Imagine suffering from constant pain and fatigue, even when you havenâ€™t done anything strenuous. Your muscles are weak, they sometimes twitch and spasm, and any touch or pressure is agonizing. But itâ€™s not only your body; your mind seems to be weak as well. You often have trouble concentrating, suffer from memory loss, and even have difficulty sleeping. Living such a life would be unimaginable for most people, yet millions of people in the United States alone deal with these problems every day. They suffer from fibromyalgia.
In addition to the principal symptoms described above, fibromyalgia can also cause tingling of the skin, nerve pain, and bowel disorders. The impairment of mental function, sometimes called â€œfibrofog,â€ can dramatically slow down cognitive performance, reduce attention, and make it difficult to concentrate on more than one task at a time. A 2007 study by Dr. Mohammed Yunus found that as many as 30% of individuals who suffer from rheumatoid arthritis and lupus may also have fibromyalgia. Fibromyalgia has also been linked to symptoms of anxiety and depression.
Confusion and Controversy
Although doctors have recognized its symptoms since the early 1800s, fibromyalgia has been one of the most misunderstood of medical disorders. For years the medical community referred to the condition by a variety of names and assigned it various causes from muscle disorders to nerve weakness to psychological impairment. Dr. Philip Hench coined the term â€œfibromyalgiaâ€ in 1976 to describe the syndrome, but widespread, systematic scientific investigation into the disorder did not occur until the 1980s.Â Five years after Dr. Hench coined it, the term â€œfibromyalgiaâ€ first appeared in the scientific literature in a 1981 paper by Dr. Yunus.
Clinical studies conducted during the 1980s established the standard characteristics of fibromyalgia syndrome and found connections between it and similar medical conditions. Based on this research, by the late 1980s, pharmaceutical companies were conducting trials for the first fibromyalgia drugs. Even so, as late as 1987 an article in the Journal of the American Medical Association called fibromyalgia a â€œcontroversialâ€ condition. Today fibromyalgia is widely accepted as a legitimate medical condition by groups including the American College of Rheumatology and the United States National Institutes of Health (NIH).
Despite greater understanding and acceptance of fibromyalgia by the medical community, its underlying cause â€“ or causes â€“ is still debated. Several alternative hypotheses have been advanced. Some physicians point to lifestyle factors including stress, obesity, smoking, and lack of physical activity. Others have even suggested that sleep disturbances are not merely a symptom of fibromyalgia, but a principal cause of other symptoms such as muscle tenderness. Still other researchers have suggested that fibromyalgia may be directly related to depression, but studies â€“ including those featuring analysis of brain-imaging scans â€“ have failed to establish a definitive connection.
Recent research strongly suggests that neurochemical imbalances may be the underlying cause of the disorder. Fibromyalgia sufferers show elevated levels of substance P, a chemical that helps send pain signals to the brain. At the same time, they exhibit depressed levels of two substances that mitigate pain sensation, norepinephrine and serotonin. Additional research has indicated that these imbalances have a genetic component. Fibromyalgia was already known to run in families, but researchers recently have isolated a gene they feel may be responsible for development of the disorder.
Treatment for Fibromyalgia
Treatment options for fibromyalgia are as many and varied as the proposed causes. Many physicians prescribe medication to deal with the main symptoms of pain and muscle fatigue. The principal drugs used for this purpose are pregabalin (Lyrica) and duloxetine (Cymbalta), both of which have been approved by the U.S. Food and Drug Administration (FDA) for treatment of fibromyalgia. Antidepressants and anti-anxiety agents are used widely to deal with symptoms of depression, fatigue, and sleep and mood disturbances.
The best treatment plan is one that combines responsible and targeted pharmaceutical therapy with a combination of non-pharmaceutical approaches to lower stress, increase coping skills, and bolster psychological well-being. These include regular, low-impact aerobic exercise; relaxation techniques such as yoga or meditation; and body therapy including massage and acupuncture. A combination of cognitive-behavioral therapy and exercise seems to be especially effective at helping patients cope with pain and improve mood.
The Importance of Diet
Maintaining a proper diet is also very important for those suffering from fibromyalgia. Increase consumption of foods that are high in antioxidants and those that show anti-inflammatory effects. Examples of these include leafy green vegetables, fresh fruit (especially berries), whole grains, as well as spices including turmeric and ginger. Foods that are high in omega-3 fatty acids, such as salmon, are also particularly beneficial. Try to cut out all sources of trans-fatty acids, which are found in products such as margarine, partially hydrogenated oils, polyunsaturated vegetable oils, and deep-fried foods. Replace these sources of fat with olive oil.
Â If you are seeking treatment for fibromyalgia, or know someone who is, you should consult with a physician who will consider the condition from all perspectives. South Florida physician Dr. Jorge Bordenave is a specialist in integrative medicine, which takes just such a holistic approach to health and well-being. Dr. Bordenave will work with patients to explore and integrate a variety of approaches that deal with the whole person â€“ body, mind, and spirit â€“ and that are tailored to needs of the individual. For more information about Dr. Bordenaveâ€™s approach to fibromyalgia treatment, visit his website.
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