Fibromyalgia is death by disease
Although there are many ongoing speculation about what triggers fibromyalgia, its causes have not been definitively identified and confirmed. Recent research has generally found that fibromyalgia is probably the result of what scientists call the central sensitization, or unusual reactions in the nervous system in relation to the perception of pain.
biochemical triggers fibromyalgia
“The consensus [current] is that fibromyalgia is not a problem with the muscles, joints or tendons, but a problem with the central nervous system,” says Dr. Bruce Solitar, associate professor of clinical medicine in the division of rheumatology NYU medical Center / Hospital Diseases common in New York. While it is easy to think that the pain experienced by a person who has suffered physical damage to the body could be classified as purely psychosomatic, feelings that fibromyalgia patients experiences are as real as any other pain.
This was clearly demonstrated when the researchers did MRI scans of patients with fibromyalgia. Pressed in certain areas of the body of the participants, they found a significantly increased activity in the pain center of the brain. One theory attributes this to an increased release of substance P, a chemical that activates the nerves when a painful stimulus. “In patients with fibromyalgia, substance P is released, even in the absence of a painful stimulus. And there seems to be an amplified version when a painful stimulus, “says Dr. Solitar. In addition, the regulatory effect of the brain, which sends signals to “Low” to turn off the pain be abnormal in people with fibromyalgia – So when a painful stimulus, which is amplified rather than wet occurs.
physical and emotional triggers fibromyalgia
So what causes the nervous system to malfunction, then? Scientists are not sure, but a number of conditions have been associated with the development of fibromyalgia. These include:
With the virus and the viruses that cause influenza and hepatitis B and C, Epstein-Barr have been involved in the development of fibromyalgia. “These viruses can have [long – long term effects] on the immune system. It is also possible that the viral particles bind to glial cells, which are cells! Brain that affects neurotransmission [and influence the response to pain], “said Dr. Solitar. In addition, there is an established relationship between Lyme disease (caused by a bacterium called Borrelia burgdorferi) and Fibromyalgia: Some patients were treated for Lyme – and apparently recover – continue aexperimentar abnormally high frequency of the pain he characterizes fibromyalgia.
Sometimes, the development of fibromyalgia are associated with physical damage, inparticular in the upper spine (neck). In other cases, it is associated with a high emotional stress, such as the death of a family member or loss of a job.
The possible relationship between these types unrelated injuries are the neurohormonal changes physical and emotional stress can trigger damage. Psychological processes can change – and can be changed by – changes in the function of regulating hormones centers such as the hypothalamus and the pituitary and adrenal glands, which in turn can affect the nervous system.
Fibromyalgia Other Common Threads
Fibromyalgia has been linked to all age groups, although women between the ages of 30 and 50 have a higher incidence of the disease,” said Dr. Solitar. Although this increase in prevalence among younger women suggests a hormonal link, he said it may also be related to the diagnosis. “Women tend to [Natural] be sweeter [or sensitive to pain] than men, so if you base your diagnosis on sensitive points, it is very likely that more women diagnosed with fibromyalgia than men. ”
In addition, fibromyalgia often develops in several members of a family, even if it is unclear whether this is the result of genetic or environmental effects. “Parents of people with fibromyalgia seem to be more sensitive than others,” says Dr. Solitar “but there are a lot of conclusive genetic research there.
In many cases, the reason for the appearance of fibromyalgia is still largely unknown. “For many patients, not come up with a good explanation for the development of fibromyalgia,” says Dr. Solitar. “Everyone is exposed to stress regularly. And while the trauma and infections seems to be a common problem [fibromyalgia], there are a lot of people coming slowly develop a sense of feeling ill. And a variable set of symptoms often confuse patients and doctors também.Ainda there a blood test or biomarker widely accepted diagnosis of the disease, although patients reported physical limitations that life altering. Now a new study from the University of Michigan called the wide range of symptoms of fibromyalgia molecule of the brain called glutamate, opening the door to new treatment options and the most accurate diagnostic testing methods.
