Experiences with (High Powered) Laser? Managing pain and trigger points

[felipao]

Hey there,

my name is Felipe and this is my absolute first post here. I've been browsing through some of the threads and I would love to reply to some as I have accrued a lot of knowledge on Fibro/CFS/MPS, but I can't - do I have to upgrade for that?

Anyways,
I have been recently looking for patients who've had some experience with High Intensity Laser Treatment (not LLLT!) and was wondering about protocols, length, device used etc... I'd love to hear more about it, considering that I did a couple of sessions and they actually showed some promise.

I can offer information/experience/knowledge on a LOT of medication, including but not limited to: Pregabaline, Gabapentine, Amitriptyline, Duloxetine, Paroxetine, Tramadol, Opioids, CBD oil, Tropisetron, LDN, Memantine... those are off the top of my head.

I can also help with many, many treatments that I've personally undertaken and some which I've researched: Trigger point injections, fitness training, cardio, rehabilitation, physical therapy, pain management protocols, meditation, cryo-chambers, acupuncture, transcranial direct current stimulation, hypnosis, psychotherapy, physiotherapy, muscle strengthening, progressive muscle relaxation, LLLT, high-powered shockwaves.... again, off the top of my head.

I'm from Germany and have been talking to a lot of people around here and in Europe, but I'm exhausting my options... it slowly feels like I've done everything there is to do but I'm CONSTANTLY researching, looking up new info, going through medical research, trying to find a path that leads me back to some quality of life, as the last 5 years have been absolute hell. Hope is on occasion very, very difficult to grasp.

But I'm a treasure trove of information, I believe, and offer everything I have on all the topics surrounding fibro/cfs and myofascial pain syndrome - if I can provide any sort of helping hand to whomever wants, I'd already be very happy. In that vein, I'd love to hear your thoughts, your experiences and perhaps, just perhaps, also something that could help me out.

Thank you.
Felipe

 

[JayCS]

Hi Felipe, seems I'm in a similar position, so you might like to read my past postings... Since
cryotherapy ("Kältetonne", -150°C 4x/wk, better than the cold-chamber at not much less than -100°C in the rheum clinic 1-2x/d) plus
(ear-)acupressure ("Ohr-Akupunkt-Massage nach Penzel") is helping me most, after originally osteopathy, I'd be interested how the cryo worked for you & if you've tried Wim Hof's cold showers and breath-holding, which also help me a lot, especially because I seem to be the only one here and elsewhere (trying &) using it!

 

[felipao]

Hey there my friend,


thanks a lot for your reply! I'm glad you found something that takes the edge off and has proven helpful!

Cryotherapy is something a did about 8 weeks straight and yes, in the "Kältetonne" - during that time, I was staying, just like you, at a rheuma clinic, also taking part in the all-encompassing approaches offered there. Unfortunately, I can't say that any of the modalities from the rheuma clinic offered much relief, neither at the time, nor long-term. Cryotherapy did give me a LOT of energy, to the point of ADHS It however didn't significantly affect my pain or dissolve my trigger points.

Other people I have been talking to seem to have been completely healed by cold therapy - I envy them very much!

Yeeeesssss, I cannot believe it!! A fellow Wim Hof fan! Boy, am I glad I found you!! Wim Hof has been a personal hero of mine when I first found out about him about 2 years ago; to this day, I remain fascinated by that freak of a human being and will mention his superhuman abilities in whatever context I can! People are sick of hearing about it though

Cold showers are part of my routine and while I did do Hof's breathing abilities for a while after taking his workshop, I modified them into something more closely resembling meditation, everyday for about an hour. What I do is closer to the Tummo meditation of Buddhist monks, which is related to WIm Hof's teachings. How long have you been doing that?

I also did the Ear Thing, but it wasn't acupressure, it was straight up acupuncture (Ohrakupunktur) - that was about 4 and a half years ago and it did do something at the time, even though it lost its effectiveness once my illness "truly" broke out and put me basically on disability; that was in March 2017.

And trigger point therapy has been the foundation of my own (somewhat effective) treatment options; around 3 years ago I started trigger point therapy, first with pressure, then during osteopathy, then dry needling, then trigger point acupuncture and lastly, as well as currently, high-powered shockwaves (the latter ist thus far the only truly working therapy - which is however extremely painful and extremely novel, and (sigh) extremely complicated.

