Nurse who suffers chronic tailbone pain

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I am a Registered Nurse who has suffered with tailbone pain for over 8 years. Like all chronic pain, it is essential that sufferers get the correct support, diagnosis and treatment appropriate for them as an individual. This blog follows my journey with chronic pain, it expresses my personal opinions and thoughts. It is not intended as a replacement for advice or treatment from your normal Healthcare Provider.

Friday, 7 August 2015

Fibromyalgia, Central Sensitisation, chronic pain, and my thoughts

The book I am currently reading (see image below), confirms some of my own findings and research into pain, but also confuses me as to my own diagnosis. To be fair the consultant said I have a 'type of pain disorder'....'one similar to fibromyalgia'. So while I can certainly identify with some of the 'symptoms', I do not seem to 'classically' fit fibromyalgia.

Conditions/symptoms listed as typically occurring with fibromyalgia are:
  • muscular pain, fatigue, disturbed sleep, anxiety, irritable bowel syndrome, headaches, allergies, muscle spasms, cognitive dysfunction ('foggy brain'), morning stiffness, irritable bladder, dry eyes and mouth, restless arms and legs, numbness and tingling, skin problems, jaw pain. In addition to these symptoms, some suffer with bloating, sensitivity to light and/or temperature extremes, teeth grinding, mouth ulcers, easy bruising and chronic rhinitis.   
I can say I have about  20 of these 'symptoms'! However, this could just be coincidental, it could just be due to other causes, it could just be my age, it could just be because I have suffered with chronic coccydynia for so long. Also many of these symptoms mirror those of Ehlers-Danlos Hypermobility Syndrome which I have also been told I have (see previous blog).

The author of this book describes fibromyalgia pain as 'widespread', with 'a history of pain in both sides of the body', 'pain above and below the waist, pain along the spine' and a condition 'causing pain or tenderness in 11 out of 18 tender points'. This is where the fibromyalgia diagnosis does not 'fit' me. My pain is very definitely my coccyx and right buttock. Yes, I do get all over body aches and pains, and have had various aches and pains for many years, but I am not sure I would call this 'widespread pain'. At least the 'widespread pain' is certain areas at certain times, not all at the same time.

If a painful stimulus is repeated over and over there is an 'amplification' of perceived pain. This causes the central nervous system to become 'sensitised'. So, prolonged, recurrent pain can affect our central nervous system. Repeated pain signals from my coccygeal area to my brain and spinal cord, have accumulated, been 'remembered'. Someone like myself, is now more sensitive to less pain. This is called 'Central Sensitisation'. My brain is now incorrectly wired to remember old memories of pain, and to not recognise the difference between what is now only mild pain and what is actually severe pain. This is what is thought to occur in those with fibromyalgia. A 'healthy' person may only feel some discomfort.

The author further explains that the two types of nerve fibres- non-nociceptive neurons and nociceptive neurons exist alongside one another in our body.  The nociceptive neurons are the ones that react to pain, non-nociceptive neurons react to light touch (a kiss, a stroke), and muscle movement. However in chronic pain when the CNS is hypersensitive these non-nociceptive neurons can also become sensitive to painful stimulus.

I have not finished this book yet. I would recommend it to anyone with chronic pain or anyone who thinks they may have fibromyalgia. It is an interesting read and explains things very clearly. There is also some good advice on diet and nutrition and coping strategies which apply to anyone with long-term pain.
....Reading this back to myself I probably do have fibromyalgia! Ah, the benefits of blogging. It helps me clear my thoughts and see things more clearly.

The following links are really good explanations of how chronic pain can develop, and 'Central Sensitisation'. 

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