Do you suffer with fibromyalgia leg pain? Pain that is associated with the tender points and trigger points in multiple sites? Although we often refer to them as tender POINTS, they are actually more like tender AREAS.
Now most people with fibro describe an “area” of pain that radiates to the surrounding tendons or trigger points. Often there is an involvement with an associated tendon, ligament or TRP (trigger point). This is what causes the pain to radiate or extend.I have yet to meet someone with fibromyalgia that has merely a POINT of pain or tenderness. (However, the 18 tender points test is still used as ONE part of diagnosing fibro) And because tender points differ from trigger points, refer also to the ‘trigger points’ article for a more in depth discussion on TRP’s in fibromyalgia.
Let’s take for example the tender points on the inside of the knee. This area can extend on average from 2-4 inches above and below the inside of the knee. So it really makes more sense for reference to call this an AREAof pain, especially when it comes to working solutions.
Certain Activities Of Daily Living (ADLs) Can Exacerbate Fibromyalgia Leg Pain
Yes, there are many tender points in the lower extremity of the fibro body. Certain ADL’s (Activities of Daily Living) can exacerbate these tender AREAS.
Examples are sitting for extended periods, standing in one place, displacement OR shifting of weight while standing, driving, travel, cleaning activities, etc.
What else can exacerbate fibromyalgia leg pain? Trigger points, inactivity, loss of muscle mass, lower back pain, sciatica, SI joint involvement, certain medications, cold/flu and more. The interesting thing about fibromyalgia related leg pain is that it doesn’t matter whether you are standing, sitting or lying down.
The propensity for pain in the lower quadrant of the fibro body is just greater due to trigger points woven within layers of muscle and extremely tender areas that are not directly related to any activity or exercise.
The longest and most widely used muscle in the leg (otherwise known as the Sartorius muscle in the quadricep area) is responsible for much of our mobility in the lower quadrant of the fibro body. Here in the adjacent picture I have hi-lited these areas that cause most pain within the lower fibro body.
When this muscle and the surrounding muscles become de-conditioned, everything around this area also weakens including tendons and ligaments.
Agility can be lost and these “areas” of interest become wider still (as shown in the adjacent graphic), with the tender point pain spreading both above and below the actual point location on the inside of the knee.
The tender points within the buttock area can also radiate pain down the leg, often on the sides and back of legs. Hip and leg pain can result because the Illiotibial band (outside of legs) runs from the hip area down the side of each leg and when this area is tight can cause stabbing pain and severe stiffness.
Weakness and/or shortening in the hip abductors can also cause extreme tightness and decrease mobility. Illiotibial Band Syndrome (ITBS) can occur in athletes through repetition and overuse but this painful condition is not uncommon for people with fibromyalgia.
Now this is where there is some controversy. Is the fibro worsening OR are these points/areas of the fibro body becoming weaker? Are you suffering with Chronic Myofascial Pain on top of fibromyalgia? That could be the reason that you feel your leg pain is getting worse, as there are many layers of trigger points in the lower body.
I say it often, I highly recommend not sitting for long first thing in the morning. When we go from lying in bed to sitting first thing in the morning, this only creates more stiffness in the lower back, hips, legs and knees.One thing to consider with fibromyalgia and leg pain is that any position we stay in too long, like sitting or standing can increase pain and activate trigger points. The tender points will always be there on some level, but it is the trigger points that become activated from repetitive movements or being in one position too long.
I had to start thinking outside of the box and this is when I set out to create fibro specific exercises and start working with my fibromyalgia leg pain in a way that I had not previously done. This doesn’t mean that we can “cure” ALL pain through conditioning of the body, but when strength and agility are lost, everything suffers. So now we must look at what will counteract this phenomena that has become so common in fibro today.
Consistent Conditioning for the fibro body
People ask “how do you workout with fibro?” However, the greater question needs to be “how do we not?” This is never all or nothing.
I sure do get it. But see, we have to approach this condition in terms of conditioning, not merely temporary pain relief. Essentially we want and need to create more LONG TERM pain relief and subsequent independence as we age with a chronic illness.
