Fibromyalgia - The Whole Story

"It's all in your head" or "just learn to live with it" are two expressions are heard more often, medical profession, people with fibromyalgia syndrome or FMS.

Most of us have an understanding, especially these days, that research in the medical field is ongoing, with results and provide a fast and furious pace. Most people also understand that every doctor can or should even be responsible for keeping abreast of each new discovery. Without a need or an interest in a specific region of data, much of what is learned is not getting as many doctors. This is an explanation, then how many health professionals are still unaware, uninformed about, or in complete denial of the existence of such a common disorder fibromyalgia.

Far from being a new discovery, the FMS symptoms were first recorded in the 18th century and recognized as a specific set of symptoms in the 1860s. Took over 100 years, in late 1980, before the syndrome Fibromyalgia official name has been designated by the American Arthritis Foundation and the National Center for Disease Control. Before that date, FMS was known for at least 100 different names, including fibromyalgia, fibrositis, and old family times, rheumatism.

Despite the apparent familiarity with this disorder, many doctors are reluctant to diagnose FMS. Maria Shriver has reported a statement by Mr. Thomas Bohr on January 4, 2000 Dateline NBC broadcast. In this report, a neurologist at Loma Linda Medical Center in California, Dr. Bohr said. ".. There is a part of the medical establishment that supports fibromyalgia is not only over-diagnosed, there are altogether no" Your opinion does not seems to be shared by most physicians. However, they are not enough like him that sometimes makes diagnosis and treatment difficult to find. Even doctors who are familiar with FMS, the diagnostic process often exceeds five years.

Fibro defined literally refers to fibrous or connective tissue. Myalgia means pain in one or more muscles. Therefore, fibromyalgia means pain in muscles and connective tissue. Is often referred to as a state of musculoskeletal soft tissues.

While this may be literal, is not entirely descriptive. Often described as the feeling that life was the flu. It is not enough, either. Today is the second most common rheumatic disease and ten million people in the United States, sharing the fate of this very painful condition. Between 1.5-6% of the world population with a positive diagnosis for fibromyalgia, a wide range of descriptions.

This is true for fibromyalgia symptoms, too. They are also varied individually and as human beings. The most frequently encountered symptoms are insomnia, exhaustion and / or extreme fatigue, hormonal dysfunction, irritable bowel and bladder, blurred vision, thermoregulation dysfunction, dysmenorrhea, ATM, food and environmental allergies, restless sleep, prolapse mitral valve, muscle pain and spasms, joint pain, myofascial pain, depression, anxiety, sugar cravings, excessive thirst, confusion, memory loss, chest pain, irritability, acne, diarrhea, gum disease, oral inflammation, and headaches. The list goes on, again, the comparison of a patient to another will produce two totally different sets of symptoms. This in itself can hamper the process of diagnosing many diseases and disorders share symptoms.

In 1990, the American College of Rheumatology established diagnostic criteria, which helps distinguish FMS other disorders. This criterion should be included, but are not limited to:

Persistent generalized muscle / joint pain, can not be explained by an inflammatory or degenerative musculoskeletal disorder for 3 months or more

Fatigue extends over a similar time period

Sensitivity in at least 11 of 18 tender points on palpation.

This diagnostic criterion is beneficial, but FMS remains misdiagnosed with diseases such as chronic fatigue syndrome, myofascial pain syndrome, lupus, Epstein-Barr, and many others. The chronic nature of each, demographics and similar therapies adds to the confusion.

Comparative tests of researchers to distinguish between multiple chemical sensitivity, fibromyalgia, chronic fatigue and were conducted in the early 1990s, the use of questionnaires to assess patient symptoms. The results showed that 70% of previously diagnosed with FMS and 30% of people diagnosed with MCS meet the criteria for CFS established by the Centers for Disease Control.

Many of the symptoms are similar to these diseases and the initial diagnosis is usually different from FMS anything until they are dismissed for images blood tests, studies and other clinical trials. To date, there is no evidence to positively identify FMS exists, but a press release in February 1999 appointed testing anti-polymer antibodies based FMS based on evidence that researchers found anti-polymer in the blood of patients with fibromyalgia.

Recent reports of the tests begin to identify specific clinical factors. However, it still must be combined into a coherent set of factors identification. Get to doctors' offices this information, once established, is another concern. Diagnosed according to the criteria of elimination remains coupled to the general course of events.