Fibromyalgia: New tests can help diagnose
Fibromyalgia symptoms ranging from fatigue and body aches and extreme disorder flu digestive migraines. Due to the absence of a specific qualitative or quantitative evidence, however, clinicians have been forced for a long period of self-assessment of a patient to help diagnose this condition difficult. For this reason, some doctors do not take seriously the disease.
Innovative research conducted in 2002 by Daniel Clauw, MD, professor of medicine and associate director of the University of Michigan Medical School, provided the first biological and physical evidence that solid lespatients fibromyalgia actually feel intense pain when they said they fait.imagerie magnetic resonance imaging one way call functional brain imaging (fMRI) showed that lespersonnes fibromyalgia were more sensitive to pain than those of a control group; Similar levels of pain also caused different brain areas to light scans the FM band control group.
The prevalence of chronic pain associated with fibromyalgia – specific pain of a whole group of muscles or joints – – not currently under consideration. “Most doctors believe that lafibromyalgie is a peripheral issue, which affects muscles and joints, because it experienced patients and reported,” said Richard Harris, Ph.D., research investigator in the Department of ladivision rheumatology internal medicine at the University of Michigan medical School and researcher at the University of chronic pain and fatigue Research Center; and a colleague of Dr. Clauw. “The results of our recent research suggests that fibromyalgia may be a condition of the nervous system central.Cela makes it harder for critics to explain the results patients can make a misstep MRI test results. ”
Dr. Harris and other researchers from the University of Michigan have found that levels of pain in patients suffering from fibromyalgia positively correlated with the levels of glutamate, an amino acid and neurotransmitter (brain chemical) responsible for stimulating nerve cells. “When patients receiving treatments to reduce pain, decreased correspondingly glutamate levels,” says Harris.
Previous research has shown a relationship between activity in a part of the brain called the insula (insular cortex) and pain in patients with fibromyalgia. The insula region is also involved in the stimulation of muscles and skin and internal sensations, such as the intestine. This association may help explain the increased incidence of digestive problems such as irritable bowel syndrome, fibromyalgia. Other conditions associated with fibromyalgia, such as anxiety and migraine, may also be related to the involvement of the central nervous system, according to Andrew Holman, MD, a rheumatologist and assistant professor of clinical medicine at the University of Washington.
Fibromyalgia: Research leads to new drugs
New drugs are now available for use in the treatment of fibromyalgiasymptoms through this research. “The Food and Drug Administration recently approved pregabalin (Lyrica) and duloxetine (Cymbalta), two drugs that both direct accordingly work center of a new research,” said Dr. Holman. “Fibromyalgia has its own process, but the problems of the autonomic nervous system that cause stage 4 sleep deprivation [of the symptoms of fibromyalgia] are from the same brain areas that are responsible for issues such as motility [reference SII] and fight basic or flight syndrome [for anxiety symptoms]. ”
Despite these results validate the most subtle symptoms experienced by fibromyalgia patients, more research is needed before the fMRI testing becomes part of a routine diagnosis, said Harris. Until then, Harris stresses the importance of being aware of their symptoms and manage them properly. “Fibromyalgia is not one of those situations where you can do one thing and done,” he said. “It is a symptom management issue through a multifaceted approach.”
Medical fibromyalgia tions
The exact cause of fibromyalgia is still a subject of speculation, so that current treatments even FDA approved are not specific to the best hipóteses.Muitas pharmaceutical options, however, are available for the treatment of various symptoms of fibromyalgia, which can vary from muscle pain and sleep problems with depression and anxiety.
To date, the antidepressant duloxetine (Cymbalta) and milnacipran (Savella) and pregabalin (Lyrica), an anticonvulsant drug, which is also used for certain types of pain, are the only drugs approved by the FDA specifically for the treatment of fibromyalgia. But many doctors use other drugs approved for related conditions, to treat specific symptoms of fibromyalgia. Many of these drug problems as an address associated with fibromyalgia. As with all drugs, most drugs listed here have side effects and significant side interactions. You should discuss all prescription with your doctor and pharmacist before taking them. This will help you know what to expect and when you need to report a problem or find a substitute drug.
Pain relief and improved sleep are the main objectives of medicines and fibromyalgia treatments, but doctors also prescribe various drugs to treat depression and fatigue.