I believe at this point I have memorized all the trigger point diagrams and their pain patterns - god, I wish they'd only cause pain.... their clinical manifestation goes, as you probably know, way beyond that....

I was inquiring about the laser treatment, because I did a couple of sessions for the first time lately and have found some research demonstrating its efficacy in fibro treatment - it appears to be, just like the high-powered shockwaves, an extremely new modality for the indications of fibro and myofascial pain syndromes and hence, I can't as of yet corroborate that with other patients. What gave me more hope is that I "felt" the effect of the high-powered laser during and after the few sessions I did - that is, I felt immediate, positive effects on my body in terms of both pain and other symptomatic, including pressure and fasciculations.

Given that there is neither any clinic offering that treatment close to me, nor are sessions covered by insurance, I was considering purchasing my own device to give it a go at home. If I was SURE of its potential long-term benefits in fibro and myofascial pain syndromes, I'd save up the necessary €10.000 for the device in a heartbeat. Perhaps you yourself have tried out some sort of laser or know somebody who did?

How long have you been dealing with your problems? Can you do some fitness training to keep energy levels constant? What medication is effective for you? What about supplementation?

I look very much forward to hearing more!

Felipe

 

[JayCS]

Sorry Felipe,
you probably saw that I was 'occupied'... ;-)

Cryotherapy is something a did about 8 weeks straight and yes, in the "Kältetonne" - during that time, I was staying, just like you, at a rheuma clinic,

8 weeks rheum. clinic? Only 2 weeks are done here. In ours it was a cold chamber, Kältekammer, much less effective, because warm ;-)

also taking part in the all-encompassing approaches offered there. Unfortunately, I can't say that any of the modalities from the rheuma clinic offered much relief, neither at the time, nor long-term.

Same here. All physiotherapy there hurt, made me nauseous, altho they have had a lot of fibro-people for decades... Electrotherapy gave me my focal seizures, like I warned the doc, she said: It can't...

Cryotherapy did give me a LOT of energy, to the point of ADHS It however didn't significantly affect my pain or dissolve my trigger points.

Well it doesn't do anything for my 'pains' (joints, trigger points etc.) but on my Ache & exhaustibility, which is the main thing.

Other people I have been talking to seem to have been completely healed by cold therapy - I envy them very much!

Oh I've been healed by it too, for a few hours/days.. ;-) In warm weather - looking forward to the summer...

Yeeeesssss, I cannot believe it!! A fellow Wim Hof fan! .... What I do is closer to the Tummo meditation of Buddhist monks, which is related to WIm Hof's teachings. How long have you been doing that?

A friend told me a few months ago, seeing as cryo was helping me. So his normal breathing doesn't help you, the meditation does? I've just caught on about the origins in yoga-breathing & Tummo meditation, influenced by his parents - hadn't read his website properly.

put me basically on disability; that was in March 2017.

I've been on sick leave since Jan20 and am slowly carefully starting again with 2 hours a day and very understanding colleagues.

high-powered shockwaves

Sounds like I shouldn't think about trying it...

I believe at this point I have memorized all the trigger point diagrams and their pain patterns - god, I wish they'd only cause pain.... their clinical manifestation goes, as you probably know, way beyond that....

No, I didn't, my osteopath showed me the milder Jones technique, and together with him, now the acupressure & my own guesses, plus arnica cream & hot water bottle I can get all pains down inside of minutes, so I haven't had to delve there deeper... (yet...)

laser treatment, because I did a couple of sessions for the first time lately and have found some research demonstrating its efficacy in fibro treatment

Could you share? I just got some lasering on my Achilles' tendons, which helped a lot, but I'm sure that's something quite different. (OK - I did sort of feel it...) I'm skeptical if cutting is a good idea, but would also try it if nothing else were helping the pains.

If I was SURE of its potential long-term benefits in fibro and myofascial pain syndromes, I'd save up the necessary €10.000 for the device in a heartbeat. Perhaps you yourself have tried out some sort of laser or know somebody who did?

Wow - unfortunately no, but even if I knew 2 people, you couldn't be sure at all... My cryo-physiotherapist bought the cold barrel because it helped her with her fibro plus she can use it in her job - but she tried it somewhere else before to be sure.

How long have you been dealing with your problems?

