Sunday, August 16, 2015
To get a better understanding of fibromyalgia and the disorders that cluster with them, we need to study them side-by-side so any trends are exposed. Also important is screening for the presence of myofascial pain syndrome (MPS) to assure the participant pool has been identified correctly, because MPS is known as the great imitator.
It’s Not Just Fibro
Many pain disorders have centralization affects, probably most, so while looking at centralization in fibromyalgia; we may need to be more diverse in our thinking. Dr. Robert Bennett and his team
found that fibromyalgia is often accompanied by another pain disorder. Therefore, while we do experience body-wide pain not directly related to injury or peripheral disease (which indicates centralization-involvement of the brain), and sleep problems, fatigue, and cognitive issues, we also have clustering of disorders. The American College of Rheumatology identifies depression or anxiety, migraine, tension headaches, digestive and bladder problems, pelvic pain, and TMJ. The CDC suggests FM occurs with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and ankylosing spondylitis (AS), and it could have a loose underlying genetic factor. Low back pain syndrome is also considered a disorder of centralization, but chronic low back pain patients do not share a clustering of noted disorders. If we compare the two, it suggests that centralization of pain is not the only factor at play in fibromyalgia. It could be, and is suggested in some studies that the amplification of pain by the brain (centralization) is not the only central nervous system involvement.
Investigators are doing some interesting work by looking at fibromyalgia and chronic fatigue syndrome together because they are often associated. Gene expression might help us understand clustering in a meaningful way. Leaky gut syndrome has been associated with fibromyalgia and a study on ME/CFS and the association and treatment of leaky gut holds some promise. Since these two disorders frequently occur together, this might help us find better treatments. Though the results differ somewhat, studies suggest the need for more research regarding abnormal immune reactions in both FM and ME/CFS (SEID). Interestingly, leaky gut syndrome has been implicated in many autoimmunedisorders and in irritable bowel syndrome, prevalent in fibromyalgia.
Myofascia and Fibromyalgia: Could There Be an Answer to Your Question?
Any time a person tells me their physician cannot explain neuropathy symptoms (numbness, tingling, sensitivity, weakness, cramping, spasms, etc.), I ask them to learn more about myofascial pain syndrome (MPS). Myofascial trigger points are pain generators in many of the comorbid conditions identified in this article. Rheumatologists are internal medicine doctors and many do not understand MPS, how to assess for it, or what treatments work. However, there are physicians and therapists who do.
You will find an article I did at Health Central from an interview with pain specialist, Dr. Karl Hurst-Wicker quite interesting. It is a necessary read for anyone who wants to understand the role of centralization and peripheral pain generation in fibromyalgia and other unexplained pain.
It’s time to get it right. When funding by unbiased organizations is at an all time low, such as the NIH, we need to make every effort to do it the right way. If you have any of the clustering of symptoms, report them to your doctor and share this blog. Every piece of data counts and so do you.
American College of Rheumatology, Fibromyalgia
Center for Disease Control, Fibromyalgia
Fasano A. Leaky gut and autoimmune diseases.
Health Central, Fibromyalgia Centralization and Peripheral Myofascial Pain: Interview with Karl Hurst-Wicker, MD
Hyland NP, et. al. Microbiota-host interactions in irritablebowel syndrome: epithelial barrier, immune regulation and brain-gutinteractions.
Jacob E, et. al. Gene expression factor analysis todifferentiate pathways linked to fibromyalgia, chronic fatigue syndrome, anddepression in a diverse patient sample.
Kosek E, et. al. Evidence of different mediators of central inflammation indysfunctional and inflammatory pain--interleukin-8 infibromyalgia andinterleukin-1 β in rheumatoid arthritis.
Maes M and Leunis J. http://www.ncbi.nlm.nih.gov/pubmed/25617880
Myofascial Pain Syndrome at CelesteCooper.com
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"Adversity is only an obstacle if we fail to see opportunity."
Celeste Cooper, RN
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All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.