Fibromyalgia and its related conditions (e.g., chronic fatigue syndrome or myalgic encephalomyelitis) can be extremely debilitating during the daytime. However, one thing that many people who experience the symptoms describe how they feel that fibromyalgia is worse at night.
We have written many times about the relationship between the upper neck and fibromyalgia syndrome. In this particular article, we want to describe 5 reasons why your fibromyalgia is worse at night.
First, as just a very brief bit of background, the joints of the upper cervical spine transmit 3 general types of information to your brain:
- Pain (otherwise known as nociception)
- Pressure (aka mechanoreception) is important for balance and equilibrium
- Prioprioception is important for joint position sense, posture, and muscle tone
So, if you have an injury to the soft tissues in your upper neck, the damage can affect these three types of messages that transmit signals to your brain.
Even if you don’t have any broken bones, dislocations or torn ligaments, irritation to nerves can produce a wide array of symptoms including pain, weakness, loss of energy, and coordination troubles often associated with fibromyalgia. In other words, a problem in the upper neck may produce the neurological symptoms associated with fibromyalgia syndrome whether it is in the daytime or at nighttime. So, now let’s have a look at why your Fibromyalgia is worse at night.
The #1 reason why Fibromyalgia is worse at night
The #1 reason why Fibromyalgia is worse at night is believed to be due to the “pain gateway hypothesis.”
In brief, your brainstem contains a series of processing centres collectively known as the “reticulation formation” (which includes the periaqueductual grey mater, rostral ventral medial nucleus, and median “raphe” nucleus). The reticular formation selects the pain, pressure, and proprioceptive information transmitted to your brain so that it is not continuously overwhelmed with noxious signals.
Think of it like wearing a set of noise-canceling headphones in a daycare center.
The problem for many people with fibromyalgia appears to be that the reticular formation is not functioning properly. As a consequence, the brain is overwhelmed and continuously active, unable to properly block all the signals it receives.
While this can be problematic in the daytime, it is especially pronounced and can make fibromyalgia is worse at night when your brain needs quiet in order to sleep.
Not only can the joints of the upper neck bombard the brain with noxious signals (what is known as the “dysafferentation hypothesis”), it may also produce abnormal mechanical tension that diminishes it function to be able to block the signals in the first place.
Think of it like a pebble in your shoe that produces minor irritation. Just a bit of irritation can be ignored. However, if the irritation goes on long enough it can cause very significant discomfort.
The same may be true also if a mechanical problem in the upper neck affects your spinal cord, brainstem and interferes with the normal ability of your reticular formation to do its job.
The #2, #3, and #4 reasons why your Fibromyalgia is worse at night
The next three reasons why fibromyalgia is worse at night are intimated connected because they all have to do with head position. Therefore, we will mention them all together.
The #2, 3, and 4 reasons why your fibromyalgia is worse at night may be related to your pillow,
your posture and pressure.
#2 - Pillow
First, consider your pillow.
There is no such thing as a perfect pillow, but as a general rule thinner and flatter are better. Pillows that are too thick cause your neck to protrude forwards. Even if you are a side sleeper, a thick pillow has the tendency to push against your jaw.
The problem here is that your pillow may be pushing your neck further in the direction of aggravation. If so, you can start to experience more pain, pressure, or muscle tightness as a result, which makes you only more uncomfortable when you are trying to sleep.
Many people with fibromyalgia - especially when their fibromyalgia is worse at night - think that their pillow is the problem. While that may be partially true, the underlying problem with their neck could actually be an even bigger part of the problem.
And until that is addressed, the problems may only persist no matter what pillow they use.
#3 - Posture
Sleeping posture is also a big issue for people who experience fibromyalgia worse at night.
The worst posture a person can sleep in is on their stomach with their head turned sideways. Side sleeping is usually okay. However, what many people do is curl up into a ball, which ultimately protrudes their head forward the exact same wrong way as if they as sleeping with too thick of a pillow.
Again, this may have the potential to irritate the joints and nerves of the neck, which in turn makes the fibromyalgia symptoms worse at night.
The key here is to sleep so that your head stays neutral over the tip of your shoulder, and also that you do not twist excessively, which can produce the same problems.
