Check out this brief video on how to stretch your thoracic spine over a foam roller at home.

Fred Samorodin,RPT

http://www.youtube.com/watch?v=vQ_RvGB3TFU

Visceral Manipulation: How important is it for you?

by barralinstitute.com

• Did you know that the attachments of the sigmoid colon and the caecum on the anterior sacroiliac joint could be the cause of your client’s sacroiliac joint dysfunction?
• Did you know that the ligaments that attach from the superior border of the lungs to the cervical spine and the first rib can tighten due to scar tissue from a lung infection, and this can cause brachial plexus issues?
• Did you know that Jean-Pierre Barral, DO, the developer of Visceral Manipulation, has found that 90% of all musculoskeletal disorders have a visceral component?

Visceral Manipulation blends into all types of manual therapy practices…The fisceral system relies on the interconnected synchronicity between the motions of all the organs and stgructures of the body,.  At optimal health, this harmoniuous relationship remains stable despite the body’s endless varieties of motion.  But when an organ cannot move in harmony with its surroundings due to abnormal tone, adhesions or displacement, it works against the body’s other organs, as well as muscular, membranous, fascial and osseous structures.  This disharmony creates fixed, abnormal points of tension that the body is forced to move around.  These fixed points create viscero-somatic interactions, which present as musculoskeletal or neuromuscular symptomology.

Clinical Study on the Effrects of VM for Low Back Spinal Dysfunction

Gail Wetzler, Registered Physical Therapist studied the effects of visceral manipulation on low back pain in 30 patients.  Some patients has previous manual therapy treatment, but did not include visceral manipulation.  Wetzler treated patients with VM (visceral manipulation) an average of 6-7 times.  Resutls were measured via a pain scale the patient completed, neurological testing, and standard movement and strength tests of the low back.  The results showed marked improvement in all but 2 of the cases across all tests.  The conclusion was “low back spinal dyusfunction may be more effectively and efficiently resolved with the addition of Visceral Manipulation into the treatment program.” Complete study can be found at www.barralinstitute.com

The voice doctor

Note: [Fred Samorodin has had the opportunity to briefly study with Dr. Jacob Lieberman, D.O. and uses the insights gathered from Dr. Lieberman's work to work directly with freeing the larynx (voice box) with hands-on techniques that may help individuals find their "voice" physically and/or emotionally.  Such work may take time and can be helped by coordinating  a counsellor's or psychologist's work with Fred Samorodin's whole body treatments.]

Jacob Lieberman’s holistic larynx treatment has made him indispensable to the stars. Actor Michael Simkins reports
• Michael Simkins
• The Guardian, Thursday 13 June 2002 13.27 BST

“Until I encountered Jacob Lieberman I thought there was only one area of my body to which I was uneasy about allowing strangers access. In fact there are two.

Lieberman is a registered osteopath and psychotherapist with an interest in psychosomatic disorders. What makes him unusual is that he has made the manipulation of the larynx his field of study. In the world of acting and singing he is well known as a man with a very particular skill, treating a part of the throat which few hands, if any, ever touch.

Lieberman became fascinated by osteopathy while working as a management executive in his home country of Israel. Having developed a serious neck problem when painting his house, he was “clicked” back into place by a chiropractor.

“That click changed my life, literally and metaphorically,” he says. “I threw up everything, my job, my home, my car, and came to Britain to study osteopathy.” But the limitations of dealing purely with the physical body without reference to the psychosomatic aspects of the complaint soon became clear, and he enrolled on a course of psychotherapy at the Tavistock clinic in London.

Most people arriving for a meeting with Lieberman are taken aback, as I was, by the fact that much of his initial consultation consists of inquiry into the person’s lifestyle and history. It is more akin to a psychotherapy session than a manipulation; throughout his questioning his manner is considered, his tone studious, almost academic. “The larynx is inextricably linked to the psychological state of the person,” he says. “We all use phrases such as ‘a stiff upper lip’ or ‘a lump in the throat’ to describe physical manifestations of emotional states – thus, by dealing merely with the symptoms of voice loss without investigating its emotional cause is less likely to prove beneficial in the long run.”

In fact, Lieberman will not even attempt physical manipulation unless he has gained an understanding of the person’s emotional state beforehand. “Often the vocal folds themselves may give no physical indication of strain or overuse. Only by working with the body, but also studying the mind, is it possible to unlock the fundamental underlying problem.”

Lieberman admits that this is an area where there has been little or no application of physical therapy before. The larynx is a largely ignored, almost forgotten part of the body. It is a complex mechanism made of collections of cartilage (muscles, ligaments and joints) suspended in the throat; in young people it is springy and flexible, with age the texture becomes harder and more unyielding. In all cases it is a delicate area to manipulate.

“Its original function was as a shield to provide protection for the airways,” he explains. “Virtually any animal of prey which attacks another will go for the throat.” He points out that the use of vocal folds for highly organised speech came at a much later stage of evolution.