The following medications are commonly used in the treatment of fibromyalgia.
Most over painkillers cons do not work very well for fibromyalgia because the disorder does not involve inflammation. opiates and localized injections may sometimes be useful, depending on the specific symptoms.
The-counter painkillers. Tylenol (acetaminophen) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Anaprox) may help some patients. However, it is generally recommended for patients with peripheral pain syndrome (involving the muscles and connective tissue and / or peripheral nervous system instead of fibromyalgia, a disorder of the central nervous system) In addition to the fibromyalgia.
opioid therapies. Some pain relief with opioids were reported as tramadol (Ultram), and the combination of tramadol and paracetamol (Utracet) – both of which can also alleviate sleep problems. While effective for acute and severe pain, opiates such as hydrocodone / acetaminophen (Vicodin), propoxyphene / acetaminophen (Darvocet), oxycodone / acetaminophen (Percocet) and oxycodone (OxyContin) does not work as well have chronic pain long, geral.Além so that they carry the risk of addiction and have been associated with other side effects – for example, increased sensitivity to pain and drowsiness and body the constipation.
injections into trigger points. Injections of local anesthetics (such as lidocaine and procaine) and / or cortisone (steroid drug) can help treat muscle pain, tendons or ligaments and breaking the pain cycle and muscle spasms.
These drugs help regulate certain chemicals in the brain, called neurotransmitters, which are involved in various fibromyalgia symptoms, including muscle pain, sleep disturbances and fatigue. For best results, they are sometimes used in combination. Among the most commonly prescribed include:
Tricyclic antidepressants. Amitriptyline (Elavil), nortriptyline (Pamelor) and doxépine (Sinequan) and trazodone tetracyclic antidepressant (Desyrel), increased levels of norepinephrine and serotonin neurotransmitters pas brain Affecting the signs of pain and depression, and they often have a sedative, sleep inducing effect.
reuptake selective inhibitors (SSRIs). In this group are citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox) and paroxetine (Paxil).
Serotonin selective reuptake inhibitor of the reuptake inhibitor of norepinephrine (SSNRI) .This new class of antidepressants, also known as dual uptake inhibitors, helps regulate the neurotransmitters serotonin and norepinephrine. They include venlafaxine (Effexor), desvenlafaxine (Pristiq), duloxetine (Cymbalta) and Savella (milnacipran).
Medications such as cyclobenzaprine (Flexeril, and Cycloflex Flexiban), carisoprodol (Soma) and methocarbamol (Skelex) are often prescribed to treat painful muscle spasms; commonly used for short-term relief.
This class of drugs used for fibromyalgia, because these drugs also help treat neuropathic pain that occurs when nerves are very excited and should be insensitive. Drugs in this category include pregabalin (Lyrica) and carbamazepine (Carbatrol, Epitol, EQUETRO, Tegretol, Tegretol-XR and) and gabapentin (Gaborone, Neurontin).
Restful sleep is essential to alleviate the symptoms of fibromyalgia. If other medicines (especially muscle relaxants and antidepressants) are not effective, doctors may prescribe short-term sleeping pills such as zolpidem (Ambien) and zaleplon (Sonata), and eszopiclone (Lunesta), which work by brain activity slows to allow sleep. These drugs often lose their long-term effectiveness, however.
Some doctors prescribe drugs used for attention deficit disorder and hyperactivity, such as methylphenidate (Ritalin), sulfate, dextroamphetamine (Dexedrine) and modafinil (Provigil) to alleviate the symptoms of fatigue and “fog brain “(difficulty in reasoning and concentration) that fibromyalgia patients often experience.
Among the new drugs under investigation for the treatment of fibromyalgia is sodium oxybate (Xyrem), also known as GHB. That depress the central nervous system is currently approved for the treatment of narcolepsy, but showed promise for relieving pain and improving function in patients with fibromyalgia. The FDA approval was filed December 15, 2009.
Finally, in addition to drugs, doctors often recommend thatother pain treatments will be explored. Among the most effective are the only therapeutic specialized technique used to relieve tension in the body, which can help relieve the discomfort and reducemuscle spasms and therapy myofascial massage.