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The turn-out was fantastic this month and I'm glad you all shared your "weird" symptoms. This month I pretty much monopolized the whole time period talking about disorders that can mimic fibromyalgia or can happen in conjunction with fibromyalgia. Here is the research I found, it is very basic information so if any of these sound like they are possibilities I would encourage you to do further research and also ask your doctor. Also I am providing a list of common symptoms associated with Fibromyalgia.
Disorders That Can Mimic Fibromyalgia
First lets Explain the symptoms of Fibromyalgia widespread pain (right left upper and lower), tender points, cognitive and memory problems, sleep disturbances, unrefreshing sleep, fatigue, morning stiffness, headaches,irritable bowel syndrome, painful periods, numbness or tingling in hands and feet, temperature sensitivity, sensitivity to noise and light. ache all over, flu-like symptoms, muscles feel pulled or overworked and can twitch or burn. Pain has no boundaries, deep muscular aching, burning throbbing shooting or stabbing pain. Pain and stiffness are worse in the morning. Pain located in areas like neck, shoulders, sternum, low-back, hip, shins, elbows and knees. chronic headaches, fatigue. Alpha EEG anomaly, micro arousal sleep awakenings disturbing stage 4 rem cycle sleep. Reduced exercise tolerance, chronic facial muscle pain or aching. skin sensitivities, allodynia.
physiology of FMS and CFS is reduction of midbrain and cortical blood flow, autonomic dysfunction, suppression of the hypothalamic pituitary axis, disturbed stage 4 sleep, reduced serum or csf serotonin levels, suppression of growth hormone, somatomedin C, or IGF1.
Chronic Fatigue Syndrome or Exertional Intolerance Disorder main complaint is fatigue, few or no tender points, fever, inflammatory markers (c-reactive), unrefreshing sleep, headache of a new type, sore throat, enlarged lymph nodes, muscle and joint pain no swelling, onset after infection, sleep disturbances, impaired memory or concentration, dizziness, bowel disorders, anxiety or depression. Large percentage of fm patients fit criteria for cfs diagnosis. Symptoms worsen after an exertion mental or physical, pacing is important for reserving energy.
FMS vs CFS
substance p elevated in FMS but not is CFS.
cellular antiviral enzyme RNaseL is elevated in CFS but not in FMS.
pure CFS is diagnosed when a patient has no complaint of muscle pain.
pure FMS is diagnosed when cognitive symptoms are minimal and muscle pain is greatest complaint.
70% diagnosed fit both categories.
Myofascial Pain Syndrome no widespread generalized pain, muscles and connective tissues develop hard knots called trigger points. painful when touched or poked. This pain differs from fibromyalgia in that it is localized to specific muscle groups and as opposed to tender points when a trigger point is pressed it causes a twitch in the muscle. headaches, disrupted sleep, unexplained sweating, tinnitus and memory issues. worsen with activity and under stress or weather changes. You can have both mps and fms.
Multiple Chemical Sensitivities Syndrome MCSS symptoms exacerbated by exposure to chemicals or smells even at low levels many substances trigger symptoms, involve many organ systems, chronic, perfumes, fabric softeners, air fresheners, sprays, dyes, detergents, organic smells can also trigger symptoms. symptoms improve when chemical is removed. Profound fatigue, headaches, nausea, vomiting, dizziness, hives, rapid heart rate, allodynia. Many fms patients also have MCSS along with sensitivities to light and sound.
Adrenal Gland Disorders feeling tired or drained all the time, dizziness and lightheadedness especially standing up, constant infections, increased cravings sugar and salt, digestive issues, sleep schedule shift (feeling more alert later in the evening 10-2am and difficulty waking up), flu-like feeling, muscle weakness, decreased appetite or increased need for stimulants, weight loss, dehydration, rapid heart rate, episodes of high or low blood pressure, unexplained sweating, anxiety or panic attacks, moodiness or irritability. Many fms patient have some amount of adrenal insufficiency.
Polyglandular Deficiency Syndromes sequential or simultaneous deficiencies in the function of several endocrine glands. candid infections, hypoparathyroidism, adrenal insufficiency (addison disease) or shmidt syndrome (type 2) adrenal insufficiency, hypothyroidism or hyperthyroidism, type 1 diabetes. type3 glandular failure, hypothyroidism and one other disorder (hypogonadism, idiopathis thrombocytopenic purpura, myashtenia gravis, parkinsons, vitiligo, alopecia, seronegative arthritis. (hashimotos) anemia, celiac, biliary cirrhosis. cold intolerance, fatigue, somnolence, poor memory, constipation, menorrhagia, myalgias and hoarseness. (graves) heat intolerance, weight loss, weakness, palpitations, anxiety. (addisons) anorexia, nausea, vomiting, weight loss, weakness, fatigue.
Hashimoto’s Thyroiditis difficulty getting full breath, slow thinking, mental fog, raynaud's phenomenon, problems concentrating, widespread pain, fatigue, depression, anxiety, irregular menstrual cycle, sleep difficulties, headaches and migraines, muscle cramping and pain, inability to lose weight, ibs. Believed to be a cause of fibromyalgia.
Hypothyroidism often misdiagnosed as fibromyalgia but can happen along with fms. Dry skin, hair loss, no energy, weight gain, irregular heartbeat, confusion, anxiety, depression, muscle tension and trigger points, delayed deep tendon reflexes (achilles reflex foot goes down rapidly are raises slowly) as many as 70% of fm patients suffer from hypothyroidism or hormone disruption.
Diabetes excessive urination, hunger, thirst, dry mouth, itchy skin, yeast infections, weight gain or loss, nausea, and vomiting, trouble breathing, widespread pain, nerve pain and fatigue. fms and diabetes have a lot of similar symptoms and those with diabetes are at more risk of developing fibromyalgia and because of the limitations on exercise and the tendency for carb cravings lead to diabetes as well. Flare ups and pressure points and thermal sensitivities are more likely fibromyalgia, prickling and numbness are more prevalent in diabetes, burning can be caused by both. pain and numbness occurring together might suggest diabetes. Both diabetes and fibromyalgia patients can suffer from drops in blood sugar which can cause confusion, shakiness, dizziness, thirst, sweating, and weakness.
Lyme Disease bacterial infection transmitted by ticks. Blood tests can determine this disease most of the time, but can become chronic if not treated early. Mimics chronic fatigue and fibromyalgia, but depending on infection can cause many other symptoms. Long term treatment with antibiotics can cause severe problems so must be done with caution and considerable guidance. Research.
Dysautonomia dysfunctions of the autonomic nervous system. heart rate, digestion, respiratory rate, salivation, perspiration, pupillary dilation, urination, and sexual arousal. Can cause symptoms including fatigue, sleep disturbances (waking often), altered cognitive function, cold or heat intolerance, headaches, and bladder or bowel dysfunction. POTS post orthostatic tachycardia syndrome causes a heart rate to drop and patient passes out. Orthostatic intolerance (the inability to remain upright). Dysautonomia is a common comorbidity of fibromyalgia and possibly many of the neurological disorders like CFS, MS, and ALS.
Multiple Sclerosis presents very similarly to fibromyalgia and is only defined as the disease progresses and shows further symptoms. Depression, anxiety, ibs, chronic fatigue, headaches, pain, spasms, numbness and tingling, muscle weakness and stiffness. Can cause lesions on the brain detectable by mri.
Osteoarthritis causes joint pain not widespread pain occurs commonly in older fm patients.
Rheumatoid Arthritis autoimmune disorder causes inflammation and swelling, muscle and joint pain, damage to joints, extreme fatigue, digestive disorders, sleep disturbances, memory loss and anxiety. Positive ana and inflammation markers (pain in ends of fingers would more likely be fibromyalgia, raynauds, or osteoarthritis) can also have fm.
Major Depression depressed mood everyday, feeling worthless or guilty, inability to concentrate or make decisions, insomnia or excessive sleeping, low energy, restless or feeling slowed down, significant weight gain or loss 10%, suicidal thoughts, no tender points present. This depression is primary and not related to pain from fibromyalgia.
Polymyalgia Rheumatica autoimmune disorder causing inflammation, pain and stiffness. Generally in women over 50. tender points are present and almost always in hip and shoulders. fever, weight loss, fatigue. ESR and inflammation markers are high. Low dose steroid and anti-inflammatories prescribed. Can cause serious vision problems if untreated, can also remit.
