Irritable Bowel Syndrome


What is Fibromyalgia?

Imagine that you experience pain in many areas of your body and tenderness in your joints, muscles, tendons, and other soft tissues. You also experience problems with sleep, low energy, and fatigue. You feel depressed and anxious and have problems with thinking clearly. Now, imagine that you feel this way not just for one day, one week, or one month but for many months and possibly for years. 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 a real syndrome.

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 often 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. Some 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. Some 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 four quadrants of the body for at least three months and pain and tenderness in at least eleven of eighteen 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 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 or 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.

Fibromyalgia is scary, limiting, and depressing for most people. Many 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 as partners and family members often do not understand the problem and how best to help.

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