How Osteopathy Can Help People with Fibromyalgia: A Focus on the ‘Myofascial Trigger Point Cascade’ Model
Fibromyalgia is a chronic pain condition characterized by widespread musculoskeletal pain, fatigue, and heightened sensitivity to touch. Its exact cause remains elusive, but many theories attempt to explain the pervasive discomfort associated with the condition. One compelling concept is what this author likes to call the myofascial trigger point cascade—a phenomenon where the activation of multiple myofascial trigger points creates a chain reaction of pain and dysfunction, leading to widespread symptoms. Unlike injuries or infections, this cascade does not appear on diagnostic scans, leaving many sufferers feeling misunderstood or without answers.
Osteopathy offers a holistic approach that addresses fibromyalgia’s complex presentation by focusing on structural balance, myofascial release, and nervous system regulation.
Understanding Fibromyalgia and Myofascial Trigger Points
Fibromyalgia involves a heightened pain response due to changes in how the brain and spinal cord process pain signals. Many patients also experience muscle stiffness, tender points, poor sleep, and cognitive difficulties. The myofascial trigger point cascade theory provides a biomechanical explanation for some of these symptoms. Trigger points are hyperirritable knots of muscle or fascia, often resulting from overuse, stress, trauma or sedentary life styles.
In fibromyalgia, multiple trigger points can become active simultaneously, forming a “cascade.” This domino effect causes pain to radiate throughout the body, even in areas not directly affected by the original trigger point. Since trigger points cannot be detected by imaging or blood tests, patients may endure prolonged suffering without a definitive diagnosis.
How Osteopathy Can Help
Osteopathy is uniquely suited to address fibromyalgia’s multifaceted challenges. Using a whole-body perspective, osteopaths aim to restore movement, release tension, and promote the body’s natural healing mechanisms. Key osteopathic techniques for fibromyalgia include:
1. Myofascial Release Therapy
This hands-on technique gently stretches and releases fascial restrictions, directly targeting trigger points and the surrounding tissue. By easing local tension, myofascial release helps disrupt the cascade effect, reducing widespread pain. Additionally, improved fascial mobility promotes better circulation and nutrient delivery, fostering tissue repair.
2. Soft Tissue Manipulation
Osteopaths use gentle kneading and stretching techniques as well as advanced soft tissue releases such as Counter-Strain and ligamentous balancing techniques to reduce muscle tension and restore balance in the musculoskeletal system. These methods aim to alleviate stiffness and pain caused by prolonged muscle guarding, a common issue in fibromyalgia patients.
3. Joint Mobilization
Fibromyalgia often results in joint stiffness and reduced range of motion due to pain and inactivity. Gentle mobilization techniques improve joint function and encourage movement without aggravating symptoms.
4. Nervous System Regulation
Fibromyalgia patients frequently experience autonomic nervous system imbalances, manifesting as heightened sensitivity to stimuli and poor stress tolerance. Osteopathy can help calm the nervous system by addressing tension in key areas like the spine, cranium, and diaphragm, promoting relaxation and resilience.
5. Postural Assessment and Correction
Poor posture, often linked to chronic pain, can perpetuate the activation of trigger points. Osteopaths work to optimize alignment and reduce mechanical strain, addressing underlying contributors to the myofascial trigger point cascade and other factors.
Beyond Pain Relief: Additional Benefits of Osteopathy for Fibromyalgia
While pain management is central, osteopathy can also improve other fibromyalgia symptoms, such as fatigue, poor sleep, and low mood:
Improved Circulation: Enhanced blood flow supports cellular repair and reduces inflammation.
Stress Reduction: Techniques promoting nervous system balance can help reduce stress, a known fibromyalgia trigger.
Better Sleep Quality: Relaxation-focused interventions can aid sleep, breaking the cycle of pain and fatigue.
Empowered Self-Care: Osteopaths often provide lifestyle advice, including ergonomic adjustments, gentle exercises, relaxation and stress management techniques, empowering patients to take charge of their condition.
Why Choose Osteopathy for Fibromyalgia?
Fibromyalgia presents a unique set of challenges that require an equally unique approach. Osteopathy, with its focus on the interplay between structure and function, offers an effective means to address the complex symptoms of this condition. By reducing tension, improving nervous system regulation, and addressing key factors such as the myofascial trigger point cascade, osteopathy provides hope for those living with chronic pain.
References
Simons, D.G., Travell, J.G., & Simons, L.S. (1999). Myofascial Pain and Dysfunction: The Trigger Point Manual. Williams & Wilkins.
Clauw, D.J. (2015). "Fibromyalgia: A Clinical Review." JAMA, 313(15), 1547–1555.
Fernández-de-Las-Peñas, C. et al. (2011). "Myofascial Trigger Points in Chronic Pain Syndromes." Current Pain and Headache Reports, 15(5), 353–360.
Author’s personal clinical experience.