Although there is much speculation about what triggers fibromyalgia, its causes are not definitively identified and confirmed. Recent research has generally found that fibromyalgia is more likely the result of what scientists call the central consciousness or unusual reactions in the nervous system in terms of perception of pain.
- biochemical triggers of fibromyalgia
- The physical and emotional triggers of fibromyalgia
Infection The influenza virus and the Epstein-Barr virus causing hepatitis B and C have been implicated in the development of fibromyalgia. “These viruses can have [long-term] effects on the immunological immune system.También particles can bind to glial cells, which are brain cells that affect the lanotransmission [and influence the response to pain],” explains the Dr. Solitar. In addition, there is a well-established relationship between Lyme disease (caused by the bacteria Borrelia burgdorferi) and fibromyalgia: Some patients treated for Lyme – apparently cured – still face an abnormally high frequency of pain that characterizes fibromyalgia without provocation.
Trauma. Sometimes the development of fibromyalgia is a related injury, especially in the upper spine (neck). In other cases, it is associated with emotional stress such as the death of a family member or the loss of a job. The possible relationship between these types of self-injury is that neurohormonal changes in physical injuries and emotional stress can trigger. Psychological processes can change – and can be modified – to change the function of hormonal regulatory centers such as the hypothalamus and pituitary and adrenal glands, which can affect the nervous system.
- Other fibromyalgia company underway
“Fibromyalgia is associated with all age groups, although women between the ages of 30 and 50 have a higher incidence of the disease,” says Dr. Solitar. Although this increase in prevalence among young women suggests a hormonal relationship, he said it is also possible that this is related to the diagnosis. “Women tend to have [natural] [or pain-sensitive] competition that men, so if you base your diagnosis on sensitive issues, it is likely that the diagnosis of fibromyalgia with more women than men . ”
In addition, fibromyalgia often develops in several members of the same family, but it is not known if this is the result of genetic or environmental effects. “The parents of people with fibromyalgia seem to be more sensitive than others,” says Dr. Solitar, “but not the very conclusive genetic research. ”
In many cases, the proportion of fibromyalgia is still largely unknown. “For many patients, not finding a good explanation for the development of fibromyalgia,” says Dr. Solitar. “We are all exposed to stress regularly. And there are many people gradually developing wounds and infections seem to be a common theme [fibromyalgia] a feeling of unease. ”
and symptoms of variable area of distribution, often confused, patients and doctors. There is no widely accepted blood test or diagnostic biomarker, although people with physical limitations report a change in life. Now, a new study from the University of Michigan joins the broad spectrum of symptoms of fibromyalgia in a brain molecule called glutamate, opening the door to new treatment options and the most accurate methods of diagnostic testing.
- Fibromyalgia: new evidence could help diagnose
The symptoms of fibromyalgia are extreme fatigue and digestive disorders such as flu and migraine pain. However, due to the lack of specific quantitative or qualitative data, physicians have long been forced to self-assess a patient to help diagnose this difficult condition. Because of this, some doctors do not take the disease seriously.
Pioneering research conducted in 2002 by Daniel Clauw, MD, professor of medicine and deputy director of the University of Michigan Medical School, provided the first strong physical and biological evidence that fibromyalgia patients experience intense pain when they have says they did it. Functional magnetic resonance imaging by brain imaging (fMRI) has shown that people with fibromyalgia are more sensitive to pain than those in a control group; the pain caused similar brain areas at different levels with a slight FM group study compared to the control group.
The generalized nature of chronic pain associated with fibromyalgia – the pain is not specific to a group of muscles or joints – is being revised. “Most doctors believe that fibromyalgia is a secondary problem, which involves muscles and joints, as experienced and informed patients,” said Richard Harris, Ph.D., a researcher at the Division of Internal Medicine in the Department of Medicine. rheumatology from the University of Michigan. researcher at the University of Chronic Pain and Fatigue Research Center; and a colleague of Dr. Clauw. “The results of this study suggest that fibromyalgia may be a condition of the central nervous system. This makes it harder for critics to explain the results, so patients can not simulate the results of an MRI test. ”
- Fibromyelia: Ile glutamate pain
Dr. Harris and other researchers at the University of Michigan found that pain levels in patients with fibromyalgia were positively correlated with levels of glutamