Specialised information for physicians and health insurance funds

«Academic medicine and traditional Chinese medicine united»

Fibromyalgia syndrome (FMS) has only been recognised as an illness by medical science since the 1990s. FMS is poorly researched, and is still unknown to numerous physicians today. By combining academic medical expertise and traditional Chinese medicine, Prof. Dr. Dr. med. Johann Bauer developed a method of helping patients with FMS. He researched the illness and documented his work with numerous case studies.

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«Releasing pressure means relieving pain»

When diagnosing fibromyalgia, the Hoffmann-Tinel sign HTS (1915) on the acupoints is examined. «However, the HTS can also occur without trauma in the places where axons have died and new ones are sprouting, … even where fibrosis has led to the death of nerve fibres.» (Müller-Vahl, H., Mumenthaler, M., Stöhr, M., Tegenthoff, M., Läsionen peripherer Nerven und radikaler Syndrome [Lesions of peripheral nerves and radical syndromes], Thieme, Stuttgart, 2014, S. 75). It therefore makes sense to use the HTS when searching for the tender points. It accounts for the «tenderness» of the acupoints.

Perineural inflammation with formation of a collagen cuff around the peripheral nerves is scientifically proven for fibro patients (Bauer, JA, Pathological Findings and Clinical Outcomes Study of 101 Fibromyalgia Patients Treated by Quadrant Pain Intervention. Frontier Perspectives 15/2, 35-41, Philadelphia (2006)). Therefore one must assume compression and, due to nerve adhesion, elongation when parts of the body are in motion causing the illness .

How does the surgical cure method work?

Healthy peripheral nerves are relatively well protected against pressure or blows by the fascicle structure, their embedment into the epineurium and the perineurium as well as their ability to glide. Nonetheless, with persistent pressure, even a normal nerve may develop paraesthesias and dysesthesias which lead to anaesthesia (missing sensation) and paralysis if this pressure lasts for a sufficiently long time (Müller-Vahl, H. et al., cit., p. 76).

A nerve which is in the process of regeneration is naturally much more sensitive (Müller-Vahl, H. et al., cit., p. 76), may develop an HTS and become a tender point. One can assume that pain syndromes have a cause which is correctable under certain circumstances (Müller-Vahl, H. et al., cit., p. 78). If pressure – besides the elongation of a fixed (adhered) nerve – represents one of the two mechanical damage types of a peripheral nerve, this conversely means that removing the pressure and restoring the elongation ability can correct the cause of a pain syndrome.

Empirically, chronifications have, indeed, subsided and normalised. It is these relations on which the surgical cure method of the fibro disorder is based. Decompression and neurolysis of peripheral nerves is the mechanistic approach to preventing wrong messages to the brain and their interpretation as the experience of a pain syndrome.

Contralateral effects of peripheral nerve lesions

«Individual patients state problems on the opposing extremity after lesion to a peripheral nerve. It was experimentally shown in rats that following dissection of the N. tibialis on a rear leg, approx. 50% less sensory innervation is detectable in the tibialis innervation zone of the opposite extremity after five months.» (Müller-Vahl, H. et al.,cit., p. 81)

These observations explain why it is possible that after relieving and releasing surgery on one side another side may show effects. It makes more sense to observe the four quadrants, since it is then also possible to record “crosswise” improvements.

The stated period matches experiences after quadrant intervention. Here as well, a check-up is done after about five to six months because the pain memory should also have decreased by then.