FIBROMYALGIA & COVID: my clinical data, based on hundreds of patients with Fibromyalgia, postulates that many COVID survivors will develop Fibromyalgia. The pathological dynamics described provide etiology of Fibromyalgia. These ideas will manifest as this thread advances...
My dozens of essays on subject of Fibromyalgia (see my threadreader library) detail etiology of this disorder. Common to the multifactorial disorders of Fibromyalgia are Hypermobility Spectrum Disorders (in women) & mechanical injury to the pelvic girdle (common to both sexes).
Once stability of the pelvic platform has been compromised, gravity imposes mechanical burden upon the upper body tower that elicits musculoskeletal compensations to preserve medial station of the body mass center of gravity.
Body mass center of gravity medial station is preserved by unconscious functional scoliosis, which is monitored by digitally tracing the upright spine and then noting linear orientation of the spine when the patient is prone.
Above a functional scoliosis, the shoulder girdles commonly assume an asymmetric tilt, with lower shoulder usually on side of the sacroiliac (SIJ) subluxation attendant with pelvic girdle injury and instability. Interestingly, SIJ dysfunction is most commonly unilateral.
A consequence of should girdle asymmetry is commonly a chronic head tilt toward the lower shoulder. This leads, over time to greater hypertrophy and painful spasm of Superior trapezius muscle on the higher shoulder side; a “crossed muscle” syndrome (after V. Janda).
Clinical observation of crossed muscle syndrome is easily discerned by simply grasping the mid-body of each Superior trapezius muscle between the thumb & index finger of the clinical examiner. Often difference in magnitude of girths is 2-3x & pain is aroused in hypertrophic side.
The hypertrophic & spastic Superior trapezius muscle is aroused by chronic stress supporting a chronically tilted head (about 10 pounds). Companions of persons who suffer this fate, chronic muscle tension, cervicalgia, & headaches, oft notice the tilt when forewarned.
As an aside, those who evolve this dynamic of chronic unilateral Superior trapezius muscle spasm & hypertrophy commonly experience classical Migraine headaches intermittently. IMO, Migraine is a neural dysautonomia fed by a nerve feedback loop of some sort to cerebral vascular.
In women with musculoskeletal disorders being described (who oft suffer Fibromyalgia), Migraine commonly manifests at time of menses, when hormone Relaxin is secreted & incites exacerbation of upper body tower instability; due to increased ligament (vertebral disc) flexibility.
As Fibromyalgia evolves, there is oft premonitory SIJ instability/pain followed by functional scoliosis, followed by shoulder girdle asymmetry. Shoulder girdle asymmetry begets Thoracic Outlet Syndrome & shoulder pain, which is the advanced element of chronic Fibromyalgia pain.
Reader is directed to my several threadreader essays for details about biomechanical etiology of Thoracic Outlet Syndrome. The combined dynamics of pelvic girdle instability & shoulder girdle instability contribute to the chronic widespread muscle spasm/pain called Fibromyalgia.
Reason for the mystery surrounding the etiology of Fibromyalgia is that this super-syndrome evolves over an extended period of time measured in months to years. Chronic pain begets sedentary lifestyles which promote increased soft tissue disuse, weakness, & assaults via gravity.
Clinicians have overlooked the extended evolution of Fibromyalgia. The simple evaluation of Superior trapezium muscles that I described above is reported nowhere except in my own clinical reports.
Clinicians have noted relationship of Fibromyalgia to acute & chronic illnesses of various sorts. Common integer is bedrest & sedentary activity. Integrity of the upright musculoskeletal body tower is severely thwarted by as little as two weeks of inactivity; pain contributes.
As to the familial & female relationships of Fibromyalgia, clinicians need look no further than Hypermobility Spectrum Disorder, a female disorder with genetic underpinnings.
As to males, there is manifold less incidence of hypermobility. Male pelvises are biomechanically robust of bone & ligaments. Men commonly come to pelvic instability via severe mechanical injury; a few via hypermobility. Men are not immune to illnesses that incite long bedrest.
I have described multifactorial causes of Fibromyalgia and Chronic Widespread Pain. Persons who suffer this fate commonly experience pained restless sleep since an unstable pelvic girdle (a bony ring) lying on a mattress transfers mechanical forces into loosest & injured SIJ.
Chronic SIJ ligament injury is a severe pain disorder irregardless of the sufferer’s posture within the gravitational field. Chronic pain when trying to sleep prevents deep refreshing sleep (REM sleep) which commonly leads to depression, daytime fatigue, & cognitive disarray.
Inception of biomechanical events leading to Fibromyalgia are often clouded by passage of time & escape discovery in common methods of medical history taking.
At the 10th Interdisciplinary World Congress on Low Back & Pelvic Pain (Antwerp October 2019; on line), I presented eight papers about clinical data in support of my theories about the cause of Fibromyalgia, & data about several syndromes attendant with this “Super Syndrome”.
Insights & clinical impressions herein are mostly of my own inventions; gained via an iterative evidence-based method of studying tissue & organ clinical systems. Many of my threadreader library essays further describe these ideas.
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