Imagine that you experience pain in many areas of your body and tenderness in your joints, muscles, tendons and other soft tissues. Imagine that you also experience problems with sleep, low energy and fatigue. Imagine you feel depressed and anxious and that you have problems with thinking clearly (often called “fibro fog”). Now, imagine that you feel this not just for one day, one week or one month but for many months and possibly for years on end. This is the reality of fibromyalgia, a syndrome that often has a profound impact on every aspect of a person’s life.
Most people with fibromyalgia endure many medical examinations before they are diagnosed. Many are told that their pain is “all in their heads” and feel that their symptoms are not believed. The diagnosis of fibromyalgia is still controversial among many health care professionals. There are still some who question whether this is, in fact, a real syndrome at all.
However, if you have fibromyalgia, the reality of your symptoms is not in question.
What causes fibromyalgia?
The cause of fibromyalgia is unclear. Many people who develop fibromyalgia have experienced an injury, emotional trauma or an illness including an infection or virus. There appears to be a genetic factor. Fibromyalgia tends to run in families.
The pain is thought to be due to neurobiological abnormalities which cause the pain and thinking problems as well as the other symptoms. People with fibromyalgia appear to experience “central sensitization” which means that they have an increased sensitivity to pain due to an increase in neurotransmitters. Neurotransmitters are chemicals in the brain that enable nerve cells to communicate with each other. As a result, people with fibromyalgia are thought to be oversensitive to certain sensations leading to widespread and chronic pain.
Studies have shown that people with fibromyalgia have many physiological abnormalities. Some of these include higher levels of substance P in the spinal cord. Substance P is a neurotransmitter that is found in the brain and spinal cord and is linked to inflammation and pain. People with fibromyalgia have also been found to have lower levels of blood flow to the thalamus in the brain. The thalamus is a structure in the brain which, among other functions, controls consciousness and relays sensation. People with fibromyalgia have also been found to have lower levels of tryptophan and serotonin. Tryptophan is an amino acid that has a mild tranquilizing effect and helps to combat pain. It is a precursor of serotonin. Serotonin is a neurotransmitter that affects mood. Low levels are associated with anxiety and depression.
How is fibromyalgia diagnosed?
Diffuse and widespread pain is the main symptom of fibromyalgia. Fibromyalgia is usually diagnosed when the person has widespread pain in all 4 quadrants of the body for at least 3 months and pain and tenderness in at least 11 of 18 specific areas around the elbows and arms, hips, chest, knees, lower back, neck, and shoulders. For many people, symptoms are worse in the morning and worse with activity, cold or damp weather and stress. Many people who have fibromyalgia also suffer from Chronic Fatigue Syndrome in which they experience severe, chronic tiredness which is not relieved by rest or sleep and is not due to another illness.
How is fibromyalgia treated?
As is the case with many health problems, it is not necessary to identify a cause in order to implement an effective treatment. For example, whether I have a headache which is due to a lack of sleep or a stressful day, I will likely be able to decrease the pain if I relax and take a painkiller. I do not have to know the cause of my headache to find some measure of relief.
The most effective treatment for fibromyalgia combines psychological treatment with exercise and physical therapies. Medications are often prescribed and may be helpful as well.
I have provided psychological treatment to many people with fibromyalgia over the years. I have also encouraged them to work with their physician and personal trainers, physiotherapists and other health care professionals to help them regain control of their lives and cope better.
Fibromyalgia is scary, limiting and depressing for most and most people. Many people with fibromyalgia can easily fall into restrictive, limited lifestyles. The main goal of treatment is liberation from the limits imposed by the pain and other symptoms of fibromyalgia.
Psychological treatment often includes cognitive-behavioural techniques – CBT (helping people change the way they think about and react to their symptoms); emotional support; cognitive strategies to help people clear the “fibro fog”; meditation; hypnosis; and stress-management. Marital and family therapy are often included because usually partners and family members do not understand the problem and how best to help. However, each person’s unique needs and situation are always the priority. There is no set way to help someone with fibromyalgia. My goal is to help each person with his or her unique needs.
Call for a free telephone consultation or to arrange an appointment.
For more information:
1. FM-CFS Canada, Compassion in Action: www.fm-cfs.ca
2. National Fibromyalgia Association: www.fmaware.org
3. National Fibromyalgia Research Association: www.nfra.net
4. Fibromyalgia Network: www.fmnetnews.com
5. Fibro North: www.fibronorth.com
6. Fibromyalgia Association UK: www.fibromyalgia-associationuk.org
7. American Fibromyalgia Syndrome Association: www.afsafund.org
8. National Fibromyalgia Partnership, Inc.: www.fmpartnership.org