To complicate matters further, there is often a comorbid diagnosis of various diseases or FMS mimics. Comorbidity are common with irritable bowel syndrome, migraine, osteoarthritis and rheumatoid arthritis, as well as others. FMS in its opinion of April 1999 Dr. Don L. Goldenberg, Department of Rheumatology, Newton-Wellesley Hospital in Massachusetts says FMS is present in 10% and 40% of patients with SLE and in 10% and 30% of patients with rheumatoid arthritis. He further claims that 25-50% of all patients referred for treatment of systemic Lyme disease never had Lyme at all, but rather FMS. As with other systemic diseases, Dr. Goldenberg believes that it is not worth trying to distinguish between FMS and other overlapping syndromes such symptoms is so vast.

Many skeptics seem like we are led to believe that FMS is primarily a psychiatric illness. Anti-depressant medications are often prescribed to patients with FM, and often prove helpful in relieving some symptoms. There is an association between FMS and major depression. However, it is the old "which came first, the chicken or the egg?" argument. The relentless, often disabling pain of fibromyalgia can certainly lead to depression. On the other hand, the classical theory states psychosomatic depression as a result, no result.

Found that patients with simultaneous diagnosis of IBS have frequent current diagnosis and last of depression. There is a higher frequency of comorbidity with depression and IBS in women who have suffered physical and / or sexual abuse in childhood.

Stress plays an important role in the stimulation and / or exacerbate many main symptoms of these disorders beam. However, most of those who are not depressed FMS. Only one-third of patients with fibromyalgia share a simultaneous diagnosis of major depression, which eliminates the probability of being the cause of fibromyalgia.

Fibromyalgia syndrome crosses all boundaries, socioeconomic status, age, race or gender. Women are diagnosed between five and twenty times more often than men. Women have been shown to have a lower tolerance threshold and pain, and generally exhibit behavior use more care than men do. The rates of diagnosis for both sexes increased as age at diagnosis rises above fifty.

Identifying any cause of fibromyalgia is discovered. Over 100 years of research have begun to find consistent abnormalities or soft muscle tissue. Electrical stimulation produced significantly increased levels of the upper extremities in patients with FM in pain, compared to normal controls. FMS patients tend to be hypersensitive to pain and auditory stimuli, and there is no evidence to suggest that these people have an altered perception and effective response to these stimuli. Suppose that one of the main reasons for presenting extreme physical symptoms is the high level of distribution in muscle tissue.

The investigation concluded in 1999 and, to date, in 2000, found reduced serotonin levels, high levels of substance P (neuropeptide), and anti-nociceptive (pain stimulus) abnormal peptides in cerebrospinal fluid bulb. Nearly a quarter of the patients with lesions in the cervical spine developed FMS, while a much smaller number that developed after a leg injury. With FMS, many think they can trace the emergence of a new emotionally or physically traumatic specific event in their lives. Brain imaging studies of women with fibromyalgia showed a reduction of cerebral blood flow in the thalamus and caudate nucleus (April 1 basal ganglia). The caudate nucleus and the thalamus are responsible for sending the signal noxious stimuli to the brain. The reduction of blood flow to these areas have been identified in other disorders and chronic pain.

A study by the University of Washington Medical Center in the 1990s attempted to clarify whether patients with FM are more susceptible to muscle damage real activity that are people who are not FMS. The results showed that there was more damage than the other group. However, researchers questioned as to whether the pain is a good indicator of muscle damage. Magnetic resonance spectroscopy indicated that the FMS having increasingly higher phosphodiester that event were healthy subjects, indicating abnormalities in the thin shell transparent striated muscles.

Other studies in this direction have followed, with the conclusion in 1998 stating that, "P-31 MRS provides objective evidence of metabolic abnormalities consistent with weakness and fatigue in patients with fibromyalgia."

The research was presented in March 2000 found that the vegetative base people with fibromyalgia is "characterized by increased sympathetic and decreased parasympathetic tone." Physical, symptomatic and psychological health of these patients involves an autonomous deregulation. Other test reports in 2000 show that there is a significant difference in how patients respond to pain FMS compared to controls.

Sleep abnormalities are present in most, if not all patients. Men tend to suffer from sleep apnea. Men and women may have abnormal cycles slow eye movement sleep and not fast.

There is also evidence that the tendency to develop this disorder may be inherited, suggesting a genetic causal factor. Abnormalities in several neurohormones, microcirculatory disorders, low phosphate and magnesium deficient synthesis of adenosine triphosphate, exaggerated response to certain hormones, imbalances and sympathetic and parasympathetic interference in the release of growth hormone have no recently identified clinically in FMS.

