Tag Archives: medical research

Fibromyalgia research links 2010

fibro1I am a fibromyalgia sufferer who relies on alternative and complementary medicine, rather than pharmaceuticals.  This is because I have multiple food, chemical and drug allergies and decided years ago that suffering through side effects was not for me. I keep watch on all the research that’s done every year and when treatment options don’t include pharmaceuticals I try them to see if they will provide relief from the inflammation and pain.  I also keep watch for alternative and complementary medicine research pertaining to the many associated conditions.

Causes of fibromyalgia are not known

The condition produces vague symptoms that may be associated with diminished blood flow to certain parts of the brain and increased amounts of substance P, which is thought to be a sensory neurotransmitter involved in the communication of pain, touch, and temperature from the body to the brain. Researchers have identified several other possible fibromyalgia causes, including the following:

  • Autonomic nervous system dysfunction
  • Chronic sleep disorders
  • Emotional stress or trauma
  • Immune or endocrine system dysfunction
  • Upper spinal cord injury
  • Viral or bacterial infection

Alternative therapies and treatments work to heal your total being, which is why some fibromyalgia patients opt for them in treating their widespread symptoms. A variety of alternative options may ease your fibromyalgia pain—from acupuncture and biofeedback to herbal supplements and massage to yoga and meditation.

If you’re one of the millions of people who suffer from fibromyalgia, you should be aware of the new research developments involving your disorder. The more you know about fibromyalgia, the better equipped you’ll be to discuss treatment options with your doctor.

Fibromyalgia research links 2010

High Rate of Restless Legs Syndrome Found in Adults With Fibromyalgia
October 15, 2010:  A new study finds that adults with fibromyalgia had a much higher prevalence and risk of restless legs syndrome than healthy controls. The study suggests that treating RLS may improve sleep and may improve sleep and quality of life in people with fibromyalgia.

Yoga Can Counteract Fibromyalgia, Study Suggests
October 14, 2010 — Yoga exercises may have the power to combat the chronic pain caused by fibromyalgia — a medical disorder characterized by chronic widespread pain. The research is being published in the November 10 online edition of the journal Pain and will appear online on Oct. 14.

Adolescents With Fibromyalgia Who Are Physically Active Report Lower Levels of Pain and Disability
September 19, 2010: Adolescents with fibromyalgia who are physically active report lower levels of pain and disability,

How Badly Does It Hurt? Research Examines the Biomedical Diagnosis of Pain
August 28, 2010:  Sociology research investigates the challenges of patients experiencing pain symptoms that don’t visibly turn up on any tests. Research out of the University of Cincinnati is examining the diagnosis of pain that evades scientific testing, and the additional emotional suffering that can result for the patient.

New Principle Discovered for How Muscle Pain Is Signaled
July 19, 2010:  Chronic muscular pain may be linked to a previously unknown principle for how pain signals are transmitted in the human body.

Obesity Associated With Increased Risk of Fibromyalgia
May 4, 2010:  Researchers in Norway have found an association between the level of leisure time physical exercise and a future risk of developing fibromyalgia. The research team also identified BMI as an independent risk factor for fibromyalgia.

New Reliable Method Based on Patients’ Gait Helps to Diagnose Fibromyalgia
April 30, 2010:  A researcher from Spain has designed a reliable method that — combined with the diagnostic criteria of the American College of Reumathology — helps to diagnose fibromyalgia on the basis of of patients’ walk parameters, i.e. their gait.

Study Highlights New Way to Diagnose Fibromyalgia
May 27, 2010: To test the new criteria, the researchers conducted a multi-center study of 829 people who had fibromyalgia and a control group of people who had other pain disorders. The researchers found that the combination of the pain index, number of symptoms, and severity of symptoms provided the most accurate fibromyalgia diagnosis. The researchers reported that the new criteria will correctly diagnose more than 88% of people with fibromyalgia—and that’s without a tender point examination. — The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity

Fibromyalgia Affects Mental Health of Those Diagnosed and Their Spouses, Study Finds
April 30, 2010 — Researchers are examining how the diagnosis of fibromyalgia can affect marriages. Initial findings reveal that diagnosed spouses have considerably higher levels of depressive symptoms and pain and report more marital instability and anger than their spouses. For both spouses, the symptoms can trigger increased emotional withdrawal and mental strain.

