Fibromyalgia: Definition, Treatment, and Possible Causes
Fibromyalgia is a disorder associated with widespread muscular-skeletal pain and fatigue. It is usually accompanied by sleep problems. The name comes from Latin “fibro” for fibrous tissues and Greek “myo” for muscle and “algia”, pain. It is considered to be a rheumatic condition: a condition that impairs joints and/or soft tissues. Fibromyalgia has often been dismissed by doctors as a neurotic, all in the head, syndrome. Recently, it has been taken much more seriously and it is being diagnosed more frequently and a good deal of research is being done on it.
In addition to pain, most Fibromyalgia patients suffer sleep problems. Sleep studies show bursts of awake-like brain activity limiting the time spent in deep, stage four sleep.
Fibrlmyalgia is a syndrome and not a disease. A syndrome is a collection of symptoms and medical problems that tend to occur together but are not related to a specific cause.
Eighty to ninety percent of fibromayalgia sufferers are women, although men and even children also have it. It is most often diagnosed in middle age, often after several years of misdiagnosis or dismissal. People who have rheumatoid arthritis or lupus are more likely to also have fribromyalgia.
Fibromyalgia is diagnosed by finding pain in 11 of 18 “tender points” when pressing on them. There also must be widespread pain in all four quadrants of the body.
Some patients are helped by over the counter painkillers but many others need something stronger and are given prescription painkillers. In addition, doctors prescribe anti depressants in lower doses than they would for patients with clinical depression. This is done because a boost in the neurotransmitter, serotonin seems to help. The most effective use of anti depressants seems to be a combination of an older trycyclic anti depressant with a serotonin selective uptake inhibitor or SSRI. The anti-anxiety medications such as Valium, Clonazepan, and Xanax may be prescribed to aid in sleep and muscle relaxants such as Cycloflex or Flexaril are also prescribled. Sometimes the anti seizure medication Neurontin is given.
Exercise is also very important in the treatment of Fibromyalgia. A combination of gentle stretching with the use of “Spray and Stretch” and aerobic exercise seems to work best. Vigorous exercise is counter-productive, often leaving the patient in bed for a couple weeks.
If it seems like a suspicious number of drugs that affect the brain are being prescribed; there is a reason for this. Fibromyalgia appears to be a disorder of central processing of pain-the patient experiences pain amplification. What most people would experience as a slight twinge, the fibromyalgia patient feels as severe pain.
Researchers are beginning to find markers in subsets of patients. They are finding substances in the blood, or spinal fluid, signs of immune system changes, infection, hormone deficiencies, or neurotransmitter irregularities. For example, abnormal immune system responeses are found in about half of those diagnosed with fibromyalgia. Research is conclusively proving that fibromyalgia is not “all in her head,” although some of it may be in the brain.