Viral factors, including Epstein-Barr virus, is strongly suggested by the investigators and patients as a causal factor. The theory is that the infectious comorbidity been exhausted immune response, creating inflammation, which increases levels of nitrous oxide raise homocysteine ​​levels in the cerebrospinal fluid. One fourth of all patients developed Lyme FMS after the end of treatment of Lyme, presenting the possibility of viral causative agent. However, no conclusive evidence to establish this fact.

In a January 1999 report by Dr. Garth L. Nicolson, Dr. Nicolson says that almost 70% of those with a positive diagnosis may FMS mycoplasma and other bacteria, and / or exposure to respond "or other chemical insults "capable of suppressing the immune function. He does not believe that is the real cause of fibromyalgia, but the symptoms and progression of the disease worsen. Studies website in its report, and the results of their own studies suggest that most patients tested present evidence of the presence of pathogenic species such as M. fermentans, M. penetrans, M. pneumoniae, M. genitalium, M . hominis and M. pirum. The report further states using specific blood for identifying mycoplasma infections and polymerase chain reaction and validation tracker nucleoprotein genes as efficiently.

Lily T Casura reported in the January 2000 Bulletin of patients Townsend said they feel they have been "run over by a Mack truck." Sometimes, even full days when it feels as if there is not one part of your body that does not feel extreme pain. This affects daily activities, mood, ability to digest food, sleep and body parts and most people can not even identify action. Mental confusion and loss of short term memory are often overwhelming and embarrassing. Even a loving hug can cause an episode of excruciating pain lasting several days.

Treatment of fibromyalgia are as varied as the diagnosis and apparent cause. Since there is no singular reason biophysiological, how can be a cure or a single treatment protocol? While researchers continue to examine their results, providers of the medical profession and alternative medicine continue to discuss the best course of action to take. In each of these sects, and alternative med to med other debates abound. You must meet all agree this is to restore the proper sleep habits, treatment of depression and increased exercise is a great advantage.

The medical profession is divided over the treatment of a number of fronts. Those who believe in psycho-Factor tend to be treated with antidepressants and sleeping pills and nothing else. Other narcotic analgesics are added. Some believe that non-steroidal analgesics are effective while some conclude that any works. Dr. Goldenberg believes, "Drugs that affect pain perception, sleep and mood were useful and should be incorporated into the activity, exercise and educational programs." Dr. Devin J. Starlanyl believes guifenesin a common expectorant in cough syrup against the specific dose to be effective. Also follows the recommendations of exercise and education.

Here's another group occurs in this type of exercise is appropriate. Some recommend aerobic, cardiovascular intensive exercises, some believe in the strength training or extensible slow guys like Tai Chi or yoga.

Some health professionals informed as Dr. Christine Fritsch, MD, Kaiser-Permanente Northern, Dr. Bill Sieber research cortext CA, or chiropractors like Dr. Harvey Eckhart Santa Rosa, clinical preventive care also finding value of CA dietary supplements. Dr. Fritsch recommends bromelain and chondroitin to reduce inflammation and support the integrity of the joints. Dr. Eckhart examines the effects of enzymatic digestion of activator proteins and antioxidant formula formula, on the basis that many believe that the inability to properly digest proteins and free radical damage are two major contributors to the FMS.

Dr. Sieber suggests the use of omega-3, using a high protein, low carb, and the addition of vitamin C and magnesium. Low doses of antidepressants may be useful in pain control, and melatonin for better sleep. Dr. Sieber also briefly at the National Institute of Health (NIH), which advocates the use of cortisone injections in CFS or FMS, on the evidence of use of Epogen, a drug normally used to treat heart failure and accompanying renal anemia in patients with HIV, and the use of the herb licorice in the diet, but not to admit first hand knowledge of their use. In communities of herbs, licorice is known for its tonic properties specific for pain, energy and digestion.

Dr. David Darbo, MD Medical Center Indianapolis firm in his conviction that magnet therapy is beneficial for nine out of ten people in the general population. Magnets are believed to support the general welfare by supporting the body's natural processes of relaxation and stimulation, and allows body cells to function at an optimal level. The fact that mostly work in the selection of cases of chronic fatigue, pain and insomnia, make the call to the big FMS patients.

Dr. Samuel K. Yue, MD and director of the Pain Center of Minnesota in St. Paul, was to test the effects of the hormone relaxin as treatment. Its premise is that the beginning of the FMS is connected to a systemic hormone deficiency, or the body's inability to utilize existing hormone because of autoimmune antibodies or defective cellular reception. Relaxin is known to perform muscle and connective tissue integrity, but tests so far have been inconclusive.