Exercise Reduces Pain Perceptions in Fibromyalgia Patients
April 1, 2010:  People with fibromyalgia can experience debilitating pain—and that can erase any motivation to exercise. But what this study shows is that 30 minutes a day of moderate activity can make a difference in how you perceive pain. –  Effects of lifestyle physical activity on perceived symptoms and physical function in adults with fibromyalgia: results of a randomized trial

Cannabis-based Drug Improves Sleep in Fibromyalgia Patients
February 24, 2010: Sleep problems are common in people with chronic pain disorders—and fibromyalgia is no exception. There are a number of medications that may treat sleep problems associated with fibromyalgia, and anti-depressants are among the most common. But new study findings may change that—a synthetic cannabinoid called nabilone (marketed as Cesamet) relieved sleep disturbances better than the anti-depressant amitriptyline (Elavil).  – The Effects of Nabilone on Sleep in Fibromyalgia: Results of a Randomized Controlled Trial

Savella Gets Good Marks for Treating Fibromyalgia
February 22, 2010: In both studies, 52% of patients taking 100 mg of Savella and 56% of those taking 200 mg of Savella reported a reduction in pain. This is compared with 40% to 42% of the participants taking a placebo. Overall, the patients in the Savella group experienced better pain control, compared to the placebo group.–  AAPM: Drug for Fibromyalgia Boosts Multiple Outcomes

Fibromyalgia Pain Relief: Is It All in Your Lungs?
February 1, 2010: This is important because it highlights the link between emotional pain and physical pain. Many people with fibromyalgia suffer from depression and anxiety, which only exacerbates their physical pain. On the other hand, this study also shows that a positive mental state helps stave off physical pain. — The effects of slow breathing on affective responses to pain stimuli: An experimental study

Chronic fatigue syndrome may be caused by a virus

Depression1Chronic fatigue syndrome is a disabling condition of prolonged and severe tiredness or weariness (fatigue) that is not relieved by rest and is not directly caused by other conditions, including fibromyalgia and depression. To be diagnosed with this condition, your tiredness must be severe enough to decrease your ability to participate in ordinary activities by 50%.

A study published last week in the journal Science suggested that a virus be the cause of chronic fatigue syndrome. An article published online Thursday in the journal Science reports that 68 of 101 patients with the syndrome, or 67 percent, were infected with an infectious virus, xenotropic murine leukemia virus-related virus, or XMRV, which probably descended from a group of viruses that cause cancer in mice.

Dr. Mikovits, research director at the Whittemore Peterson Institute in Reno said she and her colleagues were drawing up plans to test antiretroviral drugs — some of the same ones used to treat HIV infection — to see whether they could help patients with chronic fatigue. If the drugs work, that will help prove that the virus is causing the illness. She said patients and doctors should wait for the studies to be finished before trying the drugs.

If this syndrome is caused by a virus then I won’t be surprised because my symptoms with regard to both syndromes ie. chronic fatigue and fibromyalgia began after I had a prolonged respiratory virus (flu) that kept recurring.

A tip of the hat to Dannette at Fibrohaven where she is celebrating her blog’s 1st birthday.

Fibromyalgia Research Links 2007 -2008

Although fibromyalgia is a relatively recent term, this syndrome has been known by several other names over the past years, including soft tissue rheumatism, fibrositis and non-articular rheumatism.

Symptoms and associated syndromes
Pain – The pain of FMS has no boundaries. People describe the pain as deep muscular aching, throbbing, shooting, and stabbing. Intense burning may also be present. Quite often, the pain and stiffness are worse in the morning and you may hurt more in muscle groups that are used repetitively.

Fatigue – This symptom can be mild in some patients and yet incapacitating in others. The fatigue has been described as “brain fatigue” in which patients feel totally drained of energy. Many patients depict this situation by saying that they feel as though their arms and legs are tied to concrete blocks, and they have difficulty concentrating, e.g., brain fog.

Sleep disorder – Most FMS patients have an associated sleep disorder called the alpha-EEG anomaly. This condition was uncovered in a sleep lab with the aid of a machine which recorded the brain waves of patients during sleep. Researchers found that most FMS patients could fall asleep without much trouble, but their deep level (or stage 4) sleep was constantly interrupted by bursts of awake-like brain activity. Patients appeared to spend the night with one foot in sleep and the other one out of it.

Irritable Bowel Syndrome – Constipation, diarrhea, frequent abdominal pain, abdominal gas, and nausea represent symptoms frequently found in roughly 40 to 70% of FMS patients.

Chronic headaches – Recurrent migraine or tension-type headaches are seen in about 50% of FMS patients and can pose a major problem in coping for this patient group.

Temporomandibular Joint Dysfunction Syndrome – This syndrome, sometimes referred to as TMJ or TMD, causes tremendous jaw-related face and head pain in one quarter of FMS patients. However, a 1997 published report indicated that close to 75% of FMS patients have a varying degree of jaw discomfort. Typically, the problems are related to the muscles and ligaments surrounding the jaw joint and not necessarily the joint itself.

