Neuralgia is sharp, and often severe, pain that runs along the path of a nerve. The basic cause of neuralgia pain is damage or irritation of a nerve. This damage or irritation can be caused by several different conditions, from disease to trauma.
To understand the cause of neuralgia, it’s first necessary to understand how nerves work.
The nervous system is responsible for carrying information back and forth from the brain to the rest of the body. Nerves are the long bundles of fibers that connect sensitive nerve endings to the rest of the nervous system.
Nerves are protected by a layer of protein and fatty substances called the myelin sheath. If the myelin, or the nerve that’s insulated by it, is damaged, the impulses sent along the nerve can be slowed or interrupted. This can lead to problems like neuralgia or neuropathy.
Both neuralgia and neuropathy are nerve-related and caused by damage to the nerves. However, by breaking down the origins of each word, it’s possible to see how the two conditions are different. Neuro- (or neura-) means nerve. –algia means pain, while –pathy means disease. Therefore, while neuropathy can be accompanied by pain, it’s also characterized by tingling, numbness, weakness, or other symptoms. Neuralgia, however, refers only to nerve pain.
Neuralgia pain is usually a side effect or symptom of something else.
According to the Better Health Channel:
“Generally, neuralgia isn’t an illness in its own right, but a symptom of injury or a particular disorder. In many cases, the cause of the pain is not known. Older people are most susceptible, but people of any age can be affected.”
Sometimes simple old age can be blamed for neuralgia. Other times, a disease might cause damage to the nerves, as in diabetes or multiple sclerosis. Infections like HIV, Lyme disease, or syphilis can also sometimes cause nerve damage. Even a bacterial infection, such as an abscessed tooth, can irritate nearby nerves and cause neuralgia. Pressure on a nerve might cause neuralgia pain, too; bone, tissue, or tumors that press on a nerve can cause painful irritation.
Unfortunately, some medications—including the medications used to treat cancerous tumors—might also lead to neuralgia. Sometimes even trauma, whether from an injury or from a surgical procedure, can cause neuralgia pain. Essentially, anything that can damage the myelin sheath can potentially cause neuralgia.
The different types of neuralgia are generally characterized by the cause or the location of the pain.
For example, the two most common types of neuralgia are post herpetic neuralgia and trigeminal neuralgia. Post herpetic neuralgia is characterized by its cause. It is the result of nerve damage from the herpes zoster virus, commonly called shingles.
Trigeminal neuralgia is diagnosed according to which nerve is affected and where the pain is felt. In this type of neuralgia, the trigeminal nerve is damaged or has painful pressure exerted on it. Trigeminal neuralgia pain affects the face. In addition to pain, there might also be such intense hypersensitivity that even brushing the teeth or feeling a breeze on the cheek can cause severe pain. The pain may begin in just one area or on one side of the face, but it can spread as the condition worsens.
Another type of nerve pain is glossopharyngeal neuralgia, which is somewhat uncommon. This occurs when the glossopharyngeal nerve is irritated or damaged, which produces pain in the neck and throat. Sometimes the pain can also extend to the tongue, back of the throat, tonsils, or ears.
Occipital neuralgia occurs when the occipital nerves, or the nerves that run from the top of the spinal cord up to the scalp, are injured or inflamed. This often causes pain that starts at the back of the head and radiates forward, but it can also cause pain on one or both sides of the head or behind the eye. Sensitivity to light or a tender scalp may also occur. This condition can sometimes go undiagnosed because its symptoms are easy to mistake for headaches or migraines.
There is a host of conditions that can cause or be accompanied by neuralgia pain.
Multiple sclerosis is well-known as a nerve-related disease, and it can indeed cause neuralgia pain. In fact, nerve pain is one of the best-known symptoms of multiple sclerosis. However, it’s not the only disease that can cause neuralgia pain.
Other conditions that might be accompanied by neuralgia include:
People with neuralgia pain have a lot of treatment options.
Each individual’s treatment for neuralgia pain might be different, depending on what caused the pain. For example, since the high blood sugar levels associated with diabetes are responsible for damaging nerves, someone with diabetes-related neuralgia pain might benefit from stricter control of diet (and possibly diabetes medications) to keep blood sugar levels at heathier levels. Treating the underlying condition causing the neuralgia is often a good way to treat the pain.
If treating the condition doesn’t relieve neuralgia pain—or if the cause of the pain can’t be identified—there are many other non-surgical treatment options. In some cases, over-the-counter pain medications may be sufficient. Heat therapy, massage, or rest might also do the trick. If not, a physician might be able to prescribe stronger medications, such as antidepressants, antiseizure drugs, or narcotics. Skin patches or creams that contain pain-relieving medications might also help. Physical therapy can sometimes be indicated, as well.
If the pain still persists, the physician may suggest injections of pain medications, such as an occipital nerve block injection for occipital neuralgia. He or she might also suggest radiofrequency ablation, which is focused heat that damages a painful nerve in order to cut off pain signals before they’re sent to the brain.
If non-surgical methods have failed to alleviate neuralgia pain, there are surgical ways that can treat it. The most common surgical procedures to correct neuralgia attempt to relieve the pressure on a painful nerve, perhaps by moving the blood vessel that’s pressing on the nerve. Other surgical procedures have a similar goal as radiofrequency ablation: the interruption of the nerve to stop pain signal transmission.
Unfortunately, some people are unable to find relief from neuralgia pain despite attempting all available treatments. However, most neuralgia pain is relatively minor and responds well to treatment.
Imagine waking up with intense, burning pain for no reason, or undergoing surgery only to find that the accompanying pain increases and spreads until it forces the use of a wheelchair. Worse still, imagine spending months—or even years—going to physicians who are unable to diagnose the condition. This is the grim reality for people with complex regional pain syndrome.
Once called reflex sympathetic dystrophy (RDS), complex regional pain syndrome (CRPS) is characterized by pain. According to the National Institute of Neurological Disorders and Stroke, “CRPS represents an abnormal response that magnifies the effects of the injury.” In other words, a small injury becomes a big pain.
The pain associated with this syndrome may be constant and severe. It may begin in one small, localized area, such as a finger, and spread to include a much larger area, such as the entire arm. It may also spread to the opposite extremity. Painfully-increased sensitivity, called allodynia, may also occur, so that even a light touch on the affected area can cause severe pain.
Difficulty with muscle movement and decreased ability to move the affected body part
Abnormal movement or fixed abnormal position of the affected body part
All of these symptoms are confined to the affected area of the body, so one leg might be swollen, blotchy, extremely painful, and difficult to move, while the opposite leg is completely fine. Sometimes, though, symptoms can spread, so both of an individual’s legs might be affected.
Cases of complex regional pain syndrome are divided into two types, although some sources list a third type, as well. Type one (CRPS I) is characterized by severe, burning pain at the injury site, accompanied by muscle spasms, joint stiffness, and rapid hair and nail growth. Type two (CRPS II) is more intense pain, accompanied by swelling, slowed hair growth, unhealthy nail growth, and atrophied muscles. When differentiated, type three (CRPS III) is accompanied by unyielding, wider-spread pain, irreversible skin and bone changes, and severely limited mobility.
Some people develop complex regional pain syndrome at random, with no identifiable triggers. These people may simply wake up one day in agonizing, unrelenting pain. However, many people afflicted with complex regional pain syndrome develop it after an injury or surgery. Even something as simple as a soft tissue injury, like a cut or bruise, can trigger complex regional pain syndrome.
In the case of photographer, blogger, and author Micaela Bensko, her complex regional pain syndrome developed as a result of a concussion and damage to her cervical spine after a tailgate hit her on the head.
As stated in her blog:
“Along with the mechanical injuries to my spine, after about a year symptoms began to develop that leaned toward a Motor Neuron Disease such as ALS or MS but with unrelenting pain unlike anything I had ever experienced in my life. After extensive neurological testing, and a multitude of doctors, I was diagnosed with Complex Regional Pain Syndrome in my spine after one of my procedures.”
