Understanding Fibromyalgia
(EXERPT FROM THE ABMP SUCCESSFUL
BUSINESS HANDBOOK)
Once thought to be a psychosomatic
expression, FMS is now recognized as a systemic disorder. It is estimated that between that between
3-6 million Americans suffer from FMS, but some experts suggest those numbers may
be even higher. For FMS patients, the
syndrome invades every aspect of life.
It is chronic, rarely ends in remission and has no consistently
effective medical treatment. The good
news is that FMS is non-degenerative and non-progressive.
Although symptoms generally begin gradually, in some cases there is a relatively sudden onset following a specific event, such as stress, physical or mental trauma, or infection. The symptoms are diverse and can change in any individual on a day-to-day basis. Trigger point pain is the most characteristic feature. Although there is joint stiffness and a swollen feeling, patients have no visible signs of swelling. They also experience depression and anxiety, but this is considered a result, not a cause of the disorder. While fatigue, non-restorative sleep patterns and stiffness on walking are reported in at least 75% of cases, each case differs considerably in severity of pain and fatigue symptoms and in functional ability.
Overall, FMS sufferers experience greater sensitivity,
not just to pain, but also to loud noises, odors and/or bright lights. There can be non-cardiac chest pain, urinary
urgency, sinusitis and tension headaches, excessive menstrual pain, strange
sensations in arms and legs, and irritable bowl or bladder syndrome.
Research has shown that FMS patients have
abnormal EEG patterns during sleep and lower levels of growth hormone. Higher levels of a substance involved in
pain transmission and lower amounts of serotonin, the chemical related to
sleep, mood and pain regulation, have also been associated with disorder.
Speculation about the cause of FMS centers
on an imbalance in neurotransmitters in the spine or brain, possible trauma to
the central nervous system, or an infectious agent that triggers the response;
but the exact cause remains unknown.
Experts question whether it is a homogenous
condition or one in which the clinical picture is an expression of other
conditions. It can be precipitated or
increased by stress, cold weather and exertion. The second most common diagnosis in rheumatology, FMS occurs
primarily in women of child-bearing age, but can also affect children, men and
the elderly.
Although there is no cure for FMS today, some treatments can help moderate the symptoms. Most physicians prescribe a combination of medication and non-pharmacologic approaches. The most successful medications appear to be those affecting the neurotransmitter metabolism at the receptor site. Antidepressants and selective serotonin reuptake inhibitors have been used with less success. Although FMS can mimic signs of inflammation have not been terribly effective in fighting pain.
The most successful strategies seem to be
those that teach patients how to relax, manage stress and gain mental
control. Also, studies have shown that
aerobic exercise, such as swimming and walking, can reduce some of the pain and
improve muscle tone. In a recent survey
of more than 300 FMS patients, it was indicated that therapeutic massage every two weeks was possibly
the most effective adjunct therapy to keep them functional and employed.
Scientific research regarding the effects of
massage for FMS symptoms has been limited, but promising. One study, published in 1999 by the European
Journal of Pain focused on the use of connective tissue massage. In a series of 15 treatments, subjects in
the massage group experienced a pain-relieving effect of 37%, reduced
depression and use of analgesics and a positive impact on quality of life. The effects appeared to decline over the
treatment period of 10 weeks. Three
months after treatment 30% of the pain-relieving effect was gone and six months
later pain was back 90% of the base level at the beginning of the study.
Despite scant research into the use of
massage, FMS patients are often very enthusiastic. Massage provides a positive adjunct to traditional therapies that
by themselves often don’t provide adequate relief from symptoms.
To find more on fibromyalgia, go back to ‘CONTRAINDICATIONS’
for additional links.