Other common symptoms – Premenstrual syndrome and painful periods, chest pain, morning stiffness, cognitive or memory impairment, numbness and tingling sensations, muscle twitching, irritable bladder, the feeling of swollen extremities, skin sensitivities, dry eyes and mouth, dizziness, and impaired coordination can occur. Patients are often sensitive to odors, loud noises, bright lights, and sometimes even the medications that they are prescribed.

Aggravating factors – Changes in weather, cold or drafty environments, infections, allergies, hormonal fluctuations (premenstrual and menopausal states), stress, depression, anxiety and over-exertion may all contribute to symptom flare-ups. (From Fibromyalgia Network)

Treatments and drugs

In general, treatment for fibromyalgia includes both medication and self-care. The emphasis is on minimizing symptoms and improving general health.

Medications
Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices include:

  • Analgesics. Acetaminophen (Tylenol, others) may ease the pain and stiffness caused by fibromyalgia. However, its effectiveness varies. Tramadol (Ultram) is a prescription pain reliever that may be taken with or without acetaminophen. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs) — such as aspirin, ibuprofen (Advil, Motrin, others) or naproxen sodium (Anaprox, Aleve) — in conjunction with other medications. NSAIDs haven’t proved to be effective in managing the pain in fibromyalgia when taken by themselves.
  • Antidepressants. Your doctor may prescribe antidepressant medications such as amitriptyline, nortriptyline (Pamelor) or doxepin (Sinequan) to help promote sleep. Fluoxetine (Prozac) in combination with amitriptyline has also been found effective. Sertraline (Zoloft) and paroxetine (Paxil) may help if you’re experiencing depression.Some evidence exists for a newer class of antidepressants known as serotonin and norepinephrine reuptake inhibitors or dual uptake inhibitors, which regulate two brain chemicals that may transmit pain signals. Studies have found that duloxetine (Cymbalta) may help control pain better than placebo in people with fibromyalgia. Small trials of venlafaxine (Effexor) suggest the same, though more study is needed to confirm these findings.
  • Muscle relaxants. Taking the medication cyclobenzaprine (Flexeril) at bedtime may help treat muscle pain and spasms. Muscle relaxants are generally limited to short-term use.
  • Pregabalin (Lyrica). Pregabalin may reduce pain and improve function in people with fibromyalgia. Pregabalin, an anti-seizure medication that’s also used to treat some types of pain, is the first drug approved by the Food and Drug Administration to treat fibromyalgia. Studies show pregabalin reduced signs and symptoms of fibromyalgia in some people. In one study, about half of the participants taking the highest doses of the drug reported at least a 30 percent improvement. Side effects of pregabalin include dizziness, sleepiness, difficulty concentrating, blurred vision, weight gain, dry mouth, and swelling in the hands and feet.

Prescription sleeping pills, such as zolpidem (Ambien), may provide short-term benefits for some people with fibromyalgia, but doctors usually advise against long-term use of these drugs. These medications tend to work for only a short time, after which your body becomes resistant to their effects. Ultimately, using sleeping pills tends to create even more sleeping problems in many people.

Benzodiazepines may help relax muscles and promote sleep, but doctors often avoid these drugs in treating fibromyalgia. Benzodiazepines can become habit-forming, and they haven’t been shown to provide long-term benefits.

Doctors don’t usually recommend narcotics for treating fibromyalgia because of the potential for dependence and addiction. Corticosteroids, such as prednisone, haven’t been shown to be effective in treating fibromyalgia.

Cognitive behavior therapy
Cognitive behavior therapy seeks to strengthen your belief in your abilities and teaches you methods for dealing with stressful situations. Therapy is provided through individual counseling, classes, and with tapes, CDs or DVDs, and may help you manage your fibromyalgia.

Treatment programs
Programs that combine a variety of treatments may be effective in improving your symptoms, including relieving pain. These interdisciplinary programs can combine relaxation techniques, biofeedback and receiving information about chronic pain. There isn’t one combination that works best for everybody. Your doctor can create a program based on what works best for you.

Research

Most of the research findings in fibromyalgia point to a malfunctioning of the central nervous system (CNS), which includes the brain and spinal cord. Yet, there appear to be a variety of abnormalities occurring in the peripheral soft tissues (muscles and connective tissue) and the peripheral nervous system that communicates with the CNS. This dysfunctional interplay between the CNS and peripheral systems is believed by most investigators to be the source of the many body-wide symptoms. In a way, fibromyalgia could be considered a disease of the CNS.