As pointed out here, the diagnosis of complex regional pain syndrome can be difficult. The symptoms can vary from person to person. There is often no clear-cut cause. In some cases, the condition can improve without treatment, which might end all attempts at diagnosis until the symptoms flare up again and make it necessary to start the diagnostic process all over.
Additionally, there is no single test to confirm complex regional pain syndrome. A diagnosis relies on observation of symptoms and the combined results of several different diagnostic tests to rule out other conditions.
The researchers from the University of Liverpool’s Institute of Translational Medicine, alongside researchers from the University of Pecs in Hungary, carried out a study on the autoantibodies in people with complex regional pain syndrome. Autoantibodies are naturally-produced but harmful antibodies that attack and damage bodily tissue. Usually, the body self-regulates autoantibodies, but sometimes—particularly in autoimmune disorders—the body fails to do this, allowing autoantibodies to multiply.
In this study, researchers took autoantibody serum from healthy people and from people with complex regional pain syndrome. The serums were injected into mice. Mice injected with serum from people with complex regional pain syndrome began to show symptoms of the syndrome. As stated on the University of Liverpool’s website:
“Although it had previously been thought, that the cause of CRPS is exclusively an abnormal brain activity after injury, more recent results, including from the Liverpool group have pointed to an immune dysfunction.”
If the cause of complex regional pain syndrome can be pinned down by more studies like this one, there may someday be a cure for it.
For now, although there is no cure, there are several treatments that show promise at treating the symptoms of complex regional pain syndrome.
Traditional treatments for complex regional pain syndrome symptoms include rehabilitation therapy, neural stimulation, or medication. Some alternative treatments, such as biofeedback, acupuncture, or chiropractic care, have also had some success.
One newer treatment for complex regional pain syndrome symptoms is the use of hyperbaric oxygen (HBO) therapy. This involves the afflicted individual spending time in a pressurized, high-oxygen hyperbaric chamber. One study found that after regular HBO treatments, pain and swelling from complex regional pain syndrome were reduced, while the range of motion was increased.
Another potential treatment for complex regional pain syndrome symptoms is the anesthetic drug ketamine. A study in Australia found that 76% of patients experienced full, although temporary, relief from pain after receiving regular infusions of ketamine. Eventually, this treatment was brought to the United States, where it has shown real success.
A previous study at the University of Liverpool examined the effectiveness of intravenous immunoglobulin (IVIG). Patients in this study showed an average drop in pain of 1.55 on an 11-point pain scale. While this study wasn’t as thorough or as promising as others, it was noted that IVIG is significantly more cost-effective than some treatments, such as ketamine therapy.
In Italy, researchers recently found that a bisphosphonate called neridronate can have very profound effects on type one complex regional pain syndrome symptoms. Bisphosphonates are typically used to treat bone-related conditions like osteoporosis. However, this study found that regular applications of the bisphosphonate neridronate caused significant reduction of pain and hypersensitivity when given intravenously.
Every once in a while we get a client that comes through the door with both Fibromyalgia and sciatica. Unfortunately, for many people with Fibromyalgia, most new symptoms get put down to simply yet another Fibro symptom. However, if you do have Sciatica, then you will likely already know, that sciatica pain feels very different to normal everyday Fibromyalgia pain.
So, with that being said, I am going to say the same thing to you at home reading this, as we do to our clients in the studio: Do not put symptoms down to Fibromyalgia.
Sciatica is the loose term for one type of lumbar radiculopathy, essentially meaning pain and other symptoms, caused by irritation of a lumbar nerve root or at least a part of it. It’s also good to keep in mind that sciatica is a symptom, rather than a specific diagnosis, and not a particularly specific one either. The term sciatica can be rather confusing, with many medical professionals using it to describe radiculopathy involving the lower extremities and relating to herniated disks. And many patients refer to sciatica as any pain that shoots down the legs.
Now, for anyone with Fibromyalgia, adding sciatica into the mix can make an already painful day, into a seemingly impossible task! However, the good news though, is that most cases of sciatica will resolve on their own within 6 weeks, without the need for any special intervention or treatment.
Most people will never have this problem again, and the rest perhaps a few more times in their lives.
There are myriads of ways for the lumbar roots and sciatic nerve to get irritated, including, but not limited to: a nerve pinch, disk herniations, and genetic abnormalities. However, what’s important to remember, is that generally, nerve impingement doesn’t cause pain, inflammation does. In fact, the majority of the time, Sciatica is referred pain from the lower back and doesn’t even result from nerve-root compression. How one person reacts to load, movement, or even stretch, can be very different across the spectrum of people, and it’s likely that some people have nerve roots that are just a little quicker to react. Those with Fibromyalgia suffer from abnormalities in the way that the brain deals with pain. Supraspinal processes have a top-down enhancing effect on nociceptive processing in the brain and spinal cord. Studies have begun to suggest that such influences occur in conditions such as fibromyalgia. This means that those who do have Fibromyalgia and sciatica, they may be far more sensitive to noxious stimuli compared to the general population. Factoring in changes in tissues, stress, load, and movement, and those with Fibromyalgia may be more prone to reacting to these changes byways of producing pain.
Very rarely is sciatica mechanical in nature. Even issues like nerve impingement are fairly difficult to occur, due to the abundance of room at the nerve root. There are also many cases of actual impingement, where the individual doesn’t even have any pain.
Whilst you very well could have Sciatica, there are a few other things that can often mimic sciatica, things such as;
Piriformis syndrome
Genic abnormalities, wherein the sciatic nerve actually runs through the piriformis muscle, instead of under it.
And less likely, things like cluneal nerve entrapment.
I’m not writing to scare you, as the wide majority of cases of sciatica are completely harmless. However, it is important for you to understand that self-diagnosing sciatica is not a good idea. If it is troublesome, comes with a wide range of completely new symptoms, or you are worried, consult your doctor and get checked out.
Bed rest has been a popular treatment for sciatica for the better part of the last few decades. In terms of published evidence, most meta-analyses and reviews show that there are no significant benefits to bed rest over staying active when it comes to sciatica pain (and vice versa). However, as mentioned in a review posted in Spine, there is no considerable difference between advice to stay active and advice for bed rest, and there are potentially harmful effects of prolonged bed rest, it is reasonable to advise people with acute low back pain and sciatica to stay active.
So, if you do have fibromyalgia and sciatica, you have been checked out and there are no red flags, keeping active can be very helpful. However, being active doesn’t mean you need to be doing crazy exercises, it just means getting up and moving around, as much as the pain will allow.
In terms of movements, gentle dynamic movement that helps to move a joint through its full range can be incredibly beneficial when it comes to sciatica, helping us to utilise our own internal pain killers. Likewise, stretching can be incredibly beneficial, helping to calm the nervous system down, reduce muscle tone and guarding, reduce pain, and to help create a sense of safety. This sense of safety is a particularly interesting topic, as fear will cause you to guard, making you stiffer and most likely in more pain.
Heat can also be used on the surrounding muscles to help them relax. Due to the thickness of the tissue in the buttocks, heat isn’t going to have much of a circulatory effect on the nerves or muscles that can irritate sciatica. However, it will provide enough input to help calm down the nervous system. A good heat pad or warm bath is sufficient.
Likewise, vibration can be used for sciatica with a fairly good outcome. Vibration therapy may help to reduce muscle soreness and interleukin-6, helping to stimulate lymphocyte and neutrophil responses, a useful modality in treating muscle inflammation. Which if we learned anything today, is most likely more important than impingement.
Chronic pain is a condition that is far more complex than a physical set of symptoms. Pain that lasts long-term has a significant emotional and mental impact, and for that reason, some chronic pain disorders have been called “suicide disease.” Because chronic pain is more than physical symptoms, the pain specialists at Chronicillness.co Site of United States focuses on an approach that is holistic – or encompassing the entire nature of the patient; physical, mental, and emotional. Through several programs, Chronicillness.co Site’s pain management specialists offer those with chronic pain a place of hope and healing.
According to Harvard Medical School, chronic pain is highly complex and involves thought, mood, and behavior. Many who suffer from chronic pain have a difficult time living active lives, and as such, will often lose their jobs and relationships will suffer. Chronic pain conditions can cause insomnia and fatigue, and this combined with affected lifestyles and relentless physical symptoms causes severe depression in many chronic pain patients.