The moment Lieberman first places his hands on the voice box is a curious sensation and he is careful to alert patients to possible reaction. In my case, I was convulsed with a bout of unstoppable adolescent giggling, but I was aware, even while laughing, that it is no mere tickling sensation; I also experienced an intense physiological relief.

Lieberman remains unfazed by such responses: “One’s personal reaction is very informative. Some people laugh, many cry profusely, while others feel overwhelmingly tired and deflated. Some can’t even bear the sensation of a scarf around their throat.” After a few moments he asks me to swallow. What he refers to as “the quality of the swallowing” is, he believes, itself, determined by psychological states. “The action causes you to tighten muscles which creates a combined movement; the larynx moves slightly backwards and then upwards and forwards from its resting place, after which it relaxes again. At this point it is possible to push it sideways and move your fingers gently behind it.” It sounds worse than it feels, the pressure of his fingers is not uncomfortable.

Many of his clients work in the performing arts and their voices have broken down, often for no immediately identifiable reason. “I had a cold four months ago and now this,” they lament. For businessmen, actors and even professional singers, the voice has been artificially maintained on constant adrenaline, often for weeks on end. Often problems only occur when they have a break or a holiday and the excessive adrenaline is no longer required. Worse still, the fact of losing the voice provokes further stress, and Lieberman believes that at this point people quickly develop what he calls “survival techniques” which only compound the problems. “Deprived of confidence in the ability of your voice to manage, you fail to support it, or even to breathe properly. It becomes a vicious spiral.”
Lieberman also believes that the performers’ lifestyle is a strain: “Performing each evening and eating late at night leads to poor digestion and disrupted sleep patterns. When one is young, the rate of recovery is faster than the damage process, but as one gets older the situation is reversed.”
The pressure experienced by workers in call centres, dealing with complaints and anxieties by phone day after day, is another area in which he believes there is a strong connection between vocal and physical illness.

At the end of the manipulation I am advised to rise from the chair slowly. As I do so, the full effect of Lieberman’s expertise becomes apparent. I feel what seems like a pint of warm oil gliding down my throat. Something has been released, both physically and emotionally, which has been trapped there a very long time.”

jacob-lieberman.co.uk

The Connection

Physical Therapists trained and experienced in the use of osteopathic manual therapy understand the importance of orthodontic dentistry as a means of improving jaw and tooth alignment and as an important factor in people’s health. Many dentists recognize the importance of craniosacral or craniomandibular osteopathic treatment as an integral part of assisting the body in making an orthodontic correction and in maintaining good health throughout the process. Understanding these mutual benefits requires an understanding of the connection between osteopathic treatments and orthodontia.

The proper alignment of teeth is dependent on a correct anatomical relationship of the upper jaw (maxilla) with the lower jaw (mandible). Changing tooth alignment requires changing not only the relationship of the maxilla to the mandible but also in complex relationships of these bones to several other bones of the face and skull. Osteopathic research demonstrates that all places where skull bones meet have significant capabilities of motion in infancy and childhood, and usually maintain motion throughout life. Although very little motion is permitted at any one of these joints, that motion is essential to allowing a successful orthodontic correction. Craniosacral osteopathic treatment assists orthodontic correction by helping all the bones of the skull to adjust to the orthodontic changes created.

In Canada, where physical therapists trained in osteopathic methods are relatively rare, there is a large potential for greater cooperation between physical therapists, orthodontists and dentists who recognize the importance of normal cranial mobility as a factor in the success of orthodontic correction. Through osteopathic manual therapy, the therapist can help the individual to better tolerate the orthodontic changes and can alert the dentist to the possible need to adjust the orthodontic plan. It is not uncommon to find that when osteopathic treatment accompanies orthodontia, the desired results are obtained in half to two-thirds the time estimated by the dentists, and the correction is more likely to hold well over time!

Orthodontic considerations

It is typical for the normal mobility of the cranium to be compromised somewhat during orthodontic correction. The degree to which this happens depends on the types of appliances used and on the ability of the patient to tolerate the changes brought about by the appliance. Most orthodontic corrective appliances fall into one to two categories—fixed or functional. Fixed appliances, such as braces or head-gear, hold firm the relationship of some teeth to other teeth. Because teeth are imbedded in bone, this rigid relationship of teeth to each other results in rigidity in the motion of the maxilla and mandible and, through them, limits the normal motion of other bones of the skull. Functional appliances, such as adjustable plate expanders, permit the cranial bones to retain more of their motion pattern during orthodontic procedures. They are, therefore preferable whenever they are capable of making the needed correction.

The topic of tooth extractions is a controversial one! While there are times when avoiding extractions makes the orthodontic treatment plan unreasonably lengthy and complex, it is best to keep all the teeth whenever possible. Removing the canine teeth, which serve as stabilizers of the jaw, can have profound negative consequences to the cranial mechanism and to the general health of the individual!