Ache & exhaustibility probably started about 8 years or so ago. A flare in 2016 went down again in 2017, but then it went continually up and in 2019 my wife pleaded (kicked? ;-) for me to go to a rheum. who didn't diagnose it, but found something else, and then I've gone thru checking everything with 40+ docs, Fibro was diagnosed Feb20 by the 2nd rheum. I'd made an appointment with parallel to the first.

Can you do some fitness training to keep energy levels constant?

Sometimes the 7' scientific workout is too much, sometimes I can do 30' gym machine workout, because often 3' stints are OK.
Table tennis every day outside with long breaks (yoga, feet up, Wim's breath-holding if necessary) has started getting longer (6 games on good days instead of 4) & more energetic, altho going to work has been a set-back, I think because of the FFP2-masks, so I'm finding workarounds for that.

What medication is effective for you?

Absolutely none for fibro. I did Amitriptyline for 4 months until the 8 adverse effects got too much (seizures increased), but on stopping I'd got my sleep regime good enough to go without. - I have/had identified 30 "wakers" and at least one trick to get each of them down quickly, so I'm almost getting the 9 hours of sleep I now need (instead of 8 hours 2 years ago). CBD oil was the last thing I tried, made me too tired, so I'm probably not trying MMJ, altho it was applied for by my pain docs a few months ago...

What about supplementation?

Heard of the "environmental doc" Bodo Kuklinski in Rostock? (website, youtube) - an acquaintance is a fan of his. I'd done all herbs I can tolerate for sleep & pain in the first months, same for supps too. Nothing helping by around April I did his whole supp-regime for 2 months, I got the book-excerpt and there was nothing harmful in it (high dosages of B12, then K, Mg, Se, Zn, then B1+2, C+E 8-fold, then linseed oil, then Q10; I've ended up with Vitamin B12 on 2700 instead of 700, which makes the docs laugh, everything else was OK anyway, but then higher.)
I dislike the guy tho, a guru-type who says everyone's dumb except for himself. My acquaintance has an appointment there in about a year, because just doing the regime isn't helping enough ...
Then changed L-Tryptophan to 5HTP, didn't help either.
At the moment I'm trying Symbioflor2, apart from Psyllium for my gut, after Mutaflor was nauseating...

I look very much forward to hearing more!

Yup, same here...

 

[sunkacola]

Absolutely anything that causes me to get cold exacerbates my pain exponentially.
A cold winter is hard for me, which is why I live in a warm climate. The thought of taking cold showers or being in a cold environment in order to treat my pain gives me the heebie-jeebies.

 

[JayCS]

Hehe, I can imagine! Last winter was terrible for me, standing outside for more than 20 mins. I'd told people at work I just can't, if it's necessary, others will have to do it. So I know where you're coming from. Been there and actually still am partly there - last night the temperature jumped down outside and after a pain/thought-dousing cold shower I took a hot water bottle and warmed up nicely, but an hour later the room temperature, not the cold shower temperature, had me putting a thicker top and trousers on, because I realized I couldn't sleep for cold - so it's again the sweet spot: long cold is bad for me, 5 or 10 minutes of showering does not help me, it hurts my skin and muscles more than it helps, however much others can do it.

Maybe that's why cryotherapy was one of the last things on my long list of things to try out.
But I must say that I am so motivated to get this stuff down as far as I can, that no heebie-jeebies have ever stopped me.
The stark pain of the acupuncture, the excruciation of the 2 spinal taps (he didn't get any liquid out on the first go) and the following 6 day splitting headache which laid me back on the floor like a punch every time I tried to get up, the debilitating pain of getting hyaluronic acid injected into my lower back under CT which caused 3 months of additional pain there - and I believed the doc when she said I have to go thru this for my middle and lower back too, thankfully my wife stopped me, and she was right. Taking chemical meds altho I don't believe in them & no most of them will do something bad/painful with me, which most did.
Born to be wild and brave, I spose.
40 secs. in a cold shower or the 3 minutes in a cold barrel or chamber is a short sharp shock. The cold shower is harder, I'd say. The cold barrel is like a short crisp winter walk. But the feeling of getting out and the pain is gone, energy is up, which is absolutely thrilling! And as opposed to all the above, the shock of the cold is completely forgotten. If anything remains cold (such as fingers, toes, I even have Raynaud, so I've been wearing 4 pairs of socks even in the summer, I forgot to add above) I do put a hot water bottle on it afterwards at night, at daytime that's never necessary.

