Fibromyalgia: The basics

I realized when hunting through posts that I have not done a good solid what the hell is fibromyalgia post (according to currently acknowledged information). So here it comes…

Fibromyalgia is a condition where the pain processing system is faulty in the brain so that we feel pain faster, longer, and where there is no pain at all. It is characterized by widespread pain. That doesn’t mean, though, that we cannot have places where pain is more severe, only that, yes, we tend to have baseline pain all over. What they know is the pain starts in the brain and pain processing. The syndrome varies from person to person and through one’s own lifetime. One person can be disabled by it while another can cope and function within limitations. One person can have severe pain while another severe fatigue.

fibromyalgia pain

Research has indicated that people with FM have as much as three times the levels of a brain chemical called Substance P which is responsible for sending the pain messages to the body. Due to sleep dysfunction cortisol has shown to be low during the day and higher at night leading to daytime fatigue and evening insomnia. Low levels of growth hormone due to lack of quality sleep could be responsible for some of the muscle pain felt. Hubpages

The Canadian Fibromyalgia Guidelines has this to say about causal factors: “Abnormalities in pain processing have been identified at various levels in the peripheral, central, and sympathetic nervous systems, as well as the hypothalamo-pituitary-adrenal (HPA) axis stress-response system. Documented abnormalities include evidence of peripheral sensitization and wind-up phenomenon, central sensitization with changes in functional MRI and SPECT scans of the brain, increased levels of substance P in the cerebrospinal fluid, and impairment of descending noxious inhibitory control (DNIC) [111-118].Familial studies point to some genetic predisposition with up to 26% of relatives of patients with FM reporting chronic widespread pain (CWP), and FM diagnosed in 28% of offspring of FM women [119, 120]. Genetic factors may predispose some individuals to a dysfunctional stress response via the HPA axis [121]. While no individual gene has been associated with FM, there is increasing evidence of a polygenic effect, with polymorphism of genes affecting serotoninergic, catecholaminergic and dopaminergic systems playing a role [122, 123].Psychosocial distress has been shown to predict onset of chronic widespread pain in population studies conducted in England [124, 125]. Early life adversity is linked to chronic widespread pain in adult life [126]. Abuse, which may have been sexual, physical or psychological, particularly in childhood has been reported with greater frequency in FM patients than controls [127-129]. These numerous interacting factors may be the setting in which a stressful event, which could be physical such as a viral illness, traumatic, or psychological, can lead to a vulnerable health status and may be a trigger for FM as reported for nearly a quarter to a third of persons with FM [130].”

It is not (as of currently known research)

  • Autoimmune
  • Arthritis

But there has been research indicating neuro-inflammation. There is, to date, no known cause of fibromyalgia.

Fibromyalgia: The basics

The statistics

  • Prevalence is about 3-6% of the world’s population
  • 80-90% are women, however, men and even children can have FM
  • It statistically leads to a lower quality of life. 40% less physical functionality. 67% less mental health.
  • 3 times more likely to have major depression
  • High death rate from suicide and injury
  • And a higher rate of getting other rheumatic conditions
Source: http://www.cdc.gov

Three types of fibromyalgia pain are:

Hyperalgesia: this is our major pain as part of the syndrome itself. It is an abnormal sensitivity to pain. This is what is causing us to feel pain faster, longer, and more severely than normal people

Allodynia: With allodynia, there is a triggered pain response from stimuli that does not normally cause pain. It can feel like a very mild sunburn to excruciating flesh pain. Just touching the skin can cause immense pain and clothes can be agonizing when severe. Often tramadol and topical Lidocaine are recommended.

Paresthesia: Causes the ‘pins and needles’ sensations, an itch, tingling, prickling and numbness. And can cause pain.

Primary symptoms (There are a lot of potential symptoms given nervous system involvement, however, these are the primary ones needed for diagnosis)

  1. Widespread pain for over 6 months (They used to do a tender point test but that is no longer a requirement for diagnosis)
  2. Cognitive dysfunction– also known as ‘fibro fog’- we can have issues with short-term memory, long-term memory, working memory, vocabulary issues, and concentration among other things.
  3. Sleep issues– People with FM have been shown to have disrupted stage four sleep. This means while they can sleep for eight or ten hours they still wake up feeling tired because the sleep is not restorative since stage four sleep is where energy is recovered and muscles are repaired. However, we can also have delayed onset insomnia, frequent wakings, restless leg syndrome, sleep apnea.
  4. Fatigue– fatigue is more than tired. It is more than rest can resolve. It is a heavy physical feeling like you are dragging your body through the day.

Medications

There are three medications specifically used for fibromyalgia and a lot more off-label ones.

  • Duloxetine (Cymbalta)
  • Milnacipran (Savella)
  • Pregabalin (Lyrica)

Other than medication a routine of exercise is recommended. However, this may take time and you may have to start quite slowly and work your way up to prevent severe flares of pain and fatigue. It is often also recommended we take Vitamin D and Magnesium. (I use FibroCane as a supplement myself)

Comorbid conditions (conditions that can occur with fibromyalgia)

  • IBS (Irritable Bowel Syndrome)
  • IBD (inflammatory bowel disease)
  • Migraine
  • ME/CFS (chronic fatigue syndrome)
  • Sleep disorders: RLS (Restless leg syndrome), sleep apnea, insomnia
  • Depression- up to 70% have had a depressive episode
  • Anxiety- 47% will have a panic disorder, 60% will have some sort of anxiety issue
  • TMJ
  • Environmental sensitivities
  • Endometriosis

Triggers (there is the idea that Fibromyalgia can have initiating causes that trigger it)

  • A hereditary component is seen in families (research has even been looking at a possible genetic link)
  • After a physical trauma to the body
  • After acute illness
  • After acute injury
  • Psychological stressors such as early life trauma

See other fibromyalgia posts:

Fibromylagia introduction post: all the posts you need in one post

Challenges of fibromyalgia

Fibromyalgia is more than pain
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14 comments

  1. Very thorough! I just did a ‘what the heck’ is fibro post. And I fear I may have come off as obtuse. Yes, fibro is all-encompassing, screw with every aspect of your life, complicated syndrome. BUT, I said to ‘just keep it simple’. Now I wonder if I have done an injustice to the severity of what fibro is… crap. I’m going to repost. This post is incredible!!! Thanks Nikki!

    Liked by 1 person

  2. appears to be all the essential contemporary information on this ailment. Lends understanding to those unfamiliar with the suffering involved. Thanks for informing.

    Liked by 1 person

      1. well construed in form; thourough in depth. An information fountainhead for anyone seeking to know more about it; or for anyone passing through. Raising awareness and understanding/reducing ignorance/ eliminating confusion/ improving support networks. I have troubles too – but i so ❤ you folks. Good work Nick; good post.

        Liked by 1 person

      2. It will be a reference post for the newly diagnosed. I hadn’t realized I never made one. So I put it in my fav section so people can find it as needed

        Like

      3. I imagine it will be a great help for a lot of people, especially those that are just learning that they have the illness, where information is going to feel as though at a premium; and probably will be. That’s a good place for it, right up front, so to speak – where after a search or link click folk can eye tag it immediately – get help right away; help others. Very good thing Nick, Fine work.

        Liked by 1 person

  3. Great, thorough and very informative post. It’s truly astonishing how one illness can ravage every aspect of your life. For those newly diagnosed, I think this is a really good overview, without being scary, to explain how all encompassing Fibro can be. Thanks!!

    Liked by 1 person

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