Tongue muscle action is a powerful force in shaping the developing oral cavity. When the tongue is not functioning properly within the mouth, speech, and breathing are also affected. Conditions such as respiratory allergies or asthma, which prompt mouth breathing, foster the development of an oral cavity that is more likely to need orthodontic correction. Children who continue to such their thumbs or to use a pacifier after the age of about 30 months are more likely to have orthodontic problems requiring attention. Sometimes the dentist may recommend myofunctional physical therapy in order to help correct the position and action of the tongue, before attempting orthodontia.

Health Challenges during Orthodontia

A person’s posture and overall health can suffer both when jaw alignment is poor and when jaw and teeth are undergoing orthodontic correction. It is ideal when the only complication of correction is the experience of pain in the teeth for one or two days aftr obtaining or adjusting an appliance. Unfortunately, some people suffer persistent headaches as a direct result of the compromise in bone and membrane mobility of the cranium.

With many years of daily practice in osteopathically-based craniosacral therapy, Fred Samorodin, Registered Physical Therapist is able to assess and treat body conditions that can help optimize the benefits of orthodontic dentistry.

THE DEVICE

You have the option of purchasing a specially-designed device called the “CV-4 Still-Point Inducer” (See physical therapist for details) or obtaining two equally-sized sponge rubber balls to create a CV-4 Self-help Device for home use. You may wish to use two racquet balls or two sponge rubber balls such as the red, white & blue rubber balls children play with.

(more…)

Congratulations on your decision to use one of the most widely accepted technologies around the world and just now making its presence known in the United States and Canada. All our magnetic products are sold as consumer products and as a result we make no medical claims for them. They have been used by hundreds of thousands of people here in North America and by millions upon millions of people worldwide. Because they may be new to you we have prepared the following to answer any questions you may have. Always remember that these products are non-chemical, non-toxic, non- invasive and have no known side effects! They work! Use them in good health!

HOW LONG WILL IT TAKE?

There is no right answer to this question. You may receive relief within minutes, hours, days or weeks. One good rule of thumb starts by remembering just how long you’ve had your discomfort. If it’s been 10 or 20 years then you should be realistic in your expectations. Knowing that you’re likely to receive relief within a couple of weeks to a couple of months, from a problem you’ve suffered with for 20 years, it would be in your best interest to continue using the product for that period of time. Let your body set the pace of health restoration and be patient.

THE THREE WEEK RULE

Talk with your doctor, chiropractor, physical therapist, pain management clinic, etc., and they’ll tell you two things. First, that they don’t expect their patients to receive any noticeable relief for at least 3 weeks! Knowing this, and since our products are not sold as medical devices here in North America, you need to be just as patient in your expectations. The second thing they’ll tell you is that it’s very common, in fact likely, that your discomfort will appear to get worse before it gets better.

CAUTION TO THESE FOLKS

Pacemaker users; talk with the manufacturer of your unit. Do not talk with your doctor because they do not know how your unit was constructed; only the manufacturer does. ∑ First trimester pregnant women; talk with their doctor first. ∑ Medication users to keep the immune system down; such as people with organ transplants, as the magnetic products actually stimulate the immune system to strengthen it.

Because everyone’s body responds in its own way to magnetic field products, you may or may not experience some or any of the following during the beginning stage of use:

INCREASED DISCOMFORT

The body often retraces the action and processes that occurred previously, meaning that you may have to work back through the discomfort you experienced in the past. This is usually of short duration with relief beginning soon thereafter. It is suggested you continue to use the magnetic products, removing them for short periods of time and then replacing them until you have passed this stage. If discomfort persists, discontinue use (your problem may be so severe as to require a medical professional). Be sure to drink plenty of water to help flush your body of toxins should increased discomfort occur.

CHASING PAIN

After placing a magnetic product on an area you may find after a period of time the stressful area has moved! Move the product or add another to the new area. It’s not unusual at all to find that the origin of the discomfort is not the area where the major point of stress or discomfort is felt. This is common, particularly in extremities.

INDIGESTION

While your body is re-adjusting itself to “normal” it is recommended that during the initial time you begin using the Sleep System you do not eat a full meal and then immediately go to sleep on the mattress pad. You should wait approximately one hour. As your body becomes accustomed to the Sleep System, which is usually just one day to one week, this will no longer be a concern.

FOOT TENDERNESS

When using the shoe inserts for the first time it is recommended you begin using them with the smooth side up! The purpose of the bumps is to stimulate the reflexology points of your feet. Do not initially jog or take lengthy walks on them, until your feet have become accustomed to the magnetic insoles. It’s just like breaking in a brand new pair of shoes. Also, if you find your shoes are too tight when using the shoe inserts then remove the manufacturer inserts in your shoes. You won’t miss them and your feet will have a bit more space and feel great. If your feet feel a bit tingly-warm on the Magsteps, drink more water.

