May is Fibromyalgia awareness month!
American Arthritis Foundation Delivering on the Promise in Fibromyalgia
Did You Know?
* Fibromyalgia is characterized by chronic, widespread, musculoskeletal pain and multiple tender points. People with fibromyalgia also frequently suffer from profound fatigue, sleep disturbances, cognitive difficulties, anxiety and depression.
* Fibromyalgia affects an estimated 3.5 million Americans. Women are seven times more likely to develop fibro-myalgia than men. Fibromyalgia can affect individuals of any age, including children and the elderly.
* Studies have reported disability rates as high as 44 percent in people with fibromyalgia.
Current treatment includes medications to relieve pain and improve sleep and exercise.
The causes, underlying pathologic processes, and optimal treatment of fibromyalgia are not yet well understood. There is increasing evidence that abnormalities of the nervous system involving heightened pain perception play a role in its development. The pain intensity that people with fibromyalgia report correlates with changes that can be detected in the brain. Researchers are focusing on trying to better understand the role of chemicals such as hormones and neuropeptides, which convey pain messages from nerve cells to the spinal cord and the brain. Two such chemicals shown to be altered in fibromyalgia are substance P, which initiates pain signals after injury, and serotonin, which tones down the intensity of pain signals. Studies have shown elevated levels of substance P and low levels of serotonin in people with fibromyalgia.
Investigators have also found alterations in the stress response of people with fibromyalgia. The stress response is a mechanism that allows for interactions between the brain and body to help people respond to physical and emotional challenges. Researchers are also interested in examining in the role of environmental factors in fibromyalgia. Fibromyalgia can be triggered by musculoskeletal pain due to arthritis or injury. Almost 20 percent of people with rheumatic diseases, such as systemic lupus, osteoarthritis or rheumatoid arthritis, also have fibromyalgia. Certain types of infections, such as Lyme disease, can also trigger fibromyalgia. Ongoing research aims to determine what factors may make certain people susceptible to fibromyalgia. Behavioral research has begun to identify important non-drug approaches to fibromyalgia treatment such as using behavioral therapy to enhance coping skills, instituting an exercise program, or improving sleep habits to help improve quality of life. Determining new and optimal treatments for fibromyalgia is an important part of the research effort.
Arthritis Foundation-funded research is improving the lives of people with fibromyalgia by:
* Increasing our understanding of the role of neuro- logical and psychological factors in fibromyalgia, which could help lead to advances in treatment.
* Evaluating coping interventions to help people with fibromyalgia take control of their condition.
* Evaluating the role of treatment options including exercise, medications, and complementary and alternative therapies in fibromyalgia.
Despite frequent reports that poor memory is a cause of disability and poor job performance in fibromyalgia, very little is known about memory abnormalities in people with fibromyalgia. Denise Park, PhD, at the University of Michigan is comparing people with fibromyalgia, people with chronic fatigue syndrome, and healthy controls with similar educational backgrounds.
Preliminary results showed that people with fibromyalgia had significantly more memory problems than adults their same age and similar to those 20 to 30 years older.
Roland Staud, MD, at the University of Florida, is conducting a clinical trial to evaluate different interventions including exercise, a COX-2 inhibitor and dextromethorphan (a cough suppressant). This study should help enhance treatment options for people with fibromyalgia.
An Arthritis Foundation-funded research project at Harvard Medical School is examining different approaches to managing pain and fatigue in people with fibromyalgia. Daniel Rooks, PhD, is comparing three self-management programs: the Arthritis Foundation's Fibromyalgia Self-Help Course, a group exercise program specially designed for people with fibromyalgia and a new program that combines exercise and several lifestyle activities. The study will clarify which approach is most cost-effective in improving health and function.
The persistent pain in fibromyalgia may be due to abnormalities in neuropeptides that convey pain messages. Preliminary findings of a study being conducted by Brent Appleton, MD, at the University of Michigan, have shown that people with fibromyalgia have changes in levels of certain types of neuropeptides. The study will continue to explore the significance of these differences and how levels of neuropeptides in the spinal fluid are related to stress hormones. This research may help identify more suitable and effective pain treatments.