Lupus autoimmune disease causing joint pain, muscle pain, fatigue, skin rashes, sensitivity to the sun, joint swelling, sores in mouth, fever, hair loss, blood and protein in urine, positive ANA, often specific biomarkers for types of lupus. A diagnosis of lupus will not be made without at least 4 lupus features: mylar rash, discoid rash, photo sensitivity, oral ulcers, arthritis, serositis, renal disorder, neurological disorder, hematologic disorder, ana, immunologic disorder. Lupus is treated with corticosteroids and immunosuppressants. It is common for lupus patients to develop fibromyalgia but is less common for a fm patient to develop lupus, however it can take years to develop enough symptoms for a correct diagnosis.
Ehlers-Danlos Syndrome mixed connective tissue disease causing overly flexible joints, stretchy, fragile skin. Can cause chronic pain, inflammation, joint dislocations and subluxations, scarring, poor wound healing, poor muscle tone, early onset of osteoarthritis, bruising and tearing of skin. Mild cases of this disorder can be misdiagnosed as fibromyalgia. Can be diagnosed with genetic testing. Many fm patients have hyper-mobile joints that cause pain but are not severe (taping and physical therapy can help stabilize painful joints).
Sjogrens or Sicca Complex mixed connective tissue disease causing dry eyes and mouth, extreme fatigue, joint pain, digestive problems and nerve disorders. Lip biopsy can diagnose but is invasive.
Complex Regional Pain Disorder or Reflex Sympathetic Dystrophy extremely painful disorder (considered one of the most painful) characterized by constant, extremely intense, and out of proportion pain to original injury. Usually originating in same location as an injury but can show up years after initial injury. This pain is accompanied by swelling, skin changes, extreme sensitivity and can spread to other parts of your body. Constant chronic burning pain, affected area may feel cold to the touch. Inflammation causing bruising, mottling, tiny red spots, shiny or purplish skin, excessive sweating, spasms, memory problems, concentration difficulties, sleep disturbances.
Myasthenia Gravis autoimmune disorder causing weakness of muscles that increases during periods of activity and improves with rest. Muscles of the eyes and face are often affected as well as muscles that control breathing, neck and limb movements.
Nerve Trunk Compression and other nerve compression syndromes can cause pins and needles as well as burning, sensations of coldness or bluish white skin around affected area. these are common in joints like wrist, elbow, shoulder, spine, hips and can happen any place a nerve can be compressed. These compressions are typically easier to diagnose.
Degenerative Disk Disease back and leg pain, weakness, tingling or numbness in legs or buttocks, difficulty walking and poor posture. seen on MRI
Spinal Stenosis nerve root compression, pain in the buttocks, thigh, or leg, low back pain, inability to walk, numbness tingling or weakness in lower extremities certain positions relieve pain.
Polycystic Ovary Syndrome PCOS findings suggest that many women suffering PCOS also suffer from hashimoto's autoimmune thyroiditis. Infertility, fatigue, weight gain or inability to lose weight, irregular menstrual period, cramping, excess hair, acne. Some evidence that PCOS, Fibromyalgia, and Primary hyperparathyroidism form a very prevalent triad. PCOS and endometriosis fall in similar categories.
Common Symptoms Associated with Fibromyalgia
PAIN - diffuse musculoskeletal pain and fatigue. The syndrome is defined by the presence of musculoskeletal tender points on physical examination. Pain is often described as aching, burning, throbbing, gnawing, shooting &/or tingling. It can be localized, generalized, can feel like muscle spasms and can be scattered throughout the body. It may be migratory, with pain presenting in one or more areas on one day and other areas on another day. Pain is often experienced very quickly after any repetitive movement - even something as simple as holding arms up to brush or comb hair etc.
Numerous vague unspecified symptoms that wax and wane and cause fibro sufferers to "just never feel good".
Due to the lack of Stage 4 sleep, muscle repair does not occur properly and therefore muscles take longer to heal and regenerate after micro injuries or trauma, as is experienced by everyone in day to day life. Micro trauma during exercise is not repaired in FMS patients in the same manner as it is in normal people - thus the muscle stiffness causes much more distress in fibromyalgics or FMSers and takes longer to subside, therefore exercise is not refreshing but continuously causes pain making patients reluctant to engage in an exercise routine.
Fibromyalgics have 3 times the amount of Substance P in their bodies than do normal people. Substance P is the vehicle that carries pain stimuli to the brain. The brain may also interpret the pain improperly and respond inappropriately. What might be experienced as a "tickle", itch or annoyance normally - is often experienced as pain in those who suffer with FMS. There are often more pain receptors in FMSers, therefore pain is magnified.
Bilateral Pain in various points in areas throughout the body. There are 18 TPR’s - Diagnosis of FMS is made if pressure on 11 of these 18 points causes pain. Areas throughout the body may feel "bruised" when touched. The tender point is considered to be positive if an approximate force of 4 kg. of pressure causes pain when applied to the specified points. Widespread pain must have been present for at least 3 months with the associated tender point pain in order for Fibromyalgia to be diagnosed.
FMS patients may bruise more easily than others and some may experience excessive bruising.
Keloids and excessive scarring.
Temporomandibular Joint Disorder: in many FM patients, problems are encountered because of the abnormal tone in muscles around the joint, not because of abnormalities in the joint itself. (Pain in the face and jaw.) Can cause headaches and referred pain and is made worse by clenching.
Grinding of teeth at night.
Clenching of jaw at night.
Headaches: tension &/migraine. Visual Migraines may also be experienced.
A phenomenon called Alice in wonderland syndrome is thought to be a visual form of migraine or possibly even stroke that makes the person see or feel sensations of expansion and shrinking.
Recurrent sore throat, hoarseness.
Itchy or painful ears.
Chest Pain: Non-cardiac pain that may simulate cardiac disorder. This may be Costochondritis which is pain in the sternum or breastbone where the ribs attach.
Rib pain made: makes daily activities intolerable we often wrap arms around body protectively and have trouble sitting upright. Ribs are made worse by postural weakening and shallow breathing. Lidocaine patches help but may require steroid injections to reduce inflammation.
Heart murmur: may be Mitral Valve Prolapse. (MVP occurs in up to 75% of fibromyalgics.)
Heart palpitations.
Heartburn, GERD and digestive problems.
Esophageal dysmotility or reflux.
Back Pain: usually low back pain - may be exacerbated by muscle spasms in this area. A pillow placed under the thighs to tilt the pelvis while in bed may help, as it flattens the low back against the mattress. Pillow should not be under the knees as this might contribute to causing blood clots.
Sacro-iliac instability and pain.
Joint Hypermobility and Laxity: lax ligaments or what is commonly referred to as being "double-jointed". People who have this condition often ache and are more susceptible to osteoarthritis later in life. Studies suggest that joint hypermobility and fibromyalgia are associated and that the hypermobility can play a role in the pathogenesis or development of pain in fibro.
Arm and Shoulder pain: Often burning type of pain - often between the shoulder blades. May go across shoulders and down arms. Neck may also be sore &/or stiff. Arms may ache or pain may be severe in them. One side may be more painful than the other. A small pillow placed under the arm to elevate it slightly when lying down is often helpful, as arms tend to drop down on the bed and pull on the neck and shoulders. When riding in a car, it is often helpful to place a pillow over your knees and rest your arms on it. This helps elevate the arms and shoulders and can alleviate the "drag" one them and stop arms from going numb if this is a problem.
Postural Changes: shoulders hunched forward or rounded, head thrust forward with neck kinked forward, chest sunken, low back pushed forward causing abdomen to protrude, knees locked, muscles in back of thighs flexed - all a mechanism to find a comfortable position.
Painful lymph nodes: under the arms and in the neck.
Carpal tunnel syndrome: numbness, tingling and pain in wrists, hands and/or fingers. Pain in hands makes writing, typing, wringing out dish cloth etc difficult. Pain when plunging hands into cold water. (also pain maybe experienced on entering the water if swimming in cold water).
Paresthesia: Numbness or tingling (non-dermatomal) Numbness in arms and legs.
Hyperaesthesia: Painful areas may feel acidic or needling.
Allodynia: normal stimuli that feels painful, like clothes against skin or someone touching you.
Raynaud's - like symptoms - numbness and tingling in the extremities especially in fingers, exacerbated by the cold, aching in joints just above hands and feet. Can also affect ears and nose. Arm warmers help somewhat.
Many fibromyalgics feel cold even when it is not particularly cold inside or out. Often hands & feet are very cold. Sometimes the sensation of cold seems to cause pain as well as giving the sensation of cold. A warm shower will usually help to alleviate this sensation whereas turning up the heat in the house does not.
Tennis Elbow: Pain in elbow and forearm.
Dry, itchy, blotchy skin &/or skin rashes. Especially on the face by ears and jaws and on forehead.
Ridges: may develop in finger nails and toe nails. Nails may split. Nails may break off easily. If they do grow they may curve or curl under.
Restless Leg Syndrome: Aching in legs especially at night causes legs to be moved constantly in an attempt to ease the pain or aching.
Weak knees and ankles. Cramps in legs.
Foot Pain: Plantar arch or heel pain, may be plantar fasciitis or just "fibro feet". Orthopedic shoes and orthotics may help.
Muscle and joint aches.
Severe muscle weakness.
Muscle spasms: may feel like tight knots or charlie horse or lumps. Muscles contract but do not release properly. Muscles apparently may contract without receiving stimulus from the brain.
Twitching: can be muscular called fasciculations- may experience eye twitch or a facial twitch.
Burning sensations in muscles throughout the body. Lactic acid burn without working out.
Nausea: may be caused by overload of pain stimuli bombarding the brain - nausea may also be experienced when moving from a horizontal to a vertical position.
Recurrent flu-like illness with muscle pain and aching.
Weight change: - usually gain - a feeling of swelling or puffiness might be experienced. May experience retention of fluid for a few days and then return to "normal". May "feel" swollen even if inflammation and swelling are not actually present. Weight gain may also be due to various medications used to treat fibro.
Hair loss: hair may come out in great "gobs" when combed or brushed. May notice hair coming out when it is being washed as well.
Sleep disturbance/non restorative sleep: may be described as not being able to fall asleep, not being able to stay asleep or more common, "I feel like I haven't slept at all". May awaken frequently and be unable to return to sleep for some time. May wake up "full" of pain and feel "more tired" than on going to bed.
There is a disturbance in the sleep pattern and fibromyalgics are not able to enter into stage 4 sleep, thus they awaken frequently through the night when they reach Stage 4. One may also feel that they are awake and asleep. In essence what happens is that there is brain wave activity of sleep going on in the brain and at the same time there is brain wave energy of being awake going on - almost like the sleep patterns and awake patterns are playing in the brain at the same time. Restful sleep is never achieved. Thus there follows deep aching discomfort throughout the body and the feeling of being exhausted. The shoulders, neck and low back are often the most painful.
Frequent, unusual nightmares or being unable to dream - "black" heavy sleep may be experienced if medication is taken to aid staying asleep.
Hypnic jerks: startling awake or dropping sensation.
Night sweats: wake up drenched in perspiration, then become very cold and maybe even start to shiver.
Intolerance to cold: muscles contract in response to exposure to cold - cold weather, cold drafts, ice packs etc. Sometimes referred to as muscle jelling as in jello - jello is fluid and liquid when warm and jells when chilled. Extreme sensitivity to seasonal changes, climatic changes - rain and impending storms. Most Fibro patients find that their muscles respond to the application of warmth but that application of ice packs or cold intensifies pain.
Body temperature fluctuations - hot one minute and cold the next. Perhaps inner "controls" (thermoregulatory system) are out of whack.
Unusual or excessive sweating: face, hands, behind knees etc.
Fatigue - can be described as feeling tired to being extremely exhausted after minimal physical exertion. Sometimes a short nap in the afternoon may help relieve the feeling of fatigue, yet some people require frequent rest periods to get them through the day. Sometimes the fatigue can come on suddenly for no apparent reason and can be very debilitating. Short periods of exertion can require long periods of rest to recuperate. Can be severe and have a sudden onset even with minimal physical exertion. May experience sudden debilitating fatigue that makes it necessary to immediately stop whatever one is doing and go and rest.
Lightheadedness
Vertigo
Disequilibrium - impaired co-ordination: misjudge distances - bang into door frames, walk into furniture, walls etc.
Cognitive function problems: such as attention deficit disorder, calculation difficulties, memory disturbance, spatial disorientation, difficulty with concentration and short-term memory. These things are commonly referred to by FMSers as "fibrofog".
Neurogenic inflammation: rashes and hives, inflammatory sensation, with rashes that may be severe, severe itching with inflammation - initiated by nerves.
Alteration of taste, smell, hearing. Some odors may make one nauseous.