Pain and depression are inherently linked; quite often, patients suffer from both conditions. This link requires that pain management doctors take a deeper look at the mental and emotional impacts of chronic pain and make sure that they are treating all aspects of chronic pain, not just the physical symptoms.
Chronic pain patients must advocate for themselves as well, and communicate their depression symptoms to their pain doctor. If chronic pain patient does not express their depression symptoms to their pain doctor, or if they downplay the emotional and mental components of their chronic pain, their pain specialist will be unable to help them combat these symptoms.
While some medications may help alleviate the symptoms of chronic pain and depression, there are many techniques that a patient can engage in to also help with their mental and emotional symptoms. Biofeedback, counseling with a behavioral therapist, and relaxation and coping methods are all tools that can be taught to pain patients to improve their mental and emotional health.
It is not uncommon to see those with hypermobility and EDS covered in an abundance of brightly coloured KT tape. Kinesio tape comes highly recommended for those with hypermobility, however, just like most modalities, there are those that find it helpful and those who do not. There is an abundance of claims when it comes to using KT tape, ranging from injury prevention to increased circulation. However, what does the research say about taping joints with KT tape when you are hypermobile?
This is the topic for today and boy is it a doozy!
Kinesio taping was first brought about by chiropractor Kenzo Kase, back in the mid-1970’s, when he developed the original Kinesio Tape, which he called Kinesio Tex Classic. The term “Kinesio” is a shorthand for the word kinesiology, meaning “the study of movement”.
However, it’s important to note that this is not kinesiology, but rather good marketing. It could have easily been called a number of other things: Injury tape, Rehab tape, or Chiropractic tape. But that just doesn’t have the same ring to it, does it?
In 1980 Kenzo Kase established the “Kase Chiropractic Institute” in Kojimachi, Tokyo, and officially founded The Kinesio Taping Method.
By 1985 a dedicated taping instructor programme had been developed, and by 1989 the national Japanese volleyball team were using Kinesio Taping. Fast forward to 1997 and 7 of the major league baseball teams in America were using it.
At the 2012 Olympics, KT tape exploded! Many professional athletes were spotted on camera with colourful and elaborate designs, with even more elaborate reasons as to why they were wearing them.
At the Olympics there was a huge explosion in competition, with many new brands appearing also using the word ‘Kinesio’ in in the branding. Obviously, there are a few examples of cease and desist letters being sent in this time period, as Kase protected his trademark.
There are numerous claims when it comes to taping joints for those with hypermobility, and the list will probably surprise you;
Lifts the skin, decompressing the layers of fascia, allowing for greater movement of lymphatic fluid which transports white blood cells throughout the body and removes waste products, cellular debris, and bacteria.
However, bold claims require extraordinary evidence. Once you cut through all of the marketing and fancy claims, there are only really three points that may have any substance to them: pain relief, injury prevention, and increased performance.
These extreme claims have resulted in class action lawsuits and caused companies who market Kinesiology Tape to have to remarket and change their claims, as well as pay out considerable sums of money.
Under the terms of the KT Tape settlement, KT Health Holdings Inc paid $1.75 million to resolve the deceptive marketing allegations. In addition to creating the settlement fund to reimburse customers, KT also agreed to change the way that tape is advertised, removing the label claims: “it will keep you pain-free,” “prevents injury” and “provides 24-hour pain relief per application.”
The kinesiology tape packaging also changed to include a large bold disclaimer, to inform consumers that the athletic tape is “not clinically proven for all injuries.”
Likewise, RockTape faced similar class action allegations that its tape doesn’t provide the advertised pain relief. Unfortunately, sports medicine is far from evidence-based, with inventions such as theracanes and scraping tools having a tiny amount of research. However, taping has over 2000! So research isn’t exactly lacking in this area. But what does it say?
With so many claims out there for tape, it can be hard to separate fact from fiction, and placebo from actual mechanisms. As I mentioned before, once we take away the bogus claims, it leaves us with only three main points that may have any truth to them. If you are Hypermobile or have EDS, then I am going to assume that it’s more of the potential benefits to pain that you are most interested in.
The main issue with the current evidence on tape and hypermobility is that many of the research studies conducted conclude that KT tape may be effective, however, the quality of evidence (also known as grade) is insanely low. One example of this is a study in 2013 that concludes KT tape “may be effective in reducing pain during stair climbing activities”. However, the median effect of 0.5 on a pain scale from 0 – 10, was lower than the threshold of clinical importance. Meaning, that the quality of evidence for this study was rated “very low quality” as it was a single trial with a very high risk of bias. Some authors even concluded that Kinesio Taping was effective when their data did not identify significant benefits!
There is an abundance of people with hypermobility that rely on KT tape every day, yet in the same breath, there are people that it simply does nothing for. Likewise, if you take a closer look, there are also people who get negative effects from using tape, usually in the form of blisters, sensitivity, or burning, from the adhesive commonly used in Kinesiology Tape.
Whilst there is an abundance of research into KT tape, the research conducted around taping hypermobile individuals, who are arguably the population that needs it the most, is rather disappointing. Whilst some studies do show that KT tape may have some benefits when it comes to pain and hypermobility, most of the studies are fairly poor, lacking in control groups, consisting of very small sample sizes, and with no to very little follow-up.
A study conducted in 2021, showed that Kinesiology taping may be effective for reducing shoulder pain and improving function in patients with EDS up to 48 hours post application. But, again, this was a sample size of eight females, no control group, and a possible time effect. Hopefully, as research grows, a larger study will be conducted with a control group, more participants, and over a larger time period.
Likewise, a far superior study conducted recently in 2021, showed that 10 sessions of shoulder rehab, over a 6-week time frame, found no difference when KT tape was used. Both groups improved over time, in symptoms, range of motion, and functionality of the shoulder.
An interesting study showed that KT tape, when combined with foot strengthening exercises, compared to just strength exercises, was more effective at increasing navicular height: creating more of an arch. It was a decent sample size and could have been better controlled, but the main issue I have with this study is that it seems a little biased, directly quoting Kenzo Kase’s tape claims. However, it does give us a little food for thought. One of the exclusion criteria for this study though was no neuromuscular disorders, or more pertinent to hypermobility, no lower limb injuries.
The likelihood of someone using KTtape if they are hypermobile is because of recurring injuries and dislocations. So, how does this study compare to those who are injured and prone to dislocations? There is also the issue that one modality coupled with another, is pretty much always more effective than using a single modality alone, like results shown in this Masters thesis using KT tape and Orthotics.
An interesting study performed on recreational dancers found that Kinesio taping was fairly effective in eliminating sacroiliac joint pain, occurring in 13-25% of patients in the dance population. It’s a good idea to keep in mind, that people generally gravitate to activities at which they are naturally good at. This is one of the reasons why we find a higher prevalence of hypermobility amongst dancers, compared to say Rugby or other contact sports.
With research severely lacking in KT tape and hypermobility, I looked more towards the studies that would naturally include those with hypermobility, which is why these studies into dancers give us a little more insight into KT tape and hypermobility. Having analysed numerous publications on the effectiveness of Kinesio taping amongst dancers and athletes, you could conclude that KT tapes proves to be ineffective when it comes to increasing muscle strength or improving proprioception of the joints. However, only if it is used by healthy individuals using moderate physical activity.
Studies of Kinesio taping under strenuous physical exercises, for healthy individuals, have demonstrated numerous positive effects of taping, such as improvement of articular proprioception and postural stability (both static and dynamic), relieving of muscle fatigue and enhancing their recovery, as well as a reduction in the severity of delayed-onset muscle soreness. Kinesio taping turned out to be exceptionally effective for patients with different acute and chronic injuries of the musculoskeletal system. It helped to restore impaired proprioception, stabilise joints, ease pain symptoms, and improve muscle strength. However, there still is one giant issue when it comes to tape and hypermobility; what is the actual mechanism that yields these results? It is incredibly hard to dive deep into this topic with so little specific research into hypermobility and tape.