I admit I was afraid of the winter coming, but I am managing pretty well up to now, although it was freezing tonight already: Wearing long johns, do yoga if I have to stand outside, to keep moving, still have my 4 pairs of socks on (3 cotton, & 1 thick wool) and use a third thick winter jacket around my waist, turned to the front like a kilt or back as I need it, inside (due to CoV-airing) and out....
But what is mainly helping me is the cryotherapy since June & cold showering for months now.

I think it is a question what you are prepared to risk. I'm flabbergasted the knowing risks people are prepared to take with meds, just because it's not a short sharp shock, but a long endless one....

Most fibro-people who tried the cold in the rheum. clinic could tolerate it quite well, even if they were skeptical.
They could even tolerate cold hand "baths" in canola (spelt or rice does it too) for 15-20 minutes which completely floored me: pain and circulation problems for hours afterwards. The same with heated grain.
But brave as I am, I tried again for just my magic 3 minutes, then a long break, then another 3 minutes, and that was OK....
Haven't used it, but to get Ache/pains in my body down if I can't cold shower I just do it to my wrists, praps arms, I think that works a bit.

Just trying to encourage people to try... But if someone does want to try cold showering and you're not used to it and do have the heebie-jeebies: start gently, praps warm first, praps just with 8 seconds, first one leg, then the other, next time a bit more etc. Leave back and head till you've got used to the rest.... Unbelievably it saves me hours of restless lying around *every night. That took some effort to try it out (never heard or read of this anywhere), but hey - lying around at night in pain is one of the worst things there is in life - how can a 30'' cold shower be worse or not worth trying? ;-)

 

[sunkacola]

Ha-ha. Might be worth trying just to see. But until winter really sets in here there's no such thing as cold water that comes from the tap. And so far, winter has not yet arrived where I live. I may very well try it (30 seconds) once I can actually get cold water. You are right.....try everything you can manage to try because why not and it's a lot safer than drugs!!

 

[JayCS]

until winter really sets in here there's no such thing as cold water that comes from the tap.

- unbelievable! But there are definitely times where I wonder whether living in your kind of desert might be a great deal more of help than being able to cold shower. Like this & yesterday morning at 4am from when on my muscles seemed to be micro-shaking just because the room temperature had gone down 1-2°C. But a third blanket, hot water bottle (in case you know what that is ), jogging suit plus a specific acupressure/TCM treatment for that today will hopeful do the trick in the coming months...
Didn't used to like it hot, but that's changed too...

 

[sunkacola]

Ha-ha. In the summer, you have to run the hose for a minute or 2 if you want to wash the dog or water plants or the water in the hose will cause severe burns.. Cold water only comes from the fridge.

But, the warmth and dry air of the desert is definitely best for me. If I go somewhere cold and wet the pain settles in for the duration and gets worse every day I am there. Of course, living here also means that I deal with some heat in the summer that most people who don't live in a climate like this (and some who do) think is pretty extreme. But I have lived in extreme cold ( -45F) and in heat up to 120F and while some would think those are not survivable temperatures, they of course are. They can be dangerous, you just have to know how to dress and how to act when you are outside. Both extremes do curb outside activity more than I prefer. But I'll take the heat any day.

 

[felipao]

Hey guys,

I posted a long text with a lot of info yesterday and it's still awaiting moderation Hopefully it goes through soon.

Kind Regards,
Felip

 

[JayCS]

Had that too once - I think it's the amount of links not just the length... bit annoying, but very necessary & sensible, to reduce spam.

 

[JayCS]

Felipe - praps you should write to the mods. Probably your 'trust level' wasn't high enough to be able to post links.

 

[felipao]

Hey there,

I'm glad to hear from you and your experiences...

I should have been more precise - I stayed at a private rheuma clinic in Brazil, my native country, at the end of 2017, when I participated in all the standard activities and did daily cryotherapy.

I believe in general, the power of the cold is incredilbly underrated; exposing oneself to it may be indeed unconmfortable, especially at the beginning, but we are just at the starting line of understanding its extensive benefits to our bodies, in particular our immune systems They've been recently putting Wim Hof under the microscope and analyzing his abilities to suppress the immune response to pathogens - turns out he's pretty decent at it and scientifically speaking, his teachings could have far reaching effects on autoimmune diseases - a fascinating human being indeed!

