Thriving with Fibromyalgia

Don't try this at home!

A study was done in Canada to see if brain dopamine is a factor in fibromyalgia.  Dopamine is one of many neurotransmitters, molecules that transmit messages from your central nervous system.  They injected a saline solution deep into the muscle to produce pain in fibromyalgia patients and healthy control subjects who were matched by age and other factors.  Then they looked at the brain using positron emission tomography to see if dopamine was being released in response to the pain.  The healthy people did release dopamine, but the fibromyalgia patients did not.  In healthy people, the amount of dopamine related to the amount of pain, but there was no relationship for the fibromyalgia patients.  It must've been a hard study to get people to sign up for, but it does provide evidence that fibromyalgia patients have an abnormal dopamine response to pain.  www.fibroinfoservice.com

http://www.ncbi.nlm.nih.gov/pubmed/17610577?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Fibromyalgia - all in your head?

Next time someone tells you your fibromyalgia is "all in your head," you have a good answer for them!  Imaging studies of the brain can now see the pain areas of the brain "light up" in fibromyalgia patients.  Other studies show that fibromyalgia patients have abnormalities in several neurotransmitters, the molecules that send messages to your brain.   Finally, studies of brain anatomy show structural difference between the brains of fibromyalgia patients and healthy people.  All these differences in the brain help explain the widespread pain, sleep problems, and other related issues fibromyalgia patients feel.   www.fibroinfoservice.com

Schweinhardt P Sauro KM Bushnell MC, Fibromyalgia:  A Disorder of the Brain? Neuroscientist, 2008 Feb 12.

Music therapy for relaxation

Music was tested on critically ill, intubated ICU patients to see if Mozart could alleviate stress.  After an hour of slow movements of Mozart's piano sonatas, they measured stress hormones, cytokines, heart rate and blood pressure.  They found out that playing Mozart meant the patients needed less sedative drugs, and had lower stress hormone levels.
Medscape J Med 2008;10(1):20.  Esoteric or Exoteric? Music in Medicine
www.fibroinfoservice.com

Estrogen receptors and pain

New research shows that there is more than one estrogen receptor.  We're familiar with the estrogen alpha receptor.  This is the one that can go bad and signal cells to multiply uncontrollably, resulting in breast or ovarian cancer.  Now scientists have discovered estrogen receptor beta, that seems to put the brakes on cell growth.  A team led by Heather Harris of Wyeth Research in Collegeville, PA, found that drugs that increase estrogen receptor beta decrease inflammation.  Jan Ake Gustafsson has also been working with estrogen receptor beta in Sweden.  Women taking aromatase inhibitors for breast cancer had a bad side effect - intense pain all over their bodies. That is because the aromatase inhibitors were stopping estrogen receptor beta along with alpha.

See www.sceincenews.org, Jan. 5, 2008 vol. 173, " A Different Side of Estrogen."

www.fibroinfoservice.com

Does it help to know what's wrong with you?

A Norwegian study looked at whether it was helpful for women to find out that they had fibromyalgia.  The results of their study showed that many of the participants had been suffering for years, and initially they fell a huge relief when I found out that there was an actual diagnosis for their problem.  Some people also felt better because they realize that fibromyalgia will was better than some other more serious condition.  However, most people felt sad and depressed after they realized the limitations in treatment options, respect and understanding.  The authors conclude "the initial blessing of the fibromyalgia diagnosis seems to be limited in the long run.  The process of adapting to this diagnosis can be lonely and strenuous.

www.fibroinfoservice.com

Reduce frustration with your doctor

We could have told them this!  Researchers in Germany found that fibromyalgia patients had frustrating interactions with their doctors.  They came up with a shared decision-making training program for the doctors.  Then they did a study where some patients were chosen by chance to either get a shared decision-making or get regular treatment plus a computer based information package.  All patients got the same treatment options.  There were only 85 patients in the study, 44 who ended up in the group getting the shared decision-making.  Guess what!  The quality of doctor-patient interaction was much better with the group getting the shared decision-making compared with the group only getting regular treatment plus the computer based information.

