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What is Fibromyalgia? How do we treat, manage and get relief from the symptoms?
Fibromyalgia syndrome or FMS is a
widespread musculoskeletal pain and fatigue disorder for which the cause is still unknown. Fibromyalgia means
pain in the muscles, ligaments and tendons or the fibrous tissues in the body. Most patients with fibromyalgia
say that they ache all over. Their muscles may feel like they have been pulled or overworked. Sometimes the
muscles twitch and at other times they burn. More women than men are afflicted with fibromyalgia, however it
shows up in people of all ages.To help your family and friends relate
to your condition, have them think back to the last time they had a bad flu. Every muscle in their body shouted
out in pain. They felt devoid of energy as though someone had unplugged their power supply.
The pain of fibromyalgia has no
boundaries. People describe the pain as deep muscular aching, burning, throbbing, shooting and stabbing. Quite
often, the pain and stiffness are worse in the morning and you may hurt more in muscle groups that are used
repetitively.Fatigue can be mild in some patients
and yet incapacitating in others. The fatigue has been described as "brain fatigue" in which patients
feel totally drained of energy. Many patients depict this situation by saying that they feel as though their
arms and legs are tied to concrete blocks, and they have difficulty concentrating.
 Most fibromyalgia patients have an
associated sleep disorder called the alpha-EEG anomaly. This condition was uncovered in a sleep lab with the aid
of a machine, which recorded the brain waves of patients during sleep. Researchers found that fibromyalgia
syndrome patients could fall asleep without much trouble, but their deep level (or stage 4) sleep was constantly
interrupted by bursts of awake-like brain activity. Many wake up feeling as though you haven't slept at all. Most
patients diagnosed with chronic fatigue syndrome also have the same alpha-EEG sleep pattern. The sleep pattern for
clinically depressed patients is distinctly different from that found in FMS or CFS.
Irritable Bowel Syndrome, constipation,
diarrhea, frequent abdominal pain, abdominal gas and nausea represent symptoms frequently found in roughly 40% to
60% of fibromyalgia patients.
Temporomandibular Joint Dysfunction Syndrome
sometimes referred to as TMJD, causes tremendous face and head pain in one quarter of FMS patients. A 1997
report, however indicates that as many as 90% of fibromyalgia patients may have jaw and facial tenderness that
could produce, at least intermittently, symptoms of TMJD. Most of the problems associated with this condition are
thought to be related to the muscles and ligaments surrounding the joint and not necessarily the joint
itself.
Multiple Chemical Sensitivity Syndrome
is sensitivity to odors, noise, bright lights, medications and various foods is common in roughly 50% of FMS or
CFS patients.
Other common symptoms include painful
menstrual periods (dysmenorrhea), chest pain, morning stiffness, cognitive or memory impairment, numbness and
tingling sensations, muscle twitching, irritable bladder, the feeling of swollen extremities, skin sensitivities,
dry eyes and mouth, frequent changes in eye prescription, dizziness, and impaired coordination can
occur.
Aggravating factors can include
changes in weather, cold or drafty environments, hormonal fluctuations (premenstrual and menopausal states),
stress, depression, anxiety and over-exertion can all contribute to symptom flare-ups.
Possible Causes
The cause of fibromyalgia and chronic
fatigue syndrome remains elusive, but there are many triggering events thought to precipitate its onset. A few
examples would be an infection (viral or bacterial), an automobile accident or the development of another
disorder, such as rheumatoid arthritis, lupus, or hypothyroidism. These triggering events probably don't cause
FMS, but rather, they may awaken an underlying physiological abnormality that's already present.
Theories pertaining to alterations in
neurotransmitter regulation (particularly serotonin and norepinephrine, and substance P), immune system function,
sleep physiology, and hormonal control are under investigation. Substance P is a pain neurotransmitter that has
been found by repeat studies to be elevated threefold in the spinal fluid of fibromyalgia patients. Two hormones
that have been shown to be abnormal are cortisol and growth hormone. Imaging techniques of the brain are being
used to explore various aspects of brain function.