INCREASED FATIGUE

Again this is a common initial response which soon disappears within a couple of days to a couple of weeks. The body is working feverishly to cleanse itself, a detoxificadon if you will, and return itself to normalcy and to good health. Most of us believe we are in good health, its just that our bodies don’t agree with us! Should you experience a feeling of increased fatigue take comfort in knowing that very soon you’ll do a 180 degree turn and happily be enjoying a greater feeling of energy! Be sure to drink plenty of water to help flush your body of toxins.

FLUID LOSS

The insoles and Sleep System often help the body remove excess fluids. This is an added advantage to these products. Those who experience water retention and swelling may notice they urinate at an above normal rate for a short period. This too will pass soon. Do not reduce your intake of water. Everyone needs adequate water for the body to function at peak performance. Drink at least eight (8) glasses per day.

MEDICATIONS

When using the Sleep System in particular, this often enhances the effects of medications you are taking. If your medication would normally make you drowsy, have dry mouth, etc. or you’re using a time release patch, these medication side-effects may be exaggerated. DO NOT stop your medication but rather have your physician re-evaluate your dosages. You may very well need to take less than before. Many people have found that over-the-counter medications are no longer needed!

LESS SLEEP

Using a Sleep System often reduces the time your body needs to sleep. Be excited! Even though you’ll sleep less hours you’ll awaken more refreshed, more alert and ready to start your day with more energy. You’ll most likely find yourself able to get out of bed with less effort. This energy will carry you throughout the day and when combining the Sleep System with the shoe inserts you’ll find very little, if any at all, afternoon “blahs.

IS TOO MUCH ENERGY POSSIBLE?

You may wake a few times during your first night on the Sleep System but you’ll still feel refreshed and ready to go in the morning. This will pass after a few days to maybe a week. Stay with it. Be persistent. We’re all conditioned to saying things like “If I don’t get at least 8 hours of sleep I’m useless the next day.” Just imagine if you could drop to 7 hours or even 6 hours of sleep while feeling just as well rested or maybe better rested than before. Celebrate! You’ve just given yourself an extra one to two hours a day to do some fun things for yourself.

LACK OF SUCCESS USING THE SMALL STATIC MAGNETIC RELAX PRODUCTS (Silver foiled magnets)

In most cases, if you do not experience some relief or some positive change it’s probably because of one or more of the following:

• Time. Use for a longer duration. Use 24 hours a day (except while bathing).
• Misapplied. Replace in a different location. Reposition slightly if no response is noted after a day or two. Discuss this with the person who sold them to you.
• Inappropriate size. The product isn’t big enough to cover the area needing relief or you may need to “sandwich” the area with two or more magnets.

Again, talk with the wellness consultant (Fred Samorodin, IWC) who made the products available to you.

Full body fascial facilitation is a treatment method which treats the whole body as a delicate, inter-related series of mechanisms like the intermeshed wheels in a finely tuned watch. Fascia, which is the framework of the body, forms the envelopes or pouches for all of the body’s vital organs. The muscles, liver, heart, and brain are a few examples of the tissues and organs that are supported by fascia.

Fascial facilitation helps to reduce pain and re-align displaced and dysfunctional areas of the body. Chronic pain which has been present for more than six (6) weeks duration is most effectively helped by full body fascial facilitation.

Pain of acute onset seems to be associated with a specific event, for example, a knee or ankle sprain. Treatment carreid out only to the painful area helps to reduce pain, but may not reduce the possibility of re-occurrence! By treating the whole body, the local painful region will settle more quickly and the chance of recurrent pain will be minimized.

Chronic pain, although localized in a specific body region, is usually the result of many body areas being out of balance. After many years of research, full body facial facilitation has been found to be the best way to control chronic pain! Chronic pain in the body, is multilayered, like an onion. To localize the source of a shoulder pain (for example, requires a number of therapy sessions. It is for this reason that at least six treatment sessions are usually scheduled at the commencement of your therapy. The ideal treatment interval between treatments has been found to be one week.

Two or three sessions of full body fascial facilitation may be necessary before the therapist has some idea of the main problem causing the pain. During these early sessions, painful re-actions may occur. Facilitation wakes up unhealthy tissue! Unhealthy tissue does not wake up and say: ‘Oh, Joy and Peace in the World!’ Rather it wakes up and says, ‘Who told you to disturb me?!’ So after the first treatment or two, you may feel ten times worse or better!

Remember, that by being patient and waiting for the rest of the week between sessions, your self-healing mechanisms will be working twenty-four hours a day to restore your body to a state of wellness! Should your pain be too severe, contact your therapist and, if necessary, use some form of pain relief such as local heat, cold, or pain medication. The dormant, underlying tissue dysfunction must be woken up by facilitation for healing to occur. Once the ‘sleeping tigers’ of dysfunction are stimulated, the body’s self-healing process will be started, usually leading to pain reduction and a return of the body to a balanced energetic state.