Not only is this a hard topic to research, but when we factor in the poor quality evidence of the studies and potential bias, it’s easy to get a headache.
Research comes with many levels of evidence, and unfortunately, most of these studies aren’t great. However, I did find a study that sits firmly at the top of the hierarchy when it comes to evidence. In this beautifully done research, it concluded that KT tape, when used for a range of musculoskeletal conditions, has no benefit over sham taping/placebo and active comparison therapies. In essence, the benefit was too small to be clinically worthwhile, or the trials were of very low quality.
Regardless of the comparison used or the outcomes investigated, most research typically showed no significant difference in outcomes between groups, or a trivial effect in favour of Kinesio Taping (ie, small enough to not be considered clinically worthwhile). It seems that the growing use of Kinesio Taping is due to massive marketing campaigns (such as the ones used during the London 2012 Olympic Games) rather than high-quality, scientific evidence with clinically relevant outcomes.
Therefore, current evidence does not support the use of Kinesio Taping for musculoskeletal conditions.
It is also possible that performance could potentially be increased, say through a combination of minor benefits. Alone they are hard to identify, but collectively they may be relevant. So there you have it, the evidence for using KT tape is not very good!
The evidence shows us that KT Tape likey doesn’t do what it says it does, and any effects are likely a placebo or brought about by any number of biological, psychological, or social variables. But, some people with hypermobility like taping. It makes them feel better, experience less pain, and it makes them feel like their joints are more stable. If there was ever a reason to use tape, it’s not because of the crazy marketing, but of how it makes you feel.
So for the people who do seem to get pain relief from taping, why is this?
Well, for those with Hypermobility, and especially those that sublux/dislocate, nociceptive pain can play a large part in their life, and this is where it gets interesting.
Nociception is where high threshold nerves that detect potentially dangerous stimuli, such as extremes in temperature, pressure, chemicals and stretch, inform your brain that something may be wrong. However, keep in mind that this is not a pain signal, because they do not exist. Let’s leave pain receptors in 1664 where they belong. However, for those with hypermobility and EDS, recurrent subluxations/dislocations, are going to cause a lot of nociception. In fact, this may even lead to nociplastic pain, wherein your nervous system changes how nociception works, making it more sensitive to keep you safe.
Let’s say you sublux your hypermobile ankle. Extreme stretching of the ligaments and tendons is likely to cause a nociceptive response. Your brain decided that because of the context of the situation and about 50 million other variables, producing pain to stop you from bearing weight on your ankle and damaging it further, is a very good call.
Your joint isn’t dislocated, however, it did go out and then straight back in…this is known as a subluxation (you probably already knew that if you’re hypermobile). Depending on the degree of subluxation/dislocation that occurs, nerves and blood vessels may be damaged, muscles and ligaments may tear or twinge, the joint may swell, compression of nerves may cause tingling, and inflammatory responses can be activated. Say hello to nociception!
Due to the subluxation, you have a local inflammatory response. Your nervous system is on high alert and it’s sending far more information to your brain than it normally does when it comes to your ankle. Your brain receives around 11 million bits of sensory information every second, so what is a little more if it keeps you safe.
Tape very likely acts as a competing input for those with hypermobility, helping to drown out nociception to some small degree. If you stub your toe on a coffee table, you’re likely going to produce nociceptive pain. The first thing you are going to do is to rub your toes sending competing information to your brain to drown it out. This is why the pain changes from that sudden, acute, and sharp pain, to a more manageable low-level throbbing pain. So, it’s not a far stretch to assume that it is likely the same mechanisms at work.
Likewise, we are human and as such we are incredibly tactile. We love to touch. In fact, it’s one of the very first things we learn as babies, as our mothers cuddle us and provide love. It’s also one of the very first associations we make as small children. We fall over, we scrape our knees, and mum makes it better with a kiss and cuddle. As humans, we often learn that when it comes to pain, sensory information helps. If you don’t believe me, then the next time you stub your toe, just don’t rub it and see how long you can stand. Touch and sensory information for humans is innate.
In the weird world of pain, there are many things that mediate and contribute to why someone experiences it. Likewise, there is also an abundance of factors that help to reduce it, and touch and sensory information is one of those things. Taping a joint does seem to give people have more ownership over it, becoming acutely more aware of joint positioning (well kind of), as well as being more conscious when it comes to moving the joint. After all, it is a lot harder to sublux a joint, if you are paying attention to it. Which coincidentally, is the main mechanism most hypermobility rehab, pilates, and yoga programmes use. The only issue here is that you can be absolutely fine whilst doing the exercise (because you are aware), however, once you finish and go about your day, pop, there goes your joint.
We have said it a million times here at The Chronicillness.co, the way that other professionals go about hypermobility rehab is not right at the moment. Consciously being aware of your joints does not stabilise them outside of sessions, only slightly inside of sessions. If you take a look a some of our clients, you will see that in a very short time frame their joints become stable outside of sessions not just inside, and this is largely because we work neurologically, and don’t stress conscious awareness.
Probably one of the better reasons to choose KT tape if you are hypermobile or have Ehlers Danlos syndrome, over say a rock-hard support splint, is the effect that immobilising can have.
Immobilisation can lead to hypoxic and inflammatory conditions in the joint capsule, which can easily become an initiating factor for issues such as joint contractures, as well as sending constant nociceptive signals.
With a joint that is repeatedly dislocating, there is a fair chance that the person suffering is likely going to avoid using the joint, choosing to immobilise it. This, however, can lead to a vicious cycle of disuse and lack of nourishment to the joint. In immobilisation studies conducted over 32 weeks by binding the hind legs of rats:
Immobilised cartilage had increased collagen content (scar tissue)
The severity of osteoarthritis increased as measured by Mankin scores
The trabecular bone plate area (the spongy bone at the end of long bones, like the thigh and shin bones) at the front and back of the shin showed bone loss, but not in the middle.
Chondral vascular ingrowth was seen in the subchondral bone. This means that blood supply was increased to the bone as the cartilage and outer bone was dying.
The centre of the knee joint was being fortified, as we see in the fact that bone loss was not seen in the centre of the top of the tibia bone.
Replacement of cartilage by bone may have been mediated by chondral vascularisation, suggesting irreversible changes. These findings stress the importance of weight-bearing and joint motion to maintain cartilage structure.
Not surprisingly, it has been shown that the more a specific joint is exercised, the stronger the bone-ligament and bone-tendon complexes become. Exercise specifically helps strengthen the fibro-osseous junction, which is where the ligament/tendon and bone attach to each other, and which, incidentally, is the area where Prolotherapy (often recommended and praised by the hypermobile population) treatments are administered.
With KT tape providing some sensory tickling, as well as helping to support the joint, but not completely immobilise it, it does have the potential to be a lot healthier, given the above.
So, a big reason why a lot of those with hypermobility and EDS use Kinesio taping, is because they feel that it adds to proprioception. Now I will preface this next section by saying here at The Fibro Guy, we do use tape occasionally, however, only ever in session, and we never make KT tape out to be more than it is. Tape can be helpful for some of our clients with issues like Thoracic Outlet Syndrome, to help cue them into positions where they aren’t causing compression. With that being said, it’s only ever added for a tiny boost to positioning and awareness. To be honest, it’s more like an addition to awareness, than actually increasing proprioception.
Research around proprioception and the use of KT tape in the hypermobile population, is again, unsurprisingly sparse!
An interesting study performed on those with hemiplegia due to stroke, found a difference in values before and after the tape was applied in the case of left and right deviation whilst walking. Not a fantastic study, due to a lack of controls, too small of sample size, and the fact that physiological and psychological factors were not considered relating to the subjects.
Many ankle studies show KT tape has no real significance when it comes to proprioception. Likewise, studies around the lower back and proprioception, yield the same results. One study looking at the effects of Kinesio taping of the knee on proprioception, balance, and functional performance in patients with anterior cruciate ligament rupture (ACLr) found some interesting results, in that KT may have beneficial effects on proprioception, balance, and functional performance in people with ACLr, but it cannot completely compensate for the loss of proprioception. The application of KT during rehabilitation may be a good therapeutic option either before ACL reconstruction surgery or as a conservative treatment for ACLr. However, it’s not a great study when it comes to tape, for many of the reasons I’ve already stated in the above paragraphs.
