Proprioception and Fibromyalgia

Proprioceptive dysfunctionProprioception—a sensory nerve ending in muscles, tendons, and joints that provides a sense of the body’s position by responding to stimuli from within the body nerve endings in the joint spaces.

In other words, Proprioception is the perception of one’s own body-areas in relation to each other.

These nerve endings send messages to the brain about where your body parts are ‘in space’. I wonder now, when I am walking down the mall corridor, if  a dysfunction of this mechanism is why I sometimes feel “off balance”, like a “wooziness”?  Sometimes, I feel as if I am tilting to one side, losing my balance.

Proprioceptive – not always Central Nervous System

Studies have indicated that Central Nervous System (CNS) dysfunction frequently occurs in patients with Fibromyalgia, although proprioceptive disturbances might also explain some of the abnormalities observed. Loss of proprioception has been reported by people with pain disorders, urinary tract infection, pneumonia, multiple sclerosis, and depression.

The  result is that we may bump into things, misjudge spaces, maybe bumping into the doorframe, or knocking things over and falling.

Hypermobility the Cause of Faulty Signals

Some people living with Fibromyalgia tend to have problems with laxity, or looseness, in the joint spaces (Joint Hypermobility Syndrome) and so the messages are faulty. This is one of the reasons we fidget – unconsciously, the brain is trying to get accurate messages from the joint spaces. I’ve always been a “fidgeter”, I just thought it was “just being me”.

Observation of the patient’s mannerisms and postures during history-taking may give an indication of hypermobility. Contact of the hand to the face may reveal hyperextension of the digits, constantly changing position or fidgeting and/or sitting in an unusual posture (legs wound round each other, slumped to the side or resting on the lateral border of the feet) are familiar sightings of the hypermobile patient.

Effect of exercise on the Hypermobile Patient

This following study is the first to investigate the effect of an exercise intervention on proprioception in hyper-mobile patients. The principal aims of the study were to establish whether a home-based program of exercises could lead to symptomatic improvement and, more significantly, to determine whether improvement in objective parameters such as proprioception is achievable. Some evidence suggests that physiotherapy can be an effective management mode for many of these patients.

There was a noticeable trend for the largest improvement of proprioception to occur in subjects showing the poorest initial performance .It is unclear whether JHS patients exhibit proprioceptive deficit from birth or whether this develops during childhood.  Arthritis & Rheumatism Volume 50, Issue 10, pages 3323–3328, October 2004

Hypermobile patients may be considered a hypochondriac

Hypermobile individuals tend to look and move well even if they have pain. During active range of movement testing their reports of symptoms are often at odds with the physical examination. It is possible to see how misunderstandings may arise; the person who complains of widespread debilitating pain affecting several joints can, when asked, bend forward to touch their toes. This tends to go against medical wisdom and may lead to the individual being dismissed or considered a hypochondriac.
Scand J Rehabil Med. 1996 Dec;28(4):225-32

I have heard this story many times from friends living with Fibromyalgia. I have hypemobility and have always been able to overextend my joints. From doing the research for this site, I am practicing my yoga postures more safely, having hurt myself in the past.

Do you “sway”?

It can be difficult to measure proprioception accurately in the clinic and tests are generally linked to function. The ability to stand on two legs with eyes closed, or on one leg with eyes open and closed as in the Romberg test, will reveal exaggerated swaying and/or loss of balance once the eyes are closed. Pain may contribute to the increased sway observed due to poor stability/control around the ankle, knee,hip and/or sacro-iliac joint.

I have always “swayed”. In the past, I worked in direct care, visiting people in their homes. I was with a client that had Alzheimers and was assisting her with her bath as she sat on the edge of the bed. I always “swayed” as I waited patiently for my clients to perform their morning routines. My client grabbed me by the shoulders, catching me completely off-guard. She wanted me to stay still, as I unknowingly rocked back and forth. I find it difficult to stay still.

Supportive tight garments have been reported as helpful in improving Proprioceptive

When I read this evaluation, I thought, no way can I stand a tight garment when living with Fibromyalgia. When I come home, off come the regular clothes and on come my sweats!

“It is known that proprioceptive acuity is diminished in individuals with Joint Hypermobility Syndrome (Mallik et al 1994,Hall et al 1995)   This can have a significant effect on the way an individual moves. The research shows that both joint position sense and threshold to detection of movement are impaired such that they have less awareness of approaching the end of joint range (Chapter 6.4). The reason for this impairment is not known but may be related to increased laxity and elasticity in the tissues, which may explain why the supportive, tight garments have been reported as helpful in improving proprioceptive feedback (Simmonds & Keer 2007).”

As I write my posts, I am learning so much about myself, about my history living with the many phases and related disorders that lead up to a diagnosis of Fibromyalgia. I hope that you also benefit from this site. I would love to hear your experiences and what you do to feel better.

Photo credit:  http://tinyurl.com/n6zck8p

I would love to hear from you!

Today, besides being an active grandmother, I am a volunteer with community organizations, one being the Relay For Life, and love spreading the word about an amazing super food.

You can also email me at iambluegreen@verizon,net.



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