This is well verified and why I became a fitness trainer and studied extensively to create fibro specific exercises and routines while also incorporating ways to lessen the severity of everyday activities that can worsen leg pain. Often, by the end of any given day, fibromyalgia leg pain can be even greater than the upper body pain. Although they definitely inter-relate, after standing or prolonged sitting at a job or computer, the legs and tendons are often the first to be affected.
It is important to know that it’s the everyday activities that can be detrimental to a fibro body and not the conditioning through safe and effective exercise. There are some activities of daily living such as cleaning a bathtub or lifting heavy objects improperly that really can be detrimental to a fibro body, where as focused fitness training actually ‘protects’ the body and builds a stronger resilience and foundation.
(NOTE: for the fibromyalgia protocol for beginning fitness training, refer to fibromyalgia exercises page here on the website)
As a person with fibromyalgia leg pain starts to regain greater strength and mobility, pain levels can lessen or at least create a greater tolerance through the very act of conditioning of the muscles, tendons and ligaments.
Some Other Symptom Treatments For Fibromyalgia Leg Pain
Myofascial Treatment
It can be helpful to experiment with light “rolling” on a foam roller OR working with a therapist who is experienced in myofascial release. It does not always have to be extremely painful to ‘work’ these areas, but there is benefit in learning how to work with these affected points/areas in a way that is healing, not detrimental to the fibro body. Bowen Therapy done by a massage therapist trained in Bowen can also be very beneficial.
Tender Points Treatment
Another helpful Rx is using compression wear on the legs and knees whenever needed, even before and after exercise. We have been experimenting with various types of compression over the past few years, using compression socks, sleeves and also making our own by cutting up old socks and other pieces of material to find what works best at various rates of compression. This can increase circulation, soothe “tender” tendons and ease pain in the affected areas.
Low back pain is obviously a different subject than fibromyalgia leg pain except in one respect. Low back pain often involves the sciatica nerve which can rediate severe pain down one leg or the other.
I have recently experimented with a particular type of pressure point therapy that provides considerable relief. It is the Nature’s Pillows“BeActive” brace. I like to wear it at night and sometimes through the night, I find that I really do have less lower back and leg pain in the mornings.
If you are greatly affected by fibromyalgia leg pain, there are many ways that you can support this area through movement, strength and focused range of motion exercises.
The remedies often used to deal with the pain (salt bath, natural anti-inflammatories of any kind, light massage ,etc) can be helpful to get us through, but it becomes really essential to create and utilize a consistent program of re-conditioning on whatever level is possible for EVERY fibro body.
And because tender points are different from trigger points (TRPs) in the leg region, refer to the page/article on TRIGGER POINTS here on the site.
Treatments for leg pain
Self-help for muscle cramps
For calf cramps, straightening the leg and pulling the foot up towards you may help (even better if you have someone to help you).
Leg cramp, often called charley horse in the US, is a type of leg pain that, if other causes have been ruled out, does not call for further investigation, and treatment is limited to self-help measures.
Stretching and massaging the muscle may help, but painkillers will not – since they are too slow to take effect. However, if tenderness persists after cramps, painkillers may be helpful then. No drugs are recommended for the treatment of simple leg cramps.
For cramps affecting the calf, in addition to massage, the following can help:
- Pull the foot up toward you while straightening the leg, or
- Walk around on heels until the cramp eases off.
Charley horse can be prevented through these measures:
- Stretching before exercising
- Avoiding dehydration by drinking 8-12 glasses of water a day
- Stretching and massaging your legs.
Claudication therapy
Treatment for people experiencing claudication leg pain is important since they at a higher risk of heart attack or stroke.
Peripheral arterial disease often coexists with other atherosclerotic conditions, such as coronary artery disease (which narrows the arteries to the heart and raises the risk of a myocardial infarction) and cerebrovascular disease (which can result in a stroke).
A treatment program for claudication involves aggressively tackling cardiovascular risk factors through:
- Smoking cessation
- Management of diabetes
- Control of hypertension
- Reduction in cholesterol and lipids
- Antiplatelet (anticlotting) therapy
- Walking exercise programs
Some patients may be suitable for surgery to reconstruct the arteries in the leg.
SOURCE : www.americanhealthrules.org