Then we have another study by a team of Italian researchers found that Kinesio Tape may help improve ankle stability for athletes with chronic ankle instability.
So, looking at the research, it looks like sometimes it may help slightly, other times it makes no difference at all, and there are 100,000 other variables that are likely involved, but unaccounted for.
Research always has limitations, and a large one is that a lot of these studies were performed with vision removed from the experiments. Vision is an important part of moving, as it works in conjunction with our cortical maps, to help us over through space and time. People, especially those with hypermobility and EDS, don’t walk through life with their eyes shut using just proprioception, they include visual data. Likewise, small sample sizes, some bias, and a whole host of other things, we end up with more questions than we first started with.
By looking at the research, we can see that something happens when we use KT tape. I mean it’s probably not the KT tape that’s responsible, but a whole host of other factors. But, the fact remains, that KT tape may make people more aware of their joints, but more importantly, it might help contribute to less pain, and that’s what it’s about isn’t it.
Tape isn’t particularly invasive, it’s not damaging (well sometimes, and I will get to that), and it makes some people feel better. Given all of that, if taping does help you, then you don’t really have anything to lose; just don’t go expecting miracles. I think that the use of tape in this context is fine. It’s a little like stretching, a lot of the reasons people do it got debunked years ago. But, if it feels good and it helps, go for it.
So, you have taken a look at the evidence, and you realise that there isn’t anything specifically magical about the tape. However, you do fancy a little bit more awareness of your joints and a little bit of sensory tickling. Well, then, that’s a pretty good reason to use tape. Let’s take a look in the next few sections on how to tape. But first, let’s start with some KT tape tips, that are going to save you a lot of headaches.
For those with EDS and velvet skin, and indeed even those without, perhaps those with mast cell issues, the tape can be an irritant, and in some instances cause blisters and soreness. For KT tape to stick to your skin, it is covered with adhesive. When you apply KT tape, you are recommended to rub the tape to help activate the adhesive. Now, if you do have skin that is irritable (and to be honest, I recommended this for everyone), do a little patch test first. Cut a small square of tape off and apply it to an area for 48hrs, then see how you react. Likewise a really handy tip if you are super irritable to tape, is to use barrier film spray, the same spray used for stoma bags.
It’s all well and good having your tape on, but there will come a time that you need to remove it. Even the smallest of hairs are going to hurt when the tape comes off. So, make sure that you shave the area if it is dense with hair, and you can save yourself some trouble in the future.
Often people end up cutting off more tape than they actually need. Remember, that tape stretches, which means that once you apply some tension to it, it will reach further. This is a handy little tip, especially considering how expensive some tapes can be!
KT tape has a tendency for the ends to curl up, getting caught on clothing. So, if you are going to tape, round off the corners of your tape and it will last far longer.
Trying to pull the backing tape off KT can be frustrating. Instead, if you tear the tape with your hands, you will tear the backing paper, making it easy to remove, whilst leaving the tape unaffected.
By looking at the research, we can see that something happens when we use KT tape. I mean, it’s most likely not the KT tape that’s responsible, but a whole host of other factors. But, the fact remains, that KT tape may give people more awareness of their joints, but more importantly, it might help contribute to less pain, and that’s what it’s about really isn’t it.
So, for those of you who are wanting to tape hypermobile joints, we have compiled a few videos of how to tape some of the most problematic hypermobile joints.
We hope you enjoyed reading, and more importantly, feel more informed about KT tape and hypermobility.
A lesser-known condition, chronic fatigue syndrome, sometimes called CFS, is a condition that makes patients feel so tired that they can’t do all of their normal, daily activities. There are other symptoms too, but feeling very tired for at least 6 months is the main one.
Many people improve in a year or two and do not relapse. Some people continue to have severe fatigue and other symptoms for many years.
CFS is still not well understood. Most experts now believe that it is a separate illness with its own set of symptoms, but some doctors do not believe this.
Because there are no tests for CFS, many people have trouble accepting their disease or getting their friends and family to do so. It’s important for patients to have people in their life who believe their diagnosis and support them, along with having a doctor they can trust.
Doctors don’t know what causes CFS. Sometimes it begins after an illness like the flu, but there is no proof of any connection. It’s likely that a number of factors or triggers come together to cause CFS.
The main symptom of CFS is extreme tiredness or fatigue. Those who have CFS may feel exhausted all or much of the time, may have problems sleeping or may wake up feeling tired or not rested. CFS may also make it harder for patients to think clearly, concentrate, and remember things. Patients may have headaches, muscle and joint pain, a sore throat, and tender glands in the neck or armpits. Often symptoms may flare up after a mental or physical activity that used to be no problem. Depression is common with CFS, and it can make other symptoms worse, though antidepressant medicines can help.
As mentioned before, there are no tests for CFS. Doctors can diagnose it only by ruling out other possible causes of fatigue. Since many other health problems can cause fatigue, most people with fatigue have something other than chronic fatigue syndrome.
While there is no specific treatment for CFS itself, many of its symptoms can be treated. A good relationship between doctor and patient is important because working together to find a combination of medicines and behavior changes is the best way to help patients get better. Some trial and error may be needed because no single combination of treatments works for everyone.
Home treatment is very important. Patients may need to change their daily schedule, learn better sleep habits, and start getting regular gentle exercise.
Counseling and a gradual increase in exercise help people who have CFS get better.
Even though it may not be easy, keeping a good attitude really helps. Try not to get caught in a cycle of frustration, anger, and depression. Learning to cope with symptoms and talking to others who have the same illness can help patients keep a good attitude.
Here at The Chronicilness.co of the United States, we know that living with chronic pain can be stressful. But one of the best ways patients can help reduce the stress in their lives is by learning how to relax through breathing exercises.
Deep breathing helps lower stress in the body because breathing deeply sends a message to the brain to calm down and relax. The brain then sends this message to the body. Deep breathing also causes certain things that happen when stress occurs, such as increased heart rate, fast breathing, and high blood pressure, to decrease.
Another good thing about breathing exercises is that they are easy to learn. Patients can do them whenever they want, and they don’t need any special tools or equipment. Patients can also try out different exercises to see which works best.
The following methods focus only on breathing exercises, but there are other ways, such as combining breathing with things like yoga, imagery, and meditation.
The first exercise presented is called belly breathing and is simple to learn and easy to do. It’s best to start there, especially for patients who have never done breathing exercises before. The other exercises are more advanced, but all of these exercises can help patients relax and relieve stress.
Belly breathing is easy to do and very relaxing. Patients can try this basic exercise anytime they need to relax or relieve stress.
Sit in a comfortable position.
Put one hand on your belly just below your ribs and the other hand on your chest.
Take a deep breath in through your nose, and let your belly push your hand out. Your chest should not move.
Breathe out through pursed lips as if you were whistling. Feel the hand on your belly go in, and use it to push all the air out.
Do this breathing 3 to 10 times. Take your time with each breath.
After mastering belly breathing, patients may want to try one of the following more advanced breathing exercises.
4-7-8 breathing This exercise also uses belly breathing and can be done either sitting or lying down.
To start, put one hand on your belly and the other on your chest as in the belly breathing exercise.
Take a deep, slow breath from your belly, and silently count to 4 as you breathe in.
Breathe out completely as you silently count from 1 to 8. Try to get all the air out of your lungs by the time you count to 8.
Repeat 3 to 7 times or until you feel calm.
Roll breathing The object of roll breathing is to develop full use of the lungs and to focus on the rhythm of breathing. It can be done in any position, but while learning, it is best to lie on the back with knees bent.
Put your left hand on your belly and your right hand on your chest. Notice how your hands move as you breathe in and out.
Practice filling your lower lungs by breathing so that your “belly” (left) hand goes up when you inhale and your “chest” (right) hand remains still. Always breathe in through your nose and breathe out through your mouth. Do this 8 to 10 times.
