheria, viral and bacterial infections just to name a few.

Peripheral neuropathy may be chronic (a long term condition where symptoms begin subtly and progress slowly) or acute (sudden onset, rapid progress and slow resolution). Acute neuropathies demand urgent diagnosis. Motor nerves (that control muscles), sensory nerves, or autonomic nerves (that control automatic functions such as heart rate, body temperature and breathing), may be affected. More than one type of nerve may be affected at the same time. Peripheral neuropathies may be classified according to the type of nerve predominantly involved, or by the underlying cause. Where the cause is unknown it is described as idiopathic neuropathy.