In order to assist in understanding modern naturopathic holistic health care, I propose to use as models in this series a number of health problems such as Chronic Fatigue Syndrome, also known as Myalgic Encephalomyelitis (CFS/M.E.) as well as the widespread muscle pain problem currently defined as fibromyalgia, or Fibromyalgia Syndrome (FMS). In this article there will be a brief overview of these two conditions, and as the series develops we will examine the common threads in causation, the differences, as well as ‘what works’ in therapeutic terms based on research to date.

I have chosen these two conditions specifically because each contains within it’s possible aetiology a cluster of causative and potentiating factors and conditions which are remarkably similar. FMS and CFS(ME) also have a wide range of identical symptoms ranging from fatigue through impaired cognitive and memory functions, to muscular pain, digestive disturbances, headaches and sleep disturbance.1,2,3

By virtue of their ill-defined natures these conditions have become a refuge, one could say a dumping ground, for a host of undiagnosed and apparently undiagnosable health problems. The majority of medical practitioners seem either to be unaware of the reality of the causes, nature and appropriate care of such problems or are openly disbelieving as to their very existence. These are often patients dubbed ‘heart sink’ because of their emotional effect on the doctor, as the patient enters the room, yet again clutching a list of symptoms and requests for help.

All too often classified as ‘neurotic’ with their symptoms ascribed to ‘depression’, this is a truly miserable population of people, who often feel profoundly misunderstood by those around them (sympathy is finite and six months into such conditions it is often in scant supply from friends and family) as well as let down by the medical profession who is either disinterested, dismissive or perfunctory in its prescribing of antidepressant medication.

To have to endure this sort of emotional and social isolation as well, as the cluster of demoralising symptoms with which they are burdened, is clearly enough to depress anyone, and it is the experience of most practitioners and therapists involved in working with such patients that any apparent depression is usually a result, rather than a cause, of their problems. In the alternative and complementary health field a veritable industry has emerged which treats such problems with varying degrees of success using a range of approaches and methods – sometimes suitable and sometimes not. All too often what is on offer addresses such patient’s needs only partially, with predictably disappointing results.

There are no simple answers to conditions where causes lie in a mix of nutritional deficiencies, acquired toxicities, bowel dysbiosis, inadequate stress coping abilities, sensitivities and allergies, inappropriate or excessive medication, inadequate sugar control mechanisms, hormonal imbalances, poor posture and breathing dysfunction, current or past viral, parasitic, yeast or bacterial infections, impaired organs of digestion and elimination, emotional distress….. and more. There are certainly no magic bullets which can remedy a situation which may have taken many years to evolve.

These are a growing army of these walking wounded, the ‘vertically ill’ who are too sick to function adequately but are commonly not quite sick enough to become ‘horizontally ill’, actually bed bound, although this is all too often an outcome in severe examples.

Unless there is an underlying awareness of the true nature and causes of such conditions, and until there is a real understanding of the ways in which it is possible to offer encouragement for an abused and over-stretched immune system to begin to restore health, many forms of proffered help (orthodox or alternative) will succeed only in either masking or, at best, moderating the patient’s symptoms.

Understanding Homeostasis: Self-Healing

It is absolutely vital for anyone afflicted with a chronic illness to hold onto the fact that their body is a self-healing mechanism, that since broken bones mend and cuts usually heal, and that since most health disturbances, from infections to digestive disturbances, get better with or without treatment (often faster without !) that, in a healthy state, there must be in operation a constant tendency towards normalisation and balanced function. This is called homeostasis.

Homeostatic functions (which include the immune system) can be overwhelmed by too many tasks and demands, because of (perhaps) any or all of a selection of negative impacts including nutritional deficiencies, accumulated toxic material (environmental pollution, either as food or inhaled, in medication, previous or current use of drugs etc), emotional stress, recurrent or current infections, allergies, modified functional ability due to age or inborn factors or acquired habits involving poor posture, breathing imbalances and/or sleep disturbances and so on and on …

At a certain point in time the adaptive homeostatic mechanisms break down and frank illness, disease, appears and as homeostasis breaks down, a state of heterostasis emerges.4 At this time the body needs help, treatment, and this can take the form of either:

Reducing the load which is impacting the body by taking away as many of the undesirable factors as possible, by avoiding allergens, improving posture and breathing, learning stress coping tactics, improving diet, using supplements if called for, helping normalise sleep and circulatory function, introducing a detoxification programme, dealing with infections, and generally trying to keep the pressure off the defence mechanisms while it focuses on the current chronic repair needs.