The body's response to exercise,
stress and simple alterations in position (vertical versus horizontal) are also being evaluated to determine
if the autonomic nervous system is not working properly. Your body uses many neurotransmitters, such as
norepinephrine and epinephrine, to regulate your heart, lungs and other vital organs that you don't have to
consciously think about. Ironically, many of the drugs prescribed for FMS/CFS may have a favorable impact on
these transmitters as well.
Common Prescription Medical
Treatments
Traditional treatments are geared
toward improving the quality of sleep, as well as reducing pain. Because deep level (stage 4) sleep is so crucial
for many body functions, such as tissue repair, antibody production, and perhaps even the regulation of various
neurotransmitters, hormones and immune system chemicals, the sleep disorders that frequently occur in
fibromyalgia and chronic fatigue patients are thought to be a major contributing factor to the symptoms of this
condition. Medicines that boost your body's level of serotonin and norepinephrine both neurotransmitters that
modulate sleep, pain and immune system function--are commonly prescribed. Examples of drugs in this category
would include Elavil, Flexeril, Sinequan, Paxil, Serzone, Xanax and Klonopin. A low dose of one of these
medications may be of help. In addition, nonsteroidal, anti-inflammatory drugs (NSAIDs) like ibuprofen may also
be beneficial. Most patients will probably need to use other treatment methods as well, such as trigger point
therapy either with injections of lidocaine or manual release, physical therapy, acupuncture, acupressure,
relaxation techniques, osteopathic manipulation, chiropractic care, therapeutic massage, and an exercise
program.
What is the Prognosis?
Long-term follow-up studies on
fibromyalgia syndrome have shown that it is chronic, but the symptoms may vary considerably from one time to
another. The impact that FMS can have on daily-living activities, including the ability to work a full-time job
differs among patients. Overall, studies have shown that fibromyalgia can be equally as disabling as rheumatoid
arthritis. On the other hand, follow-up of people meeting the chronic fatigue syndrome criteria indicates that as
many as 40% may significantly improve but few are thought to completely recover from this syndrome. Longer-term
follow-up studies are not available to indicate whether these "improved" CFS patients later relapse
with an increase in symptoms. A preliminary follow-up study by the CDC (Centers for Disease Control) reveals
that for those individuals with chronic fatigue syndrome who do not recover or significantly improve after five
years duration, their most prominent symptom changes from fatigue to muscle pain with concentration problems
(sounds a lot like the permanent syndrome of fibromyalgia but the CDC is not checking patients for tender
points).
According to a research study by Dedra
Buchwald, M.D., people who meet the criteria for both FMS and CFS tend to be at the more severe end of the
spectrum of symptoms and are more likely to become work-disabled. Buchwald says her findings underscore the
importance of recognizing concurrent fibromyalgia and chronic fatigue syndrome.
Self-Help Strategies
Lifestyle modifications may help you
conserve your energy and minimize your pain. Learn what factors aggravate your symptoms and avoid them if
possible. Join your local support group and become informed about your condition.
IHC offers those with Fibromyalgia,
a host of information and tools to help you get relief and mange your condition. We urge you to get proactive
and learn, get a few tools and mange your condition. Because we treat many patients with Fibromyalgia, we have
witnessed what works and what doesn't. At this time these are the best books and tools that exist to our
knowledge:
Books
Interestingly both authors are MD's
and both have Fibromyalgia as well! They are well suited to explain in detail how the disease works and how to
best manage the symptoms.
Trigger Point Tools
- Our trigger point release tools can offer
huge relief from those nagging spots that can be so hard to reach by yourself. You know the ones along the inside
of your shoulder blade and the spots on either side of your neck where it meets your shoulders! Check out the
trigger point tools we offer, you will surely find a tool to get at those spots!
Magic Magnets
- Another big help to many with
Fibromyalgia. They simply stick on!
Bodybilt Chairs
- If you sit much of the day and are
uncomfortable you have got to see these chairs! These are clearly the highest quality most comfortable desk
chairs that exist!
We hope you find the information and
products on our site educational and helpful!
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