The first time I heard about him was via a Vice documentary, which is by now a tad old and as you are already familiar with his techniques, perhaps you've already watched it - otherwise, it's a beautiful, beautiful video which you can watch here:


I did come to terms with his breathing techniques, but I've tried to develop my own to maximize thei pain-killing and relaxing benefits and have come to find that Tummo meditation offered more relief for me, in particular. To anyone interested in pain reduction provided by mindfulness, I'm attaching that info via PDF.

Oh, I'm actually envious of you! And several other fibro patients I've been talking to who have experience "only" pain; with the medication, mindfulness, shockwave therapy and trigger point acupuncture I've gotten much better in terms of pain, which was an 11 on a 10-point scale back in 2018 - now it hovers around 3-4, depending on the day and whether I've exerted myself, which can make it considerably worse.

My trigger points have however gone way beyond that and since 2017 caused, among other symptoms: diarrhea, constipation, limited breathing, postural weakness, orthostatic postural tachycardia, migraines, fasciculations, tingling, heart palpitations, eye-sight troubles, muscle weakness, limited range of motion and the list goes on....

Some of the above I've been able to resolve by now, but what has mostly and severely hampered me since March 2017 is pressure on my breathing muscles originated by active trigger points. I haven't been able to breathe, stand, walk or run properly since then. There were times, where my breathing capabilities were at 15% - I literally could not breathe. Currently, it stands around 70%, with some variation. Means I have major trouble walking, talking and even speaking.

"
Heard of the "environmental doc" Bodo Kuklinski in Rostock? (website, youtube) - an acquaintance is a fan of his. I'd done all herbs I can tolerate for sleep & pain in the first months, same for supps too. Nothing helping by around April I did his whole supp-regime for 2 months, I got the book-excerpt and there was nothing harmful in it (high dosages of B12, then K, Mg, Se, Zn, then B1+2, C+E 8-fold, then linseed oil, then Q10; I've ended up with Vitamin B12 on 2700 instead of 700, which makes the docs laugh, everything else was OK anyway, but then higher.)
I dislike the guy tho, a guru-type who says everyone's dumb except for himself. My acquaintance has an appointment there in about a year, because just doing the regime isn't helping enough ..."
--> No, I've never heard of that dude - will definitely check him out! I do hate "guru" type doctors though.

I'm glad you are able to get back to work, little by little.... there's a fascinating book called "
Life After Pain: Break Free of Chronic Pain and Get Your Life Back (English Edition)" by Dr. Jonathan Kuttner - it's full of little techniques to deal with pain and was very useful to me at the beginning.

Have you tried out the Amygdala Reprogramming by Dr. Gupta? I'd started it some time ago, but didn't continue... maybe you did.

What therapy has helped/still helps you the most? And what are the triggers that make it worse? For me, it's actively using the affected muscles in for example exercise.

I'm attaching a major meta analysis of high intensity laser therapy for chronic pain syndromes, in which its efficacy has been extensively demonstrated; in addition, I'm also attaching a case study with a long-term fibromyalgia patient who underwent EXTREMELY high-intensity laser therapy and recorded major relief in Texas. My dad got in touch with the institute where the case study was done and we were provided with the exact protocols being used and the message that this protocol has shown extremely effective for fibro patients. We are trying to find out more and contact the patients to hear about their current experiences. I'll make sure to post any updates in case someone is interested.

Have a great day and looking forward to hearing back!

Felipe

 

[felipao]

Just tried reposting with one link less, appears to have worked!

 

[JayCS]

Hi Felipe, thanks for all your infos!

I'd still be interested what temperature you had in your whole body cryotherapy... if you know and can remember...

Just listening to the Wim-Vice documentary in the background. I do think the guy is OK, but apart from that I just want to try out those suggestions or recommendations of people which I think may be in accord with my body. To see that I watched videos of people's experiences. The part in the documentary where people did it together reminded me of the "Sedona deaths" in a pseudo-sweat lodge. Of course Wim Hof does nothing like that. When he says 'anyone can do what I do' I use that as an encouragement, but I don't think it's true.

that Tummo meditation offered more relief for me, in particular. To anyone interested in pain reduction provided by mindfulness, I'm attaching that info via PDF.