Sensitivity amplification: may be more sensitive to smells, sound, odors, lights, pressure and temperature fluctuations, vibrations and noise etc. - the buzzing from fluorescent lights, hum of computer, buzz of overhead hydro lines may become almost unbearable to an FMSer at times. FMS hyper-sensitizes nerve endings.
May develop food intolerances, allergies and chemical sensitivities.
Changes in visual acuity: impaired function of smooth muscles used for focus as well as skeletal muscles for tracking. May experience blurred vision &/or double vision. Some people require two or three different eye glass prescriptions as their needs change with the Fibro symptoms. May experience Visual or Ocular Migraines.
Exaggerated nystagmus: involuntary rapid movement of the eyeball.
Intolerance of bright lights/sunlight.
Dry eyes and mouth: dry mouth can cause dental problems - dry eyes may cause inability to wear contact lens, may cause other visual problems, may require eye drops to keep eyes moist and free from infection. Eyes may be very dry at times and water at other times.
Hearing Loss: low frequency, sensorineural hearing loss.
Decreased painful sound threshold. Sometimes normal everyday noises become very irritating. May not tolerate radio or television well.
Ringing in the ears - ringing and sounds like the rolling ocean or whispers may be experienced.
Allergies: Severe nasal and other allergies and patients may also have a deep sinus infection.
Environmental sensitivities may develop.
Enhancement of medication side effects.
Intolerance of medications that were previously tolerated.
Intolerance of alcohol.
Intolerance of caffeine.
Intolerance of processed white sugar and most artificial sweeteners.
Premenstrual Syndrome: swelling, tenderness and lumps in breasts are often experienced with PMS, painful periods as well as mood swings, exaggerated emotional responses etc. etc. as common in PMS.
Fibrocystic Breast Disease: may be experienced by FMSers especially prior to period. Breasts may become very swollen and sore and be full of cysts or lumps that disappear after period.
Frequent vaginal yeast infections.
Vulvar vestibulitis or vulvodynia.
Interstitial cystitis.
Irritable Bladder/Frequent Urination: might be uncomfortable or painful. Also bladders spasms may feel like a bladder infection.
Foul or strong smelling urine: May smell like green hay. May be dark in color.
Irritable Bowel Syndrome: alternate between constipation and diarrhea. Frequent abdominal pain, gas and nausea.
Depression: may be reactive or clinical. Often pain and feeling ill all of the time causes the depression. FMSers are depressed because they hurt. They do not hurt because they are depressed.
Anxiety: may include panic attacks.
Easily startled.
Uncontrollable yawning or sighing.
Cognitive issues: brain fog, aphasia (trouble finding words), memory issues, spacey or sluggish. Slurring words or stuttering.
Emotional liability or mood swings. May be prone to tears.
Irritability probably due to pain and fatigue but occasionally unexplained.
Personality changes: usually a worsening of a previous tendency. People who have FMS sometimes have a hard time accepting their limitations and the loss of the person they "used to be" - they may actually go into the mourning process. Because FMS is an "invisible" sort of illness - and patients often see many Doctors before being properly diagnosed, they often begin to doubt themselves.
Fibromyalgics desperately need support and understanding from those closest to them but they often feel alienated because of their illness and inability to participate fully in many common activities of daily living. Many are unable to continue working at the jobs they love and thus lose part of the identity that their job may give them. They begin to lose their sense of independence and productivity and their sense of value.
Anger and resentment towards lack of understanding may alter FMSers personality drastically and cause even further alienation from family and friends. Along with this sense of helplessness and worthlessness that may develop, they may begin to feel guilty for not being able to be the person that others need or expect them to be. They may become extremely depressed and begin to lose interest in life altogether.
Fibromyalgia requires extensive trial with supplementation, alternative therapies and medication to find the right combination for each person. Some FMSers find they are intolerant to medications or medications affect them differently even oppositely.
Exercise Programs are effective treatments for FMS but must be tailored to the individual. Swimming is helpful for some people. Warm Baths or hot tubs are sometimes comforting especially if sea salt or epsom salts are added to the water. Heating Pads are helpful - either regular pads or moist heat. Infra Red Pads are also helpful for some patients. KT Taping can provide stability and help with pain and inflammation. Analgesic rubs or liniments also bring some temporary relief. Massage, Reflexology, Acupuncture and Chiropractic treatments are effective for some FMSers but tend to be aggravating to others.