When you have filled and emptied your lower lungs 8 to 10 times, add the second step to your breathing: Inhale first into your lower lungs as before, and then continue inhaling into your upper chest. As you do so, your right hand will rise and your left hand will fall a little as your belly falls.
As you exhale slowly through your mouth, make a quiet, whooshing sound as first your left hand and then your right-hand fall. As you exhale, feel the tension leaving your body as you become more and more relaxed.
Practice breathing in and out in this way for 3 to 5 minutes. Notice that the movement of your belly and chest rises and falls like the motion of rolling waves.
Practice roll breathing daily for several weeks until you can do it almost anywhere. You can use it as an instant relaxation tool anytime you need it.
Caution: Some people get dizzy the first few times they try roll breathing. If this happens, slow breathing down and get up slowly.
Fibromyalgia and Costochondritis are two conditions that often go hand in hand with each other. Over the years we have lost count of the number of clients who were plagued with the hallmark sharp stabbing pains, that often come with Costochondritis. Within this topic are many questions, most of which become a whole lot harder to answer when we factor In Fibromyalgia.
There are many people in the general population who have Costochondritis, it’s not just another issue that comes along with Fibromyalgia. However, as we will come to find when we take a look at some of the research, Costochondritis does seem to be far more prevalent in those with Fibromyalgia.
Costochondritis is the term given to inflammation of the cartilage that joins your ribs to your breastbone, also known as the costochondral joint. Inflammation is a natural response to illness or injury, it’s essentially the immune system’s response to help initiate the healing process, in other words, it is a defence mechanism that is vital to our survival.
Whilst Inflammation is one of the body’s greatest tools, it doesn’t feel all that great when it does happen. After all, the point of inflammation is healing, and this means that more blood is redirected to the area, tissues become more permeable to allow increased blood flow and nutrients to the areas, and the nerves in the surrounding areas become a whole lot more sensitive. If you have ever had a paper cut you will know exactly what I mean. For such a small cut, it sure does impact your day to day activities.
With Costochondritis, the costochondral cartilage, which connects your ribs to your breastbone, and surrounding tissue can become inflamed, making it tender and unpleasant when pressure is applied, and in most cases, simply from breathing or even moving.
The obvious leading symptom is chest pain, typically it is described as a sharp or stabbing pain, and sometimes it is described as more of a dull ache which often becomes worse when moving or exerting the chest muscles. This can also include breathing, which can cause an increase in pain with large breaths. Many people find that even the slightest touch or pressure around the sternum and ribs can fire off a pain response, as the nerve becomes more and more sensitive due to the inflammatory response.
The most commonly reported pain from Costochondritis can be found in the sternum, around the 4th-6th ribs. However, as the inflammation increases, it’s not uncommon for the pain to begin to spread.
Again, this question takes a little research and some critical thinking to answer. There are some good studies that show us that there is a pretty strong connection between fatigue and Rheumatic conditions in general. In one study of patients with different rheumatic conditions, there was found a 54% prevalence of fatigue for those with a single inflammatory rheumatic disease, such as rheumatoid arthritis, systemic lupus erythematosus, or ankylosing spondylitis. However, this prevalence shot up to 82% for those with Fibromyalgia. In essence, from this and multiple other studies, one out of every two patients with a rheumatic disease seems to be severely fatigued.
On one side of the coin, there are many folk in the general population who do have Costochondritis but report minimal fatigue. And on the other side of the coin, we have those with fibromyalgia and Costochondritis, who report major fatigue associated with it. It’s unlikely that costochondritis directly causes fatigue, as both those with fibromyalgia and without it would be affected. However, that does not mean that it does not indirectly cause fatigue.
If you ask anyone with chronic pain about sleep, they will tell you that it’s incredibly difficult to get a good nights sleep when you are in pain. And one of the hallmark symptoms of sleep disturbances and deprivations is fatigue. Therefore, it’s not such a huge leap to assume that someone with Costochondritis, or Fibromyalgia and Costochondritis, would experience fatigue as an indirect result of being unable to sleep properly due to being in pain.
Likewise, many people with Fibromyalgia, often learn and develop certain coping skills for sleeping when it comes to dealing with the pain of Fibromyalgia. It’s very likely that due to differences in the pain experience, Costochondritis may cause undue stress and anxiety which could disrupt sleep also. Pain from Costochondritis is very hallmarked, it’s sharp, disruptive, and can often make people wonder if there is something wrong with their heart. Therefore, many people with Fibromyalgia and Costochondritis may struggle to sleep due to the new pain that comes from Costochondritis.
When living with Fibromyalgia, it is often hard to distinguish what pain comes from which issue. Many people have gone to their doctors with legitimate concerns, only for those concerns to be passed off as just another Fibro symptom.
One example of this is from a consultation we had here at chronicillness.co, some years back. A young woman had been suffering from severe headaches and every time she went back to the doctors it was promptly put down as caused by Fibromyalgia. However, at her consultation with us, and after going through her history, it was blatant that this young woman had Ehlers-Danlos syndrome. What also stood out was that her headaches were immediately cut in severity when she lay down. Suspecting a Cerebrospinal fluid leak we quickly referred her to her local hospital. And low and behold, it was indeed a spinal fluid leak. After a blood patch, and bed rest to closely monitor for leak recurrence, she recovered after around 6 weeks and has never had another headache since.
We have many stories from over the years just like this one, but the point to take is that you should never put new symptoms down to Fibromyalgia.
While working with our clients in the studio, it’s really not uncommon for us to get the “Is my Costochondritis and Fibromyalgia related?” question. And this is a good question, anecdotally you probably know a whole host of individuals with Fibromyalgia and Costochondritis, but are they related.
When looking at the evidence on this topic, it becomes more clear that they are likely linked, as the prevalence of patients with Fibromyalgia who also have non-cardiac chest pain is far higher than in the general population. In a study conducted in 2016 that looked at symptoms of people with Fibromyalgia, across 4 groups it was found that on average, 29.1% of the 313 participants either currently or previously had Costochondritis. And when compared to the general population, it was found that chest pain in primary care it only accounted for 13%.
In an overview of symptoms of patients hospitalised in the US between 1999-2007, there were over 1.7 million people during this time with Fibromyalgia, of those patients, 10% presented with non-specific chest pain (around 170,000 people). While this is closer to the general population we have to remember that these were only the ones who felt the pain was bad enough to go to the hospital, and its worth remembering that when living with Fibromyalgia, it tends to take a much higher level of pain before seeking medical intervention due to living in pain being accepted as normal.
There may well be a few reasons why are more commonly found together:
Sleep If the last few decades of research into sleep and pain have taught us anything, it’s that with lack of sleep comes a prevalence for more pain. Sleep disruptions lead to hyperalgesia pain changes, which means that your brain becomes far more responsive to noxious stimuli, lowering the pain threshold, and even going as far as to impact our own bodies’ ability to realise pain-killing chemicals. For those with Fibromyalgia, sleep is most often a major issue. Therefore, an activity that would not normally be deemed as strenuous, may become strenuous for someone with Fibromyalgia, and could potential lead to the development of Costochondritis, due to inflammatory responses from strenuous activity or movement.
Guarding response For those in pain, it’s really not uncommon to find them adopting postures to make the pain more bearable. Whilst this may help in the short term, over time staying in any one position can become painful. In the instance of Costochondritis, it’s not a far reach to assume that putting prolonged strain on the costochondral joints and cartilage, could potentially cause an inflammatory response causing Costochondritis for those with Fibromyalgia.
Lack of activity The decrease in activity levels amongst those with Fibromyalgia, as well as being in pain, can lead to sensitisation which lowers tissue tolerance to stress before an inflammatory response is deemed necessary. For tissue to be healthy, we need to move, and for those with Fibromyalgia, this can often be an issue. This gives us another potential reason for a link between Fibromylagia and Costochondritis.