It seems like common sense to patients, but I guess it is good news that researchers are least noticing that when doctors involved patients in making decisions it helped the patients feel better.

www.fibroinfoservice.com

http://www.ncbi.nlm.nih.gov/pubmed/18157994?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

What's wrong with me?

A lot of people with fibromyalgia feel pain all over, and find that their bodies overreact to stress.  A lot of doctors will tell them that they are just "nervous" and need to learn to handle stress better.  This study showed that there is a problem with how the adrenal glands of people with fibromyalgia react to stress.  The adrenal glands are tiny glands that sit at the top of your kidneys.  Their job is to release cortisol into your bloodstream in response to stress.  If you have ever had to have a cortisone shot or put hydrocortisone on your skin for a rash, you know that it tends to calm down swollen joints or skin irritations.

In the study, they tested how well the adrenal glands on fibromyalgia patients worked in comparison with patients with chronic pelvic pain.  The results showed that the chronic pelvic pain people who had normal responses, but there was less activity of the adrenal glands in patients with fibromyalgia, namely in total cortisol release.  A doctor would not pick this up from a regular blood tests, because the "free cortisol" stayed the same. 

www.fibroinfoservice.com

The weather and fibromyalgia

You knew it!  Now it has been demonstrated scientifically.  Fibromyalgia patients feel more aches and pains in cold and damp weather.  Researchers had 955 patients with number of different problems like arthritis and fibromyalgia fill out pain logs.  Their conclusion: "In our study as well as in literature we found that a high percentage of patients (70 percent) perceived that weather conditions influenced their pain and disease. Fibromyalgia patients seemed to be strongly influenced by weather changes. Our study confirms that patients perception on the influence of climate on pain and therefore their disease is an important clinical factor and it should be considered when evaluating rheumatic patients."

http://www.ncbi.nlm.nih.gov/pubmed/18159202?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Fibromyalgia-a different type of pain

One of the problems that many people with fibromyalgia face is that there are no tests that definitively show that you have fibromyalgia.  However, what scientists have learned quite a bit about what causes fibromyalgia what goes wrong to create whole body pain.  There are some genetic factors that have been shown to be related to a higher risk of getting fibromyalgia.  In addition, stress can be a factor, including physical, like car accident, viral infections, repeated intense emotional stress, and other autoimmune disorders.

It is clear that there is too much activity in the nervous system, and the whole central nervous system becomes hypersensitive.  Brain scans of people with fibromyalgia and examination of spinal fluid have shown that fibromyalgia is a real thing, not something that is "just in your head."

Dadabhoy D, Clauw D. therapy in sight: fibromyalgia-different type of pain needing a different type of treatment.  Nature clinical practice rheumatology posted 07/12/2006.

www.fibroinfoservice.com

Dopamine and fibromyalgia

Dopamine is a chemical in your brain that is used to send messages to the nerve cells or neurons in your brain that control your muscles.  James Parkinson figured out in 1817 that the tremors and speech problems seen in what we now call "Parkinson's disease" were improved by giving dopamine.  Before that, people with Parkinson's disease were sent to mental hospitals (because doctors then thought if you can't figure out the cause for a disease, it must be "all in your head").

Fibromyalgia patients still find that doctors think their symptoms are "all in their heads."  Andrew J. Holman, M.D., an assistant clinical professor at the University of Washington in clinical rheumatology, did some studies with medications that increase dopamine in your brain.  Since it cannot be easily measured, dopamine has not attracted much attention from doctors before.  Dr. Holman wondered if the sleep problems and other muscle problems that fibromyalgia patients have could be improved by the same medicine that is used for patients with restless leg syndrome.  Mirapex, or pramipexole, was given to fibromyalgia patients.  Patients found a tremendous benefit, and it also seems to help with depression.