Enhancing, improving, modulating defence and repair processes by a variety of means, mainly non-specific (described as constitutional methods, which will be explained further in later articles in this series)

Treating the symptoms: while making sure that what is being done does not add further to the burden of the defence and repair mechanisms.

Meet Fibromyalgia

Fibromyalgia (FMS) used to be called fibrositis (among many other names) and even now when the word ‘fibromyalgia’ is used in medical writing it is often accompanied by the word ‘fibrositis’. The similarities between Fibromyalgia syndrome, Chronic Fatigue Syndrome and Irritable Bowel Syndrome are listed below.5,6

In Fibromyalgia, Chronic Fatigue Syndrome and Irritable Bowel Syndrome the following similarities are found:

• Age Young Adult
• Primary Sex Female
• Prevalence Common
• Cause Unknown
• Chronic Yes
• Laboratory Studies Usually Normal
• Pathology None
• Disabling Frequently

In addition to these similar, indeed identical, factors, all these conditions are also frequently characterised by pain, fatigue, headaches, disturbed sleep patterns, anxiety, depression, numbness and tingling in the arms, hands or feet, bowel disturbances (diarrhoea and/or constipation on their own or alternating) all frequently affected by the weather, by activity and by stress and there are usually many painful and sensitive areas to be found on palpation in all of them. Irritable bowel problems will usually also be associated with palpable painful areas in the abdomen.

The Official Definition of Criteria for FMS7

The most commonly accepted definition (devised by the American College of Rheumatology in 1990) is that the person affected needs to show:

History of Widespread Pain

Pain is considered widespread when all of the following are present: pain in the left side of the body, pain in the right side of he body, pain above the waist and pain below the waist. In addition there should be pain in the spine or the neck or front of the chest, or thoracic spine or low back.

Pain in 11 of 18 Tender Point Sites on Finger Pressure

There should be pain on pressure (around 4kg of pressure maximum) on not less than 11 of the following sites:

• Either side of the base of the skull where the subocciptal muscles insert.
• Either side of the side of the neck between the 5th and 7th cervical vertebra, technically described as between the ‘anterior aspects of inter-transverse spaces’.
• Either side of the body on the midpoint of the muscle which runs from the neck to the shoulder (upper trapezius)
• Either side of the body on the origin of the supraspinatus muscle which runs along the upper border of the shoulder blade.
• Either side, on the upper surface of the rib, where the second rib meets the breast bone, in the pectoral muscle.
• On the outer aspect of either elbow just below the prominence (epicondyle)
• In the large buttock muscles, either side, on the upper outer aspect in the fold in front of the muscle (gluteus medius)
• Just behind the large prominence of either hip joint in the muscular insertion of piriformis muscle.
• On either knee in the fatty pad just above the inner aspect of the joint.

Children with FMS

Many children are also now being diagnosed with FMS, often starting with flu-like symptoms and then becoming chronic with sleep disturbance a major feature. Some children also display Attention Deficit Disorder (ADD) symptoms, fatigue, school and behaviour problems and commonly a tendency to allergies. Some FMS experts also find that such children frequently have very loose (hypermobile) joints.

How Many People are Affected by FMS?

Muscular pain which goes on and on for months or years is now very common, often causing sufficient disability to prevent people from working or functioning normally, in fact Fibromyalgia Syndrome (FMS) is now the commonest disorder seen by rheumatologists, after osteoarthritis and rheumatoid arthritis.”>

Dr.Don Goldberg, Chief of Rheumatology at Newton-Wellesley Hospital and Professor of Medicine at Tufts University School of Medicine, estimates that there are between three and six million Americans affected by fibromyalgia, mainly between the ages of 26 and 35 with the vast majority being women (86% females against 14% males according to many surveys).

Based on population size and surveys we can therefore estimate that between 750,000 and a 1.5 million people in Britain also have fibromyalgia.

In total it is estimated, by Professor Bruce Rothschild of Northeast Ohio Universities College of Medicine, that nearly 25% of patients seen at rheumatology clinics are actually suffering from fibromyalgia.8

How Disabling is Fibromyalgia (FMS)

100 out of 394 patients (that is 25.3%) with FMS (all female) and 12 out of 44 males (27) were shown in a recent survey to be sufficiently badly affected by the condition as to be unable to work; they were effectively disabled.9

Almost all the others surveyed claimed that their FMS affected their job performance very badly. In Canada a single insurance company, London Life, reported in 1989 that it was issuing monthly long-term disability payments to over 630 people with a diagnosis of fibromyalgia, involving a total of around a million dollars a month.

Historical Confusion of Names
Just as ‘fibrositis’ has become fibromyalgia, so has Chronic Fatigue Syndrome now replaced the former terms ‘chronic mononucleosis’ and ‘chronic Epstein-Barr syndrome’ of the recent past, and ‘neurasthenia’ and ‘nervous exhaustion’ of Victorian times.

