Fibromyalgia

The Mayo Clinic defines Fibromyalgia as “a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues.” Fibro is a Latin term used for fibrous tissue, myo is the Greek base word for muscle, and algia is the Greek base word for pain. The primary terminology used to describe the type of medical issue that Fibromyalgia is labeled as is a musculoskeletal disorder.

Fibromyalgia is an issue with the central nervous system, the brain and the spinal nerves. Fibro patients have a surplus of an overactive neurotransmitter referred to as substance P. This neurotransmitter is found in the spinal fluid and is part of the transmission and processing of the signals relating to pain being taken to and from the brain. With the excess of substance P, there is an excess of pain reactions by the body. Fibro patients also tend to have low serotonin (behavior, wants, needs, etc.) and dopamine (the “reward” chemical) neurotransmitter levels but excessive norepinephrine (fight or flight, anxiety, blood pressure regulation) neurotransmitter levels. These all cause a higher sensitivity to pain and overreaction to pain and any other neurological stimulations and senses.

The way I describe Fibromyalgia to people is to picture the nervous system as electrical wiring through your body. Picture the brain as a fuse box. With Fibro, the wires have spots where the protective rubber or plastic is missing and the wire is exposed, maybe even frayed. What happens is that occasionally these wires touch or an arch of electricity jumps from one wire to another. This causes lights or outlets that the wires go to flicker or buzz, and in some cases, even trip the breaker in the box. So when the wires touch or arch, our nervous system is sparking. This is why we feel random pain or worse pain than normal. This also results in other sensations like temperature issues (being too hot or too cold or unable to handle one or both easily), skin sensations that feel like tickling or spider webs, burning sensations, numbness and tingling, spasms, and so on. A flare or fog would be the instances where the breaker is “flipped” or the fuse blows. This same analogy can be used to refer to the psychological aspects of Fibromyalgia. Chemicals in the brain are pumped at levels that are unnaturally high or unnaturally low. This combined with the pain and overactive nerve sensations (especially since there is no visible rash, bruise or sign to explain the feelings) can cause anxiety and depression. Outside factors like dependency on medication, inability to do things you used to do or want to do, and how people react towards you can also influence the psychological aspects of Fibromyalgia, which in turn can make the physical symptoms worse and on and on in an endless cycle.

Common Symptoms

  • Fatigue
  • Waking up tired/unrested
  • Insomnia
  • Difficulty sleeping and staying asleep because of pain
  • Migraines
  • Tension headaches
  • TMJ (temporomandibular joint disorders)
  • IBS (irritable bowel syndrome) (chronic constipation and/or diarrhea)
  • Anxiety
  • Depression
  • Widespread pain
  • Cognitive difficulties and dysfunction
  • Abdominal pain and cramping
  • Joint pain and stiffness (especially upon waking or after being immobile for a bit)
  • Muscle pain
  • Low pain threshold
  • Sensory sensitivity (light, sounds, smell, touch, taste)
  • Temperature sensitivity and difficulty regulating (freezing, overheating, etc.)
  • Muscle spasms
  • Costochondritis (chest pain and sensitivity)
  • Memory problems
  • Numbness and tingling in hands and feet, or other parts of the body
  • Restless leg syndrome
  • Skin sensitive to touch (itchy, burning, and/or pain)
  • Concentration issues
  • ICS (interstitial cystitis) or bladder pain and/or frequency
  • Reduced exercise due to pain or fatigue it causes
  • Swelling or the feeling of swelling (even if there isn’t any)
  • Rashes
  • Dry eyes and/or mouth
  • Dry skin
  • Issues with coordination/balance
  • Cramps in muscles
  • Menstrual pain
  • Pain or sensitivities with or after intercourse (muscular, higher sensitivities)

Diagnosis

Fibromyalgia is one of those wonderful conditions that do not have a strong and definitive test. Usually with Fibro, the doctors have to rule out other possible conditions first. Once most other conditions (Lupus, Lyme, CFS, MS, etc.) are ruled out, then the doctor may do a “trigger point” test. This is when the doctor presses on 18 specific points on the human body to see the reaction. If a person responds strongly to 11 of the 18 trigger points, they are usually diagnosed as having Fibromyalgia.

Currently, though, researchers in Sweden and Australia are working on a blood test to be used to test for Fibro. This test finds a specific genetic marker that is similar to Rheumatoid Arthritis but slightly different. It is believed this marker may be the actual genetic tag for Fibromyalgia. If this is true, then future generations will have a much easier time being diagnosed without facing the ridicule and disbelief that many of us still have to deal with, as well as the constant tests and procedures used to rule out other possible culprits.

Fibromyalgia is considered a genetic disorder. The disorder affects more women than men at a ratio of about 7 women for every 1 man. The disorder also usually shows itself later on in life and is rarer to find in children. Doctors are still unsure of the exact cause of the issue or what sets it off. Currently, it is believed that traumatic physical or mental events, severe infections, and even slow build-up throughout one’s life, lead to the activation of Fibromyalgia. I say “activation” because if you have Fibro, you were born with Fibro. It can lay dormant in a person until they die. Many more people possibly have Fibro but it has never fully manifested itself strong enough to become a problem.

Unfortunately, as the years have progressed, the prevalence of the disease is rising and the age at which it is active is dropping. More and more people at younger and younger ages are being diagnosed with Fibromyalgia. There is some concern that this has become a SIDS-like diagnosis. SIDS, or sudden infant death syndrome, was a term that referred to the unexplainable death of infants. The term is rarely used anymore because we now know that, most of the time, there is a reason for the death that is explainable. For a while, though, doctors used SIDS as a sort of “throw away” answer to cases of infant deaths that they could not figure out. Many people worry that this might be happening to Fibromyalgia. There is a possibility that with the use of the internet to research terms and symptoms and self-diagnosis, as well as the difficulty in proving the actual presence of Fibro, doctors use the diagnosis to either appease a patient that may be a hypochondriac or to try to put a name to a problem they can’t figure out. This is unfortunate, as many of us still face the fact that other people think we are the hypochondriacs and that this is just “all in your head.”

One of the harshest truths about Fibromyalgia is that there is no cure. There is also no one treatment that works for everyone, as well as no known treatment that completely helps with every symptom of the condition. There are prescription medications that help some people with some of the symptoms, lifestyle changes that can help with other symptoms, and over the counter medication that may help some people deal with the rougher days. All medications have side effects, many are very expensive and not covered by insurance, and there are always difficulties in changing your lifestyle to help cope with the condition.

 

(Taken from The Fine Print of Fibro by Amanda Boyce)

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