Central nervous system research on fibromyalgia:

  • Alterations in pain-related chemical transmitters have been reported in the spinal fluid (particularly substance P, nerve growth factor, serotonin, norepinephrine, and corticotropin releasing factor)
  • Elevated levels of pro-inflammatory cytokines, which are substances that form a communication link between your body’s immune and neurological systems, have been found by many research teams
  • Different brain imaging techniques by several research centers have all shown that the blood flow and metabolic processes in the brain are significantly disturbed
  • Almost all people with fibromyalgia report difficulties staying asleep (e.g., the natural processes in the brain that maintain sleep appear to be disrupted)
  • The autonomic nervous system, whose control center resides at the base of the brain to communicate with the CNS to regulate the peripheral tissues, is not functioning properly
  • Research on the primary pain control system in the spinal cord indicates that it is not filtering out or dampening incoming noxious signals from the peripheral tissues
  • Several research studies pertaining to memory function tests show that people with fibromyalgia have an impaired ability to concentrate

Research findings show that the peripheral tissues are also involved in producing the symptoms of fibromyalgia:

  • Muscles are often tight and knotted with myofascial trigger points (areas in the belly of muscles that refer pain to other regions and cause restrictions in range of motion)
  • High levels of a nitric oxide-producing enzyme was documented by one research team to help explain why patients have exercise intolerance
  • Excessive levels of oxidative chemicals that irritate the tissues were found in the connective tissues in the tiny space between the muscle fibers
  • Reduced blood flow to the muscles as well as a reduction in the number of capillaries supplying nutrients to the tissues were confirmed by different research teams … these findings are hypothesized to be caused by the malfunctioning in the autonomic nervous system

Why do all of the above abnormalities exist in people with fibromyalgia? This is why research in this area is imperative.

  • Richard Gracely, Ph.D., and Daniel Clauw, M.D., of the University of Michigan in Ann Arbor, used fMRI to study fibromyalgia patients with and without depression.2 They found that different areas of the brain were activated when patients processed the sensory dimension of pain as opposed to those that were activated for depression (viewed as the affective component of pain because it has to do with how much emotional relevance a person attaches to their pain). They concluded, “Evaluation of these sensory and affective dimensions in patients with chronic pain is likely to improve diagnosis, choice of treatment, and treatment efficacy.”
  • The above findings are highly relevant in light of the common prescription of antidepressants for treating fibromyalgia. A 12-week treatment trial of the antidepressant, Effexor, revealed that fibromyalgia patients with depression benefited with improved mood.3 However, the pain of fibromyalgia was unfazed by the drug.
  • A separate report by Gracely and Clauw’s team measured the response to experimental pain stimuli in fibromyalgia patients and healthy controls.4 Interestingly, the healthy controls rated the stimuli to be significantly more unpleasant than the patients. Distress, anxiety or depression did not influence the patient’s unpleasantness ratings. The study’s authors suggest that the presence of chronic pain can alter one’s perception of experimental pain (perhaps as part of the brain’s reorganization process), which may pale in comparison to the day-to-day pain of fibromyalgia.
  • Ali Gur, M.D., of Turkey found an important cytokine chemical, IL-8, to be elevated in patients with fibromyalgia.5 Correlating this chemical with brain function, he found that fibromyalgia patients with little to no depression had higher IL-8 levels and more impaired brain blood flow than those with severe depression. In keeping with the concept that fibromyalgia and depression cause different alterations in brain function, Gur was able to tease out the chemical change caused by fibromyalgia (IL-8) and the compounding issue of feeling depressed.

In reference to the advances in technology, Apkarian and colleagues write: “We fully expect that the next generation of brain imaging studies of pain will impact clinical practice and thus contribute to decreasing pain in society.”6 How realistic is this projection? Very! Apkarian published a report this year showing how a single dose of an anti-inflammatory drug produced objective improvements in arthritis and a corresponding change in brain chemistry.7

1. Grachev ID, et al. J Neural Transm 109(10):1309-34, 2002.
2. Giesecke T, et al. Arthritis Rheum 52(5): 1577-84, 2005.
3. Sayar K, et al. Psychosomatics 46(4):340-4, 2005.
4. Petzke F, et al. Eur J Pain 9:325-35, 2005.
5. Gur A, et al. Clin Exp Rheumatol 20(6):753-60, 2002.
6. Apkarian AV, et al. Eur J Pain 9(4):463-84, 2005.
7. Baliki MN, et al. Mol Pain 1(1):32, 2005.

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