There is still disagreement amongst experts as to whether CFS is the same as Myalgic encephalomyelitis (ME) or not, and it seems likely that this argument will run for some time. In these articles, wherever chronic fatigue is not related to a known disease processes such as diabetes or clinical depression, or simply to over tiredness through natural causes (e.g. overwork), the two names will be bracketed together as CFS(ME).

Some doctors insist that the psychological aspects of these conditions is the most important cause and they use the terms ‘masked depression’ and ‘somatoform disorder’ to describe such conditions. This is strongly resented by those afflicted by CFS(ME) or FMS who see the psychological and emotional symptoms as being the result of their fatigue, pain and general ill-health and not as causes. CFS(ME) and FMS: are they the same?
There is also disagreement amongst experts as to whether or not ‘fibromyalgia syndrome’ and ‘chronic fatigue syndrome’ are not in fact the same condition.

Both CFS(ME) and FMS often seem to begin after an infection or a severe shock (physical or emotional) , and the symptoms are very similar. The only obvious difference seems to be that for some people the fatigue element is the most dominant while for others the muscular pain symptoms are greatest.

In other words for many people the diagnosis CFS(ME) and FMS are interchangeable terms, although there are certain symptoms (fever, swollen glands for example) which are found in a higher percentage of CFS(ME) patients than those with FMS, which sometimes make such a comparison less precise.

Symptoms Compared
One of the most interesting list of symptoms associated with FMS/CFS(ME) was that given to a conference on the subject by a leading San Francisco physician Carol Jessop MD in 1990.10 The number of patients she has seen and studied (over a thousand) makes this a comprehensive selection of associated symptoms, and is even more impressive since many of her patients are referred to her by other physicians thus making the diagnosis more likely to be accurate that is to say that both she and the referring doctor have agreed that these people ARE suffering from FMS or CFS(ME).

Common Symptoms Found in Dr Jessop’s Patients

• Chronic Fatigue 100%
• Cold Extremities 100%
• Impaired Memory 100%
• Frequent Urination 95%
• Depression 94%*
• Sleep Disorder 94%
• Balance Problems 89%
• Muscle Twitching 80%
• Dry Mouth 68%
• Muscle Aches 68%
• Headache 68%
• Sore Throat 20%

* Dr Jessop stated that this was a ‘reactive depression’ not a ‘clinical depression’ and that only 8% of her depressed patients had required prior medical attention for this before the symptoms of CFS or FMS emerged

Physical and laboratory findings
Dr Jessop reported the following symptoms and findings as well amongst her 1324 patients, average age 39, 75% of whom were female.

• Elevated temperature 10%
• Normal temperature 25%
• Subnormal temperature 65%#
• Low blood pressure 86%
• Yeast infections
• (tongue or mouth) 87%
• Tender thyroid 40%
• White spots on nails 85%*
• Tender neck muscles 91%
• FMS tender spots 86%
• Abdominal tenderness 80%
• Swollen lymph nodes 18%

# Possibly indicating under active thyroid function
* These white flecks are thought to relate to zinc deficiency

• 82% of 880 patients specifically tested had yeast cultured from purged stool samples.
• 30% had parasites in their purged stool samples.
• 38% were found to be deficient in magnesium using a three day loading test and two 24 hour urine samples.
• 32% had low zinc levels using blood tests (she believes sweat analysis is more accurate but this is not easy to use in an office practice)

Dr.Jessop stated that her patients reported that a number of classical disturbances and symptoms existed well before the onset of their CFS/FMS symptoms.

For example:

• 89% had irritable bowel symptoms before their FMS/CFS
• 80% had ‘constant gas’ or bloating before their FMS/CFS
• 58% had constipation before their FMS/CFS
• 40% reported heartburn before their FMS/CFS
• 89% reported recurrent childhood ear,nose, throat infections
• 40% had a history of recurrent sinusitis
• 30% recurrent bronchitis
• 20% recurrent bladder infections
• 90% of the females had premenstrual symptoms prior to onset of current illness
• 65% reported endometriosis before their FMS/CFS
• 30% had dysmenorrhoea before their FMS/CFS
• 22% had generalised anxiety disorders prior to their illness

Sleep problems were present in just 1% of her patients before CFS/FMS and over 90% after its onset.

As will be shown in subsequent articles, sleep is a key feature of this condition and restoration of normal sleep is vital in recovery.

