Page 6 — Healthy Cells Magazine — East Valley — February 2014

Living With FibromyalgiaCauses, Symptoms, and Treatment Therapies

By Martin S. Fekete, DHSc, CSP, SPHR, National Employers Organization

Fibromyalgia syndrome (FM) is a chronic condition associated

with widespread pain that affects the muscles and soft tis-

sues. Typical FM patients experience abnormal and reduced

pain thresholds, fatigue, sleep problems, and painful trigger points.

Fibromyalgia can be relieved through a combination of medications,

lifestyle changes, and stress management. Approximately five million

Americans are affected by FM according to the American College of

Rheumatology estimate. FM usually occurs in adults ranging in ages

between 30 and 60 years of age. It is more common in women than

men, with a ratio of 5 to 1.

After osteoarthritis, it is the second most common musculoskel-

etal condition. Because symptoms can vary between patients, it is

often misdiagnosed and misunderstood. Fibromyalgia dates as far

back as 1904 when Sir William Gowers termed the pain as fibrositis

and claimed that it was from the inflammation of subcutaneous and

fibrous tissue.

Causes The term fibromyalgia was first used in 1976 after researchers tried

to describe the primary symptom (Fibro – meaning fibrous tissue, my – meaning muscle, and algia – meaning pain). FM was not well stud-

ied or defined until 1990, when the American College of Rheumatol-

ogy established a criteria for diagnosing fibromyalgia. From that time

on, the term fibromyalgia has gained notoriety and common usage.

Initially, FM was thought to be a muscle disease, as the name implies,

and also was thought to be a psychiatric or psychosomatic disorder

due to the lack of any physical or medical abnormalities. However,

the new century brought with it new laboratory and brain imaging

technology that has provided factual evidence of fibromyalgia being a

real physical disorder. These recent findings have linked FM to a mal-

functioning of the central nervous systems (CNS) referred to as cen-

tral sensitization syndrome. Central sensitization is basically defined

as a condition where the central nervous system overreacts to pain.

Linked to central sensitization syndrome, researchers have identified

a number of psycho-physical co-morbidities that may in combination

act as contributing factors to FM.

Recent studies on FM patients have yielded documented evidence

through brain imaging showing abnormal pain processing. This re-

search has unlocked the secrets of how FM patients process pain.

These studies have shown that FM patients frequently lack the capacity

to modulate pain known as the diffuse noxious inhibitory control (DNIC)

process. In the research study, FM patients also showed no normal

decay of temporal summation after repetitive painful stimulation; a phe-

nomenon referred to as temporal summation of second pain (TSSP).

Symptoms As noted earlier, fibromyalgia patients may experience a wide

array of symptoms, most common of these are the sensitive trigger

physical

Martin S. Fekete,DHSc, CSP, SPHR

February 2014 — East Valley — Healthy Cells Magazine — Page 7

points typically associated with FM. Much of the research in recent

years has indicated that many FM sufferers have had a lifetime his-

tory of pain. Many of these patients have multiple symptoms; includ-

ing chronic fatigue, disturbed sleep, and associated problems with

memory and concentration. As these multiple symptoms increase,

the patient is more likely to suffer an increase in both pain and the

other symptoms, resulting in a downward spiraling effect of the pa-

tient’s health. The resultant outcome is a reduced activity level or

no activity, which based on current research, can adversely affect

the patient. Other areas of potential concern for FM patients is a

lack of sleep which can increase fatigue and stress levels resulting

in potential elevated blood pressures, stress, and decrease in one’s

immune system. Clearly, the effects of fibromyalgia are real with real

consequences if not properly treated.

Treatment Therapies The most current literature and research indicates a holistic ap-

proach to the treatment of fibromyalgia using a psychological and

physical approach. This three tiered approach focuses on: 1) treat-

ment through pharmacological options targeting pain processing, 2)

physical fitness and exercise, and 3) stress reduction and relaxation

techniques.

Given recent studies identifying that FM has neurological impli-

cations in the central nervous system allows for effective treatment

through a number of new drugs that work on the central pain pro-

cessing center. The second area proven highly effective in pain re-

duction is exercise and other physical activities. Research studies,

ones similar to Angela Bush with the University of Saskatchewan, in-

dicate that various physical fitness and exercise regimens improved

FM patients overall health and decreased pain levels. Similar stud-

ies by Dr. Chenchen Wang at Tuft’s University School of Medicine

have shown that fibromyalgia patients experienced lessened pain

symptoms when they were involved in an ongoing Tai Chi program.

Finally, because of the sleep disturbances and chronic fatigue ex-

perienced by many FM sufferers, a program of stress and relax-

ation techniques is also beneficial. In a recent article in the August

edition of Clinical Rheumatology (2013), the results of a two-year

study were discussed and how a total holistic approach to mind

and body showed improvement in fibromyalgia patients. Many times

FM patients suffer depression due to their inability to cope with this

syndrome, and as a result, additional physical and mental symptoms

may manifest. The study indicated that FM participants were more

positive and were more receptive to health-care interventions than

non-participants.

In conclusion, fibromyalgia is no longer revered as only a psycho-

logical disorder. Modern science has proven physiological changes

and deficiencies in the many patients. More studies are underway

to discover how this syndrome affects people and possible preven-

tion opportunities. People experiencing these and similar symptoms

should always start with their primary care doctor or pain manage-

ment specialists. The one important issue is to manage FM using a

holistic approach that includes all three approaches and is designed

specifically for the individual patient.

Dr. Martin Fekete is Director of Human Resources and Risk Man-agement at National PEO, LLC, a professional employer organiza-tion devoted to assisting small and medium businesses. He is also a member of the American College of Epidemiology.