Just read up on Tummo itself: Correct me: It's said to warm you up inside. Studies are rare. Their results have been spread in an exaggerated way. Tibetan monks started with it in the 11th century. Instructions are fairly unclear and varied. But simplified, you start with 15-20x controlled hyperventilation (not quite as strongly as Wim Hof?), imagining a fireball in the "empty vase" of your torso, which is kindled with every breath in and fanned with every breath out. Upon the last breath in, hold 5 secs and purse your lips breathing out and imagining the warmth spreading everywhere while breathing out, then holding as long as you wish. Repeat 2x or 4x like Wim. Sounds easy and similar.
In autogenic training you imagine warmth and heaviness (and/or lightness), I use the image of sun-rays moving up your body. Some people I do it with feel warmer.
I read the study(/-ies) about pain reduction by mindfulness. They divide techniques up into 2: Focused Attention and Open Monitoring. Focused Attention means concentrating on something like breath and letting other thought drift by and away. Open Monitoring means just watching all thoughts drift on. I learned both from Buddhists a few years as a youth, tried to practice them for 30' a day, as well as Autogenic Training, so I can do them OK. Since my back hurts very much thru long straight sitting on meditation stools or in half-lotus, it was/is torture for me, so I only do them lying down. Any position I hold for >10' became/becomes painful with my fibro. But I don't see any problem spicing up Wim's breath-holding with the inner fire.
Jon Kabat-Zinn was referred to in the article. I got his book and read thru it, but realized mindfulness stuff like this
My acupressurist developed my "inner cooking pot" last week, which has very much improved my inner temperature and ability to cope with the cold, like I used to be able to. My feet freezing more then, she's concentrated on that now, which has helped there too. Now I've also bought new organic woolen socks which keep my feet warmer than the old ones, so I only need one pair of cotton socks under them, instead of 3.

Oh, I'm actually envious of you! And several other fibro patients I've been talking to who have experience "only" pain;

Wait, wait, you are what? Not sure what I've got to be envious about! Pain and lots more in gut, skin, back, nerves, for 40+ years, plus focal seizures & more, 30+ diagnoses (incl. genetic hyperlipidemia and a probably harmless tumour in my spinal canal), 40+ docs & 60+ treatments in 1 year, struggling to work 1.5h. Experiencing 'only' pain?! Not sure if envy is the right word for all this. And anyway - envy is a feeling which only creates suffering, ah I feel my Buddhist influences coming on... I've learned (almost) never even to compare - you never know what life is like in the other's moccasins.
But you've given me something to think about: My main assets are probably my inner energy, determination and self-discipline, love of life and people, which have helped me find out a lot of things that are helping me, incl. mindfulness & having learned how to be happy despite pain, to live a good life. OTOH what I've had to learn most ist self-acceptance and self-care - it's hard when you feel no-one has accepted and cared for you much, esp. in childhood.

pain, which was an 11 on a 10-point scale back in 2018 - now it hovers around 3-4, depending on the day and whether I've exerted myself, which can make it considerably worse.

11 of 10, wow - that'd mean I'm dead twice over. Seriously - you may have read sunkacola and me on the another thread this week: What would that've been in my scale where 7 means having to cry?

My trigger points have however gone way beyond that and since 2017 caused, among other symptoms: diarrhea, constipation, limited breathing, postural weakness, orthostatic postural tachycardia, migraines, fasciculations, tingling, heart palpitations, eye-sight troubles, muscle weakness, limited range of motion and the list goes on....

I've had all of this in the past, except seizures & trigeminus instead of migraines. In my case almost all was due to my back and muscle problems, meaning finding the best back exercises for me (pressing hollow back & wrists down) and doing 5-10' *every morning. Now having to sleep so long, I do 5' more before going to bed. Plus 5-30' yoga back exercises at daytime.
Trigger points are of course not really causes, but symptoms and culminating areas which osteopathy etc. can start off on. Whenever I looked for some on my own I found them all over, but before fibro went off my first osteopath didn't do much on them, altho she was good. My second one did, which helped get some of the pains down.
What are you doing with your trigger points? I would have thought a good osteopath can get them down quickly? Do you do normal trigger pointing or Jones technique?

"Bodo Kuklinski in Rostock? --> No, I've never heard of that dude - will definitely check him out! I do hate "guru" type doctors though.