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References

1. Yunus M. Fibromyalgia and other functional syndromes’ Journal of Rheumatology 16(sup 19)69 1989

2. Moldofsky H. Fibromyalgia, sleep disorder and chronic fatigue syndrome Ciba Foundation Symposium 173 Chronic Fatigue Syndrome p 262-270 1993

3. Goldenberg D. Fibromyalgia, chronic fatigue syndrome and myofascial pain syndrome. Current Opinion in Rheumatology 5:199-208 1993

4. Hans Selye The Stress of Life – McGraw Hill 1980).

5. Block S. ‘Fibromyalgia and the Rheumatisms’ Controversies in Clinical Rheumatology 19(1)p68 1993;

6. Goldenberg D. ‘Fibromyalgia and its relationship to chronic fatigue syndrome, viral illness and immune abnormalities’. Journal of Rheumatology 16(sup 19)92 1989

7. George Duna and William Wilke Diagnosis, etiology and therapy of fibromyalgia Comprehensive Therapy 19(2)60-63;1993

8. Bruce Rothschild Fibromyalgia : An explanation for the aches and pains of the nineties Comprehensive Therapy 17(6):9-14 1991

9. Goldenberg D Presentation to the 1994 American College of Rheumatology meeting

10. Fibromyalgia Network Newsletters : October ’90 thru January ’92 Compendium #2, January 1993, May 1993 Compendium, January 1994, July 1994. Available from Fibromyalgia Network 5700 Stockdale Hwy, Suite 100,Bakersfield, CA 93309-2554 USA

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A practicing naturopath, osteopath, and acupuncturist in the United Kingdom, with over forty years clinical experience, Dr. Chaitow is Editor-in-Chief, of the Journal of Bodywork and Movement Therapies. He regularly lectures in the United States as well as Europe where he instructs physiotherapists (Holland and USA), osteopaths (Spain and UK), chiropractors (Denmark, USA and UK) as well as massage therapists (Ireland, Sweden, USA). He is a senior lecturer by London’s University of Westminster on under and postgraduate courses in therapeutic bodywork and naturopathy.

In 1993, he became the first naturopath/osteopath to be appointed as consultant to a UK government-funded conventional medical practice. He lives and practices in both the UK and Greece. A prolific author, Dr. Chaitow has written over 60 books on natural health and alternative medicine.

In the course of a lifetime the jaw and throat muscles will have contracted many times more than the heart will have beat. The first connection our brain has with the outside world through the jaw – we cry – we suckle. With such a long-term and close connection with the brain, jaw disorders can drain us of a lot of healthy energy.

It is inevitable that the stress and tension of life often contributes to temperomandibular joint disorders (TMD), however trauma or even “routine” dental procedures may lead to what Dr. Greg Goddard calls the “Overlooked Diagnosis”¹.

The problem is that a TMD may not directly reveal itself. The TMD may show up as:

• Tension headaches particularly in the temples but just as easily elsewhere in the head.
• Limitation of jaw movements ranging from a locked jaw in an open or closed position to a grating, clicking or popping jaw joint.
• The experience of having your head “in a vice”.
• Grinding one’s teeth at night that a dentist may address with a bite guard for nighttime use or the accelerated wear and tear on tooth fillings, dental appliances or the increased risk of cracking or splitting teeth.
• Facial, neck, shoulder and low back pains.
• Singing or speaking voice fatigue leading to vocal cord strain.

If you suspect a jaw disorder, you might want to consider receiving manual therapy from a health-care professional who is experienced in using bodywork principles and techniques developed by cranial osteopaths and bodyworkers.

Recently a business owner came to see me concerning a locked jaw. For the previous two or three weeks he had been unable to open his mouth wide enough to put in a spoon. Besides the pain, he ended up with a very limited diet, disturbed sleep and an aggravated dental condition of the gums. His concerned dentist sent him to a series of dental specialists, one of whom decided to refer him to me while another dentist used such vigorous examination procedures that the gentleman’s condition was actually aggravated.

After his first visit with me, the patient had enough relief in order to finally be able to fit a spoon in his mouth. After several visits not only was his mouth opening back to normal, but his neck was more flexible and his posture more balanced. This gentleman had gone through a particularly severe episode of the temperomandibular joint disorder.

As a healthcare professional trained in osteopathic techniques I have a good awareness of the strong positive potential to improve the symmetry of body posture and movement. I can use gentle manual therapy on the joints of the skull, the roof of the mouth, the upper neck joints, the tongue, and throat to help balance out postural malalignments. The relief of having physical distortions released from the bones and soft tissues surrounding the brain and spinal cord benefits the whole body.

Should you be experiencing a set of physical problems related to the preceding list ask your dentist or physician to recommend CranioSacral Therapy or Cranial Osteopathy. Canada has very few Osteopathic physicians. However a small percentage of Canadian physical therapists like myself and other health-care practitioners have incorporated the intricate work of cranial osteopathy into our practices. Such terms as as CranioSacral Therapy, Neuromuscular Release Therapy, CranioManidibular Therapy and Cranial Osteopathy, to name a few, offer some reassurance that we will:

1. Use gentle techniques
2. Work inside the mouth
3. Work with the total body posture.

Your efforts will be rewarded with benefits to your dental as well as general health.

1. Goddard, Greg, D.D.S. TMJ: The Jaw Connection – The Overlooked Diagnosis.