Fibromyalgia

Fibromyalgia: Battling the Pain

Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue and tenderness in localized areas. Typically, tenderness occurs in the neck and back as well as in the extremities, and even the slightest touch can lead to an immense amount of pain. The disorder was originally referred to as muscular rheumatism and identified in the 1600s. Then, in 1816, Dr. William Balfour gave the first comprehensive description of the condition. The term fibrositis was coined in 1904 by Sir William Gowers. That label stooduntil 1976, when fibromyalgia became the common moniker for the chronic pain of the disorder (Peers & Perspectives).

Modern physicians most commonly diagnose the condition in women between the ages of 30 and 50. That’s not to say that men cannot have fibromyalgia, however. Patients who discover are experiencing the symptoms of fibromyalgia complain of persistent pain that can be accompanied by stiffness. In addition to pain and tenderness, common symptoms associated with fibromyalgia include fatigue, anxiety, depression, endometriosis, headaches and irritable bowel syndrome. Some also experience increased sensory sensitivity to noises, bright lights, smells and touch. In fact, these symptoms are sometimes likened to the pain and sensory overload experienced during a migraine headache.

The underlying issue with fibromyalgia is chronic pain, which can be complicated by central sensitization as caused by inflammation. That inflammation triggers the peripheral nervous system to send increased signals along the central nervous system, leading to abnormal levels of neural excitement. This, in turn, is what presents as low tolerance to light, sound and touch; the body is overly aware because it’s always “on.” There’s no down time for a person suffering from fibromyalgia.

For those who are plagued with the symptoms of fibromyalgia, they often have challenges obtaining an accurate diagnosis. They may be misdiagnosed with chronic fatigue syndrome, nerve damage, arthritis and even hypochondria. While the American College of Rheumatology has established general guidelines for the diagnosis, a key requirement is

that the symptoms must have been ongoing for at least three months. Even more, the patient must have 11 of 18 specified body location

s exhibiting keen tenderness and pain. If not all of the criteria are met, the diagnosis is changed from fibromyalgia to myofascial pain syndrome. This diagnosis incurs a treatment methodology that closely mirrors that for fibromyalgia.

Treating the Pain of Fibromyalgia

While there is no outright cure for fibromyalgia, there are a number of viable treatments. The most significant components of treatment include managing the pain and turning off the always-on nervous system. A key — yet sometimes silent — side effect of the ailment is the strain that is placed on one’s emotional wellbeing. Constant pain can take a major toll on both the individual who is suffering as well as on his or her loved ones. Depression is often associated with fibromyalgia because of the constant discomfort and general lack

of support in some cases. When a person feels isolated because of a disease that can be hard to prove to lay persons, his or her sense of devastation can increase exponentially. Some studies have even shown that patients with fibromyalgia show an increase in suicidal thoughts due to the nature of the disease and the lack of a foreseeable cure (Lorden Myers). Family members as well as medical professionals need to be wary of potential emotional issues associated with fibromyalgia, especially if the pain goes untreated.

Doctors have successfully managed both the physical and emotional symptoms associated with fibromyalgia through drug treatments. Medicine has shown a significant impact on improving patients’ lives, often causing a remission from pain. Commonly prescribed medications include antidepressants, analgesics or acetaminophen, muscle relaxants, membrane-stabilizing drugs and sleeping aids. Although medication alone can sometimes be prescribed, physicians will often choose to take a more holistic approach, incorporating acupuncture, physical therapy and even exercise and other activities to get the body moving (Rooks, 2007).

Sometimes referred to as “alternative healing,” more natural treatments have been shown to offer significant relief for the symptoms of fibromyalgia. A naturopath may work in harmony with a more Eastern-trained physician, incorporating other healthcare professionals to suggest a variety of approaches including physical therapy, acupuncture, chiropractic, yoga, massage therapy, meditation, prayer, exercise, trigger-point injections, aqua therapy, transcutaneous electrical nerve stimulation, application of heat and cognitive-behavioral therapy.

The effects of partnering medicine and other therapies on they symptoms of fibromyalgia have proven to substantially reduce the physical and emotional pain that plagues patients. In fact, some treatments even introduce herbs, supplements, and tinctures; ginkgo biloba, for example, has been shown to improve sleep (Lister, 2002).

The Future of Fibromyalgia Treatment

As physicians and natural healthcare professionals work to minimize the suffering of fibromyalgia, they continue to seek out new treatment options. Since 2007, the Food and Drug Administration (FDA) has approved three medications for use with fibromyalgia patients: Lyrica (pregablin), Cymbalta (duloxetine), and Savella (milnacipran) (Peers & Perspectives). In addition, clinicians continue to test new modalities for their efficacy in reducing both the physical pain and emotional upheaval caused by fibromyalgia.

In South Africa, a trial was conducted using Botox (Botulinum toxin A) for the treatment of fibromyalgia. Of the 16 patients who received Botox injections, a number felt pain increase in different parts of the body, where they did not receive the injections. Others, however, did feel some relief following the treatment. Until the FDA approves this alternative for use in fibromyalgia cases, more clinical trials will be needed to determine both the safety of this course of action along with potential side effects.

Dextromethorphan, commonly found in over-the-counter cough and cold remedies, is currently being studied for its possible efficacy, along with lidocaine and ketamine. Unfortunately, none of these drugs has been proven effective, but the search continues to identify long-term relief for patients suffering from fibromyalgia. Patients who are experiencing this problem should seek out treatment from a local pain clinic that specializes in fibromyalgia.

Resources

  1. Fibromyalgia Treatment Update. PMID: 17278924. Curr Opin Rheumatol. 2007 Rooks DS. Mar;19(2):111-7. Study finds acupuncture improves fibromyalgia symptoms. PMID: 17102788.
  2. Mayo Clin Womens Healthsource. 2006 Dec;10(12):3. Improvement in fibromyalgia symptoms with acupuncture: results of a randomized controlled trial. PMID: 16770975 Mayo Clin Proc. 2006 Jun;81(6):749-57.
  3. Effectiveness of Massage Therapy for Chronic, Non-malignant Pain: A Review. PMID: 17549233 Evid Based Complement Alternat Med. 2007 Jun;4(2):165-79. Epub 2007 Feb 5 Tsao 2007
  4. Fibromyalgia syndrome: review of clinical presentation, pathogenesis, outcome measures, and treatment. PMID: 16078356 J Rheumatol Suppl. 2005 Aug;75:6-21. Mease 2005
  5. An open, pilot study to evaluate the potential benefits of coenzyme Q10 combined with Ginkgo biloba extract in fibromyalgia syndrome. J Int Med Res. 2002 Mar-Apr;30(2):195-9 Lister 2002
  6. Peers & Perspectives, www.MDMag.com
  7. Lorden Myers, Lisa. Killing Me Softly: FM/CFS & Suicide.