Hypermobility It has been shown in a number of studies that there is a link between hypermobility and Fibromyalgia. One study showed that 46.6% of the Fibromyalgia patients participating, scored at least 4 or more on the Beighton scoring system (A method used to determine hypermobility), compared to 28.8% of the control group. When we look deeper at the connection between Fibromyalgia and Hypermobility, the issues surrounding chest pain and Fibromyalgia can be further explained.The high prevalence of misdiagnosis in the hypermobile population, most likely contributes to the increase of those with Fibromyalgia experiencing inflammation of the chest. A common symptom surrounding hypermobility, is that of joint subluxation/dislocation, due to the genetic make-up of collagen. And a common issue associated with this is rib subluxation. We wrote an article around hypermobility rib subluxation earlier this year, which you can find here. Hypermobility may account for the prevalence of Costochondritis in the Fibromyalgia population, as slipping rib syndrome is pain from inflammation of the cartilage that.
Chest pain can be terrifying when it happens, it can even be severe enough to mimic the symptoms of a heart attack. I remember when I had my first experience of this, I actually thought I was dying and it wasn’t until I was in the hospital, that I found out that I was fine. But, none the less it was a pretty scary experience, as I couldn’t breathe properly because of the pain, and it felt like a tight band around my chest.
The good news though, is that Costochondritis is it is not cardiac related, so it isn’t related to the heart. When there is inflammation in the chest this often leads to shortness of breath, due to us trying to breathe in a more limited fashion to reduce the pressure on the chest. This change in our respiration will often lead to us not taking in as much oxygen as we normally would, and can leave us feeling like we can’t breathe and panicked. But, again, Costochondritis is it is not cardiac related.
Living with Fibromyalgia is bad enough, but when adding Costochondritis to the mix it can seem a whole lot worse. But can Fibromyalgia make Costochondritis worse?
Fibromyalgia often leads to central and peripheral sensitization where nerves are a lot more sensitive to noxious stimuli, so it will take less pressure on the chest before these nerves fire and alert the brain of a potentially dangerous stimulus. This would make it feel a lot more tender to the touch than it should normally be. Think of a turn dial that usually likes to sit at 1-3 unless something is wrong (like inflammation) and is then turned up when there is an issue. With Fibromyalgia though, the dial is already sitting at 7, so when a potential threat is noticed this can turn it up to 10. This can result in more painful sensations than are usually warranted. So, given what we know about the current pain mechanisms, having fibromyalgia is likely to make having Costochondritis worse than it would be for someone without fibro.
Your first port of call when it comes to Fibromyalgia and Costochondritis should be your doctor. Anti-inflammatories will help to deal with a lot of the pain from Costochondritis, but this isn’t a long term solution. As we previously mentioned, having a healthy and happy rib cage means that it needs to be able to move freely, so this should be your second port of call: focusing on relearning to move your ribs.
We would also suggest that you check to make sure that you are indeed not Hypermobile and that the pain doesn’t arise from a rib subluxation.
Dealing with knee osteoarthritis usually means dealing with pain and stiffness all day long, but that doesn’t have to be the case. Not only are medications available to be taken by mouth, but knee injections are quickly becoming just as popular. If you are interested in injections for knee osteoarthritis, be sure to talk to your pain management specialist at Chronicillness.co Site of the United States to find out if it is a good option for you.
There are different types of injections that can be especially helpful for patients who haven’t gotten relief from NSAIDs like ibuprofen, or people who can’t take those drugs due to side effects.
It’s important to understand how knee injections work. First, a doctor will inject a shot of anesthetic to numb the knee. Then, a needle may be used to draw out any extra fluid that’s in the knee. After that, the patient will receive the pain-relieving injection, usually just below the kneecap. The shot shouldn’t hurt, and the drug will work throughout the joint.
Different treatments have side effects that patients should discuss with their doctor beforehand. The two most common types of knee injections for OA are corticosteroids and hyaluronic acid.
Corticosteroid injections are useful for treating flare-ups of OA pain and swelling with fluid buildup in the knee. These injections help relieve symptoms by reducing inflammation in the joint.
However, they are not a perfect solution in every case. Those considering this treatment should keep in mind that they work quickly, meaning these injections offer “very rapid” relief, usually within 24 to 48 hours. Also, the benefit is short-term. On average, the pain relief lasts from 6 to 12 weeks, which is long enough to get patients through a flare-up of osteoarthritis until their symptoms subside.
Patients should also not use them frequently. A corticosteroid shot often works best the first time and after that, they tend to give less relief. In most cases, patients are advised to use these shots two to three times a year. Using them too often may damage cells in the knee that make cartilage.
Most of the fluid in a healthy knee is hyaluronic acid but for those who have knee OA, the hyaluronic acid in the knee thins. Doctors can inject more hyaluronic acid into the knee to boost the supply.
Studies have shown that hyaluronic acid injections may help more than pain-relief medications for some people with OA. Other studies have shown they may improve symptoms as well as corticosteroid injections do.
But patients should be aware that it’s often not the first approach due to hyaluronic acid treatments being more expensive. They are often covered by insurance, however. Hyaluronic acid may be suggested to patients if their symptoms aren’t improved by pain-relief medications or non-drug treatments such as heat or ice.
Patients who can’t take pain relievers such as Advil or Motrin (ibuprofen), Aleve (naproxen sodium), or Tylenol (acetaminophen) are encouraged to try hyaluronic acid injections.
Hyaluronic acid injections are often used if a steroid shot doesn’t help enough, or if patients and their doctors are concerned about its side effects.
After an injection, hyaluronic acid helps cushion and lubricate the moving parts of the knee. This effect is fairly short-lived, but the treatment seems to also provide more long-term benefits by relieving pain and inflammation.
Patients may need more than one injection. Five versions of hyaluronic acid injections are available in the U.S. Some types require only one injection while others require up to five injections, usually within a five-week period. If needed, patients can get another shot after six months.
We often get asked about Fibromyalgia and Osteoarthritis from our clients, because more often than not, they have been told numerous scary stories by consultants. Likewise, many of the people we speak to have read many articles online, that are laden with misinformation. Osteoarthritis as a whole, gest a bit of a bad reputation, despite being completely normal and inevitable.
In fact, even the name Osteoarthritis is somewhat of a misnomer, as “Osteo” means bone,”‘Arth” means joint, and “Itis” means inflammation. And when we realise that Osteoarthritis is a degenerative condition, not an inflammatory one, we can start to see why there is likely so much misinformation around fibromyalgia and osteoarthritis, especially considering it’s not even named correctly!
For those of you reading, we can appreciate that having more labels attached to you can be a scary thing. A lot of the time people have only just gotten used to and accepted the Fibromyalgia label, before being hit with another in the form of osteoarthritis. Unfortunately, for most people, a quick google of Fibromyalgia and Osteoarthritis brings up many horror stories and a tonne of misinformation. This misinformation has the potential to not only make your pain worse, but ultimately make your world smaller and smaller as you inevitably try to protect yourself more and more over time.
So, in the following article let’s take a look at a few things that we should know about when it comes to Fibromyalgia and Osteoarthritis.
Osteoarthritis is defined as “Degeneration of the joint cartilage and underlying bones, usually accompanied by pain and stiffness, and most commonly found in the hips, knees and thumb joints.”
In a healthy joint, a coating of tough but smooth called cartilage covers and protects the surface of the bones, helping them to move freely against each other. However, when a joint develops osteoarthritis, part of the cartilage thins and the surface becomes rougher. This means the joint doesn’t move as smoothly as it should, causing the protective cartilage on the ends of your bones breaks down, potentially causing pain, swelling and problems moving the joint. When cartilage becomes worn or damaged, all the tissues within the joint become more active than normal, as the body tries to repair the damage. This can result in swelling and inflammation of the joint.
As we mentioned earlier, Osteoarthritis isn’t really properly named, because whilst there can be inflammation present, it’s the degeneration that defines it. After all. we already have a name for inflammatory arthritis which we call Rheumatoid arthritis.
There is a good chance you are reading this because you have Fibromyalgia and Osteoarthritis, and you want to know if they will affect one another. Well, having fibromyalgia does change a few things when it comes to osteoarthritis, but it’s mainly not anything to do with the actual tissues, and don’t worry, we will cover these other factors in this article. But, before we get into how Fibromyalgia may affect osteoarthritis, let’s start with a question that’s a little easier to answer for: why do we get Osteoarthritis in the first place?