Maybe it's just me...

fascinating book called "Life After Pain: Break Free of Chronic Pain and Get Your Life Back (English Edition)" by Dr. Jonathan Kuttner - it's full

I've read 3 pain-books now, Jon Kabat-Zinn, Peter (A.) Levine and Helga Pohl, plus looked at the pain specialists Liebscher-Bracht, and none of them helped me at all (L-B occasionally). What they say I've been doing already.

Have you tried out the Amygdala Reprogramming by Dr. Gupta? I'd started it some time ago, but didn't continue... maybe you did.

Didn't/don't like the look of it...

What therapy has helped/still helps you the most?

For fibro? Osteopathy first, then whole body cryotherapy (WBC) 4x/w for the pains, now TCM/acupressure after WBC 2x/w, plus Wim Hofs' breath-holding & cold showers & putting legs & arms up 2-3x/d, for pains, Ache and sleep. Yoga, hot water bottle and arnica cream (Traumeel) for pains, when necessary. Learning where my invisibly moving sweet spots are for each activity (often 3' for whole body activities like housework or cycling fast, and 20'' for a single exercise like yoga). And pinpointing, analyzing, searching for & finding remedies for absolutely every little symptom, tending to zero tolerance of any pain, trying not ever to wait. I try to no longer simply rest, only active rests (at least: legs straight up).

And what are the triggers that make it worse? For me, it's actively using the affected muscles in for example exercise.

That used to be the case, but I now usually know where the sweet spots are, i.e. know when to stop, even if it's 5'' on a certain day.
The big area where it's happening again is my daily outdoor table tennis. Before starting work, acupressure had brought me from 4 up to 6 games, even with stooping for the ball and without breaks. Now I get myofacial torso-pain or the Big Ache again after 4-5 games with stooping and with only a few breaks. So it's not single pains, not trigger points, but the whole body.
Also work itself, talking loudly thru a FFP2 mask for 40-60', even with several fresh air breaks in between. A really good mask helped better, but not alone, using a nose-strip under the mask worked better than without on one of 2 days, I think, so I'm going to try doing that every day from now on. In this case no myofascial pain, but strong Ache and feverishness (5 if 7 means having to cry).
Haven't told my acupressurist that clearly yet perhaps, because we were focusing on body temperature this week. Next issue.
Because otherwise I won't be able to work more. Only one more week with 60' of loud talking, then it's got to go up to at least 90' per day.
I could try to reduce the loud talking more, I'm thinking, too. A third of the time instead of half the time... or so...
I also want to get into the habit cold-showering &/or breath-holding directly after the table tennis instead of taking a break, and see if that helps.

BTW I'm using mindfulness in the cryotherapy, acupressure and now also during the cold-showering, reminding my body how great I will feel afterwards and how the pain is being washed away.

major meta analysis of high intensity laser therapy for chronic pain syndromes, in which its efficacy has been extensively demonstrated;

Hmm, well not quite that extensive: They're talking about - they say: only - 11 studies which were pretty different, so hard to compare. Usually neck and some back pain, not fibro. So "additional well-designed studies involving larger samples with long-term follow-up are needed to further assess each laser application, treatment region, and comparator. Since experiencing heavy & long-term adverse effects after trying hyaluronic acid injections in my lower back applied under CT, I am not keen at all on anything this new and praps risky... but

a case study with a long-term fibromyalgia patient who underwent EXTREMELY high-intensity laser therapy and recorded major relief in Texas. My dad got in touch with the institute where the case study was done and we were provided with the exact protocols being used and the message that this protocol has shown extremely effective for fibro patients. We are trying to find out more and contact the patients to hear about their current experiences. I'll make sure to post any updates in case someone is interested.

Not sure if I can follow on the "extremely effective" bit, I'd have to look at the new studies and a second opinion first to be sure. But I'm also very wary of a whole body cutting-edge treatment. I've found there's a lot more to be tried out than "standard pharmacotherapy and treatment in an interdisciplinary pain management program" as is said for this woman. What I do has also dramatically improved my fibro in a certain sense, despite still not being able to work. Also my rheum clinic report claimed that I'd come out of it slightly better than I went in, which was not true. But of course they will tend to say that, despite all attempts to be honest, because their living and reputation depends on this.
But gladly post updates, I am definitely interested, also because this treatment may provide clues for how fibro is caused, works & can similarly be treated.
Cheers, Felipe, keep us posted... and as I say I'd be glad for more details, like about your trigger points and sweet spots....