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Understanding Fibromyalgia

~ by Jo Jordan

Formerly referred to as fibrositis, fibromyalgia is a chronic disorder characterized by muscle pain, fatigue, stiffness, and tenderness of the muscles, tendons, and joints.

Rather than being caused by tissue inflammation, the pain of fibromyalgia seems to be brought on by an extremely low pain threshold. Patients have an increased sensitivity to numerous sensory stimuli that are not normally perceived as painful to others. Emotional stress, noise, and changes in the weather aggravate the condition.

Sufferers have what are known as tender points, specific places that hurt when pressure is applied to them. These points are normally found at the back of the head, front of the neck, sides of the breastbone, shoulders, around the elbows, hips, and knees.


Other Symptoms of Fibromyalgia

While the predominant symptom of fibromyalgia is pain, people with the disease may also experience other symptoms such as restless sleep, awakening feeling tired, anxiety, depression, problems with thinking and memory, poor concentration, mood changes, irritability, migraine and tension headaches, painful menstrual periods, tingling or numbness in hands and feet, and disturbances in bowel functioning.


What Causes Fibromyalgia?

Nobody knows exactly what causes fibromyalgia. However, it is no secret that more and more our bodies are being exposed to damaging endocrine disrupting environmental chemicals, toxic substances and allergens, causing some researchers to speculate that liver toxicity may be a cause of fibromyalgia.

It is a struggle for a dysfunctional liver to remove fat-soluble toxic substances from the body, making people with toxic overload more susceptible to the adverse effects of accumulations of chemicals in fatty tissue.

Researchers have put forward a variety of other speculative causes for fibromyalgia:

  • Autonomic nervous system dysfunction (the system that helps to control bodily processes such as digestion, reaction to stress, and metabolism, including the functioning of hormones and neurotransmitters)
  • Bacterial overgrowth
  • Certain diseases/illneses
  • Genetic predisposition
  • Immune system abnormalities
  • Infectious agents (including certain viruses)
  • Injury and muscle trauma (such as a car accident)
  • Repetitive injuries
  • Sleep disorders (the brain nerve chemical serotonin is relatively low in fibromyalgia patients)
  • Stressful or traumatic events


Who Does Fibromylagia Affect?
Risk Factors

Estimates suggest that as many as one out of fifty Americans is affected by fibromyalgia.1 Eighty to ninety percent of those who contract the condition are female, and while diagnosis normally takes place between the ages of twenty and fifty-five, elderly men and women can also develop fibromyalgia.2

Various other risk factors, including certain medical conditions, are thought to be linked to the onset of fibromyalgia. For example, people with ankylosing spondylitis (spinal arthritis) and rheumatoid arthritis are more likely to have fibromyalgia than those without the condition.

Statistics indicate that as many as thirty percent of people with systemic lupus erythematosus (known as lupus) also have fibromyalgia. Between ten and fifteen percent of people with osteoarthritis also suffer from fibromyalgia.3


Diagnosing Fibromylagia

Currently, there are no blood tests or X-rays available to diagnose fibromyalgia. Muscle biopsies obtained from patients’ tender points have failed to provide a great deal of useful data about the disease.

A diagnosis of fibromyalgia can, therefore, only be made on information gathered through a patient history and physical examination, and by eliminating other conditions that may mimic fibromyalgia: muscle pain causing diseases such as polymyositis, bone pain causing diseases such as Paget's disease, hypothyroidism, parathyroid disease, hypercalcemia, cancer, and infectious diseases such as hepatitis, Epstein Barr virus, and AIDS.

Fibromyalgia sufferers typically experience pain in eleven of the eighteen classic tender points4. And if neither tissue swelling nor inflammation accompanies widespread pain, a fibromyalgia diagnosis seems probable.


Treating Fibromyalgia

Ideally, fibromyalgia treatment ought to involve a team approach including input and guidance from a variety of specialists: the family doctor, a physical therapist, a general internist, and a rheumatologist, as well as other health care providers, and support from organizations such as community hospital support groups and local chapters of the Arthritis Foundation.

A multi-pronged approach to treatment, including medications and various lifestyle changes, is recommended.


Medications5:

Medications to help reduce pain and improve sleep are recommended. Here are some common examples:

  • Analgesics, including acetaminophen to ease pain and stiffness
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen sodium, together with other medications can also help reduce pain
  • Tricyclic antidepressants to reduce fatigue, relieve muscle pain and spasm, and promote deep, restorative sleep
  • Other antidepressants such as sertraline and paroxetine are used to treat the depression that sometimes accompanies illness
  • A newer class of antidepressants known as serotonin and norepinephrine work to regulate the brain chemicals that are believed to transmit pain signals
  • Muscle relaxants to help treat muscle pain and spasms
  • Anti-seizure medication (i.e. pregabalin) may reduce pain and improve function
  • Pregabalin, an anti-seizure medication used to treat some types of pain, is the first drug approved by the Food and Drug Administration (in 2007) for fibromyalgia treatment


Lifestyle Changes:

There are various changes people with fibromyalgia can do in order to feel better and foster overall wellness. Eating well, and getting plenty of sleep is crucial.

Sleep difficulties can be eased with medication, and health care providers can also assist patients by examining the possible cause of sleep disorders such as low serotonin levels. Some studies suggest that sleep disorders – rather than being a symptom – is a cause of fibromyalgia.

Some people find vitamin supplements that include folic acid and ginkgo biloba help to improve sleep patterns. Exercise can assist in fostering a good night’s sleep, as well as setting a regular time for turning in. Avoiding caffeine and alcohol in the evening can go a long way to promoting a restorative sleep.

It is important for the fibromyalgia sufferer to reduce stress levels. This could include modifying one’s work schedule, or becoming aware of individual environmental triggers such as weather, temperature, and noise levels, and making adjustments.

Some people find biofeedback and electroacupuncture effective in relieving stress/symptoms, while others report success with standard acupuncture, relaxation tapes, and regular counseling.

Colon cleansing is another alternative therapy advocated by some fibromylagia sufferers who report a minimization of symptoms with regular cleansing. Since toxicity is believed to be one of the causes of fibromyalgia, colon cleansing and a colon cleanse diet may help to reduce toxic buildup, reducing the stress on the nervous system and other organs, as well as boosting the immune system.


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Notes:
1. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), “Fast Facts About Fibromyalgia,” http://www.niams.nih.gov/Health_Info/Fibromyalgia/fibromyalgia_ff.asp (accessed January 3, 2008). br /> 2. Hearthstone Communications Ltd., “What is Fibromyalgia,” http://www.fibromyalgia-symptoms.org/index.html (accessed January 3, 2008). br /> 3. Ibid. br /> 4. William C. Shiel Jr., MD, “Fibromyalgia,” MedicineNet.com, http://www.medicinenet.com/fibromyalgia/page3.htm (accessed January 3, 2008). br /> 5. Mayo Clinic.com, Tools for healthier lives, “Bones, Joints, and Muscles: Fibromyalgia,” http://www.mayoclinic.com/health/fibromyalgia/DS00079/DSECTION=8 (accessed January 3, 2008).


 
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