As we age our bodies incur wear and tear from just being alive. Our hair grows thin and turns grey, our skin thins, and we developed wrinkles. It is essentially just part of the human condition, and just as we degenerate on the outside of our bodies, we also degenerate on the inside.
No, they don’t, well not physically anyway. Anti-wrinkle cream is a multi-million-pound industry, so it’s evident that wrinkles do cause some emotional distress for the majority of us!
So then, if degeneration on the outside of the body doesn’t cause us any pain, then why would degeneration on the inside cause it?
Keep in mind also, that we are way more sensitive to changes on the outside of the body than we are on the inside. There are a great many people right now, with very severe degeneration, who have absolutely no pain. Likewise, there are also people with very little osteoarthritis, who are in a great deal of pain. Before we get into the complexities that is Fibromyalgia and Osteoarthritis, it’s important to remember that this wear and tear is a normal part of ageing. In fact, in the next section, let’s take a look at a few studies that show us that normal wear and tear can actually be painless or not correlate to damage.
As we mentioned before, there is a lot of misinformation around Osteoarthritis, and probably even more around Fibromyalgia. So, let’s take a look at some studies and start to break down those damaging narratives that you have likely been told or have read.
One study focusing on professional football players found that 92% of football players had at least 1 spinal degenerative condition, but in some cases, more than 6 were found. The interesting thing was that none of them reported any pain. This is a nice study that helps us look at the complexities of pain, as when it comes to chronic pain it isn’t always about the tissue.
There is a ridiculous amount of evidence that shows us that pain is not tightly linked to tissue damage. And when it comes to Osteoarthritis, there should also be evidence of people with severe degeneration shown on a scan, but who feel fine, and vice versa. This study of 113 people found exactly that, a huge disconnect between degeneration and pain. In which they found that the people with less degeneration had more pain, and those with more degeneration had less pain!
It kind of changes your opinion on some of the stuff you have been told doesn’t it.
Another study looking at the general population, wherein the focus was on the difference between structural changes in the knees and symptoms, found that there isn’t a great connection between the severity of the condition and pain. However, they did find that the symptomatic group had a slower walking speed, longer stride and standing times and reduced strength. Which, when you think about it, makes complete sense. If you are in pain it’s unlikely that you’re going to be moving quickly, but rather taking your time in an effort to not increase pain levels.
That was the only real difference that this study found between those with Osteoarthritis who had pain and those with it who had no pain. Keep in mind also, that another study found that cartilage defects were found in around 11% of those under the age of 40 who had no pain. This percentage jumped to 43% for those over the age of 40, but still without pain. As you can start to see, that actual amount of degeneration doesn’t really correlate with the amount of pain you would expect someone to have.
In this study, it wasn’t just the cartilage they focused on, but also tissue. There were instances of meniscal tears in up to 19% of the study, bone marrow lesions and even bone spurs were present in 12-24%. I think a good place to end this section is to look at a study from 20 years ago, that will really challenge your beliefs about osteoarthritis and pain.
This study showed that people who received a fake arthroscopic knee surgery for Osteoarthritis had results just as good as people who received the real surgery. And in 2008, the New England Journal of Medicine added more experimental evidence to the pile, reporting that “surgery for osteoarthritis of the knee provides no additional benefit to optimized physical and medical therapy.”
In the years to follow, there has been an exceptional level of evidence showing that arthroscopic debridement has no benefit, showing that it is no better than a placebo.
We have established that the amount of Osteoarthritis doesn’t really correlate with the amount of pain a person experiences. So what is going on then if it’s not about the actual degeneration? Well, this is where Fibromyalgia can start to make things a little bit more complicated.
When we look at the pain and symptom severity of Osteoarthritis, historically, cartilage damage was believed to be the hallmark of Osteoarthritis. However, since cartilage is an avascular, aneural tissue, the mechanisms of pain are likely to be way more complex than first thought, and most likely influenced by non-cartilaginous structures in the joint including the synovium. The current body of evidence points to pain sensitization, and molecular pathways, as the possible main driver of Osteoarthritis pain.
Like we said before, when it comes to chronic pain, it’s not always about the tissue. We know chronic pain changes the brain and nervous system, causing the brain to take note of inputs that it really shouldn’t be. Hence why so many with conditions like Fibromyalgia often developed other conditions such as allodynia.
The Simple answer is yes, it is more common than you think, in fact when you are going through all the tests to get your Fibromyalgia diagnosed, you’ll most likely be told about degeneration somewhere in the body.
Both diagnoses have overlapping symptoms such as pain, stiffness, and limited range of motion. It’s also not just Osteoarthritis and Fibromyalgia, but other rheumatic conditions. One study showed that between 20-30% of those diagnosed with Fibromyalgia, also had co-morbid rheumatic conditions. When we look at the data for just Osteoarthritis, we find that between 10% – 17% of those living with Fibromyalgia also have Osteoarthritis
As we mentioned earlier, Fibromyalgia does indeed have the potential to complicate Osteoarthritis.
Those with Fibromyalgia suffer from abnormalities in the way that the brain deals with pain. Supraspinal processes have a top-down enhancing effect on nociceptive processing in the brain and spinal cord. Studies have begun to suggest that such influences occur in conditions such as fibromyalgia. This means that those who do have Fibromyalgia may be far more sensitive to noxious stimuli compared to the general population. Factoring in changes at the joint, those with Fibromyalgia may be more prone to reacting to these changes byways of producing pain.
There have been a few studies that have looked into how Fibromyalgia may affect Osteoarthritis. One such study published in the European Journal of Neuroscience, measured brainwaves in response to short painful laser pulses on the skin of patients suffering from osteoarthritic and fibromyalgia pain, as well as test subjects who had no underlying pain. Scientists discovered that the insula cortex part of the brain increased its activity when expecting a painful pulse, as it predicts the extent and intensity of the patients’ own chronic pain.
It is important to keep in mind, that increased activity in this brain area has been linked to a number of phenomena, including body perception and emotional processing, which might explain the greater pain perception in some patients.
In essence, there are a lot of factors that come with fibromyalgia that can make osteoarthritis worse, when compared to individuals without it. One such factor is sleep disturbances. It is well documented that with sleep disturbances and lack of sleep, comes an increase in pain. For those with Fibromyalgia, getting a good, restful night’s sleep can be somewhat of a challenge due to pain. Meaning that it has the potential to create a breeding ground for worsening the symptoms of not just fibromyalgia pain, but also the pain of Osteoarthritis.
With chronic pain, also comes the prevalence of mental health issues, which can also make symptoms worse. It is well established that mental health issues can be a large driving force behind chronic pain. And for those with Fibromyalgia, they may be more prone to experiencing pain with Osteoarthritis, whereas those without fibromyalgia may likely not even notice these degenerative changes.
We have taken a look at what Osteoarthritis is, how it’s caused, and how Fibromyalgia may affect it. All that is left now is to look at some of the things that can help you when it comes to Fibromyalgia and Osteoarthritis.
Massage It has been shown that massage can be particularly effective at lowering pain in osteoarthritis and Fibromyalgia. An analysis of 9 studies found that massage helped to improve pain, anxiety, and depression associated with Fibromyalgia.
Stay hydrated It is estimated that around 70% of your cartilage is made up of water, and when we are dehydrated this is going to affect the joints, as the more lubricated a joint is, the less friction there will be. This is important when we remember the studies into those with Fibromyalgia being more sensitive to noxious stimuli. We want to reduce the amount of noxious stimulus coming into the nervous system.
Cold showers The benefits of cold showing with Fibromyalgia can be found in a comprehensive blog post we wrote, which you can find here. The benefits of cold showering with Osteoarthritis can help by reducing pain, decreasing swelling, and constricting blood vessels.
We hope the above has helped to answer the questions you have about Fibromyalgia and Osteoarthritis, and we wish you the best of luck on your journey.