#4 - Pressure
The fourth reason why fibromyalgia is worse at night can be a lot more difficult to correct. It is when the simple pressure of anything across the base of your skull or neck produces pain.
These types of disorders are closely associated with suboccipital neuralgia and myofascial pain disorders related to the TMJ (jaw) where it feels like the back of the neck is on fire when even light pressure is placed upon it.
It is a process called “neural sensitisation” and is believed to be very closely associated with increased mechanosensitigvty and central pain processing disorders as we have already mentioned with the reticular formation.
When this occurs, there may be no position that actually relieves the pain, and it is not unless the underlying issue is addressed can the problem goes away. Certainly while there may be many things that can all cause the problem, the major culprits when head and neck pressure are the problem are the joints of the upper cervical spine and also the joints of the jaw (TMJ).
The #5 reason why your Fibromyalgia is worse at night
The fifth reason why your fibromyalgia is worse at night builds on the previous four.
We have described how pain, pressure, and proprioception information from an injury to your upper neck can overwhelm the sensory processing centres of your brain, which is what makes fibromyalgia worse at night. However, the problem doesn’t always end there,
If your brain is bombarded with so much information, it is believed that it can actually “spillover” into adjacent areas of the brainstem and produce other types of symptoms even if they do not seem that they are directly connected with a mechanical problem in the neck.
One of the more common ailments can occur if sensory information spills into the sympathetic centres of the brainstem that are responsible for coordinating the fight, fight, or freeze responses (i.e., the locus coeruleus or rostral central lateral nucleus). If this occurs, your brain essentially can get stuck in a hyper sympathetic state (also known as “sympathetic dominance”) that keeps your metabolism stuck in stress, hyperarousal, and anxiety,
… Quite literally the EXACT OPPOSITE of what you need in order to sleep, which would normally be where your parasympathetic centres should predominate.
So while meditation, warm tea, and even relaxation activities are important to calm the mind and shift the body from a sympathetic to a parasympathetic tone before bed, if a problem in the neck prevents the shift from occurring, it is possible that the symptoms of fibromyalgia will persist and be worse at night.
Then, when you multiple that effect of poor sleep continuously over days, weeks, or even months, it only creates a positive feedback loop that makes things worse.
The key then to making the shift is changing the way that the brain itself can function so that you can actually sleep and repair.
The upper neck and fibromyalgia
Fibromyalgia syndrome is certain a complex clinical entity that has many moving pieces. In other words, there is usually not just one thing that causes it. Nevertheless, one of the more important pieces of the puzzle may well be the health and function of the joints in your upper neck.
While stretching and physical exercise are often important, when there are specific types of problems in the upper neck, one of the most important things that you can do is to consider what is known as an “upper cervical chiropractor.”
Unlike general spinal manipulation, upper cervical chiropractic is a special division of healthcare that focuses on the relationship between the joists of the upper neck (C1, C2, and C3 vertebrae) and how they affect the nerve system WITHOUT twisting, popping, or cracking the neck.
An upper cervical chiropractor is trained in natural methods to identify conditions of the upper neck that are often undiagnosed by other healthcare professionals and even specialists.
The process typically involved a detailed physical and neurological examination, and then also a precise series of 3D images that help show the exact location, directions, and degree of any misalignments in your neck that may be contributing to your condition and making your fibromyalgia worse at night.
If you or a loved one has been experiencing the symptoms of fibromyalgia and looking for a different approach, we would be happy to assist.
Our practice, Atlas Health, is dedicated to helping people with chronic health issues including fibromyalgia so that they can find long-term solutions and enjoy the quality of life that they want most.
If you would like more information or find out if upper cervical care may be right for you, we offer a 15-minute complementary phone consultation with our principal upper cervical chiropractor, Dr. Jeffrey Hannah so that you can ask any questions you may have and discuss your particular situation.
If you would like to schedule a no-obligation consolation, you can reach us at 07 3188 9339 or through the Contact Us link on this page, and one of our staff will get back to you as soon as possible.
Atlas Health Australia - “Hope, healing, and wellbeing from above-down, inside out."
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