Healthy Living

Cracking the Fibromyalgia Case!

Fibromyalgia has confounded researchers and doctors for decades. Here's everything we know about the condition so far.

Cracking the Fibromyalgia Case!

Fibromyalgia is a difficult condition to diagnose. The depression, anxiety, brain fog, fatigue and pain that affect those with this condition has baffled the medical community for decades. However, researchers are making progress toward understanding fibromyalgia's complexities.

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In a fact sheet by the Mayo Clinic, the primary symptom of fibromyalgia is the chronic musculoskeletal pain. Sever pain is often accompanied by persistent fatigue, trouble sleeping, plus depression, stress and feelings of lost hope and anger. The cycle of fibromyalgia is constantly repeated.

About 5 million Americans adults experience fibromyalgia. There is no definite cause of the syndrome. It might be a condition that is a corollary disorder involving pain signals sent out by the brain. Medical professionals conclude that symptoms often occur after patients experience chronic illnesses, injuries, surgery, and poor mental health. Extreme stress or depression also seem to cause fibromyalgia.

Other risks of contracting fibromyalgia may include family history or chronic conditions such as osteoarthritis. Women are at high risk of fibromyalgia, and according to the NIAMS fact sheet, 80 to 90 percent of all fibromyalgia incidents involve women.

What Makes Fibromyalgia Hard to Diagnose?

Symptoms vary between patients, and this alone makes the condition difficult to diagnose. In a study of patients and medical professionals by Briones-Vozmediano et al., it was concluded  that there is no standardized diagnosis or treatment protocol for fibromyalgia.

If you go into your doctor claiming you have fibromyalgia, you might receive a stupefied look wondering where you came up with that self-diagnosis. There are no standards for recognizing fibromyalgia. Many doctors and nurse practitioners (NP) are also very reluctant to diagnose it. Symptoms are very similar to other conditions and misdiagnosing a condition could delay treatment.

In a study published in the Journal of Orthopaedic Nursing, 66 nurse practitioners were surveyed and most had little experience in making an accurate diagnosis of fibromyalgia. Research said that about 76% of the respondents had to take time out of their busy schedules to learn about fibromyalgia. The conclusion? More education on the disease is needed to understand how to diagnose and treat the disease.

It is common for rheumatologists to be the medical specialist who finally diagnoses fibromyalgia, and this diagnosis comes after other conditions are ruled out. Fibromyalgia can be diagnosed as a temporomandibular joint disorder, chronic pelvic pain like interstitial cystitis and irritable bowel syndrome. These conditions have no discernable cause, either. It is almost a “toss the coin and hope it ends up heads” diagnosis.

Researchers are developing a schematic of fibromyalgia as a pain disorder caused by many individual causes. This plan will help with a better diagnosis of fibromyalgia, but it is still under construction.

Is Fibromyalgia Real?

As someone who suffers from fibromyalgia, the pain, exhaustion, brain-fog, and inability to feel “better” cause disruption to everyday lives. Patients with fibromyalgia need a definite diagnosis and suitable treatment.

“Fibromyalgia is very similar [to epilepsy], in that we have patients who complain of pain and other mysterious symptoms and are studied by physicians who find nothing wrong,” so they often dismiss or ignore the patients,” Serra says.

This dismissal causes patients to feel crazy and frustrated. While new findings of peripheral nerve damage offers no cure or a treatment these findings do represent that fibromyalgia is quickly becoming a condition that is recognized and validated.

The stress and trauma of fibromyalgia are real. Researchers still do not know why stress and trauma is a part of fibromyalgia, but psychology is associated with chronic pain. Researchers are investigating if substances are circulating in the blood that causes stressors to affect pain in those with fibromyalgia.

Perhaps stress hormones and inflammatory molecules released by immune cells in the brain or the body cause fibromyalgia? It's an interesting question.

Where Does Fibromyalgia Pain Originate?

Researchers classify pain into different categories. Nociceptive pain is the terrible pain that comes from an immediate injury. Inflammatory pain results from immune cells activating a condition, and neuropathic pain that comes from nerve damage resulting from chemotherapy, diabetes, or the brain. Fibromyalgia does not fit into these categories even though it resembles inflammatory or neuropathic pain.

This challenge has caused doctors to find a new category of pain for fibromyalgia. According to Daniel Clauw, a rheumatologist at the University of Michigan at Ann Arbor, “The term that we prefer is ‘centralized pain,’ meaning that pain clearly is coming largely from the brain rather than from out in the periphery.”

Doctors and researchers state that all chronic pain conditions cause changes in the brain and every experience of pain comes from the brain. The question is, what exact pathological process causes the problems of fibromyalgia and are these processes reversible?

In 2013, a study was published listing the evidence of damage to the small nerve fibers that transmit pain signals from the skin in those with fibromyalgia. Dr. Claudia Sommer, University of Wurzburg, Germany, found dysfunctional nerve activity in 25 patients with fibromyalgia. She used sensory testing with hot or cold stimuli and electrical recordings of peripheral nerve activity. Skin biopsies revealed withered nerve endings in patients with fibromyalgia. Could this be a breakthrough?

Two other studies showed the same results and suggested that damage to or dysfunction of peripheral nerves contributes to the pain of fibromyalgia. Still, there is more research to be done and treatments to be developed.

Research and Findings

Medical scientists agree that fibromyalgia – characterized by pain fatigue, cognitive, and emotional disturbances  - might result from the “chronic pain track.”

“Fibromyalgia is the endpoint—the end of the continuum,” says Clauw. “And maybe we can prevent people from getting there if we identify their risk early and treat aggressively,” which might include anti-depressant medications shown to improve fibromyalgia pain in some patients, according to Clauw.

Minimize the pain of fibromyalgia by these taking four steps.

  1. Prevent injuries and other traumatic events that lead to pain. Avoiding traumas and stress is not always possible, but if you have fibromyalgia, you need to avoid stressful or harmful situations.
  2. Physical exercise conditions the body against pain.
  3. Sleep will shield you from pain. You need high-quality sleep. Use doctor prescribed or natural sleep aids if you must.
  4. Find psychological coping skills to protect your body against pain. Learn to adapt to stress. Try mindfulness, cognitive-behavioral therapy, and supportive social activities.

These steps might not be possible if you are suffering from debilitating pain, but the key is for patients to play an active role in their treatment. Those with fibromyalgia need to manage their condition helped with the help of their doctors. You are the only one who can improve your sleep patterns and exercise. You are the only one who can control your diet. If you try to manage pain, you will empower yourself to reduce stress.

The most encouraging words for those with fibromyalgia comes from Dr. Clauw. He stresses, “The notion that there’s nothing we can do for people with fibromyalgia is just wrong. When you look at everything available, there is almost always something that will help. It’s important to try different medications and nondrug therapies because which treatments may work will vary from person to person.”

Researchers stress that the windows are getting answered about the causes and treatment of fibromyalgia. Windows are opening, and new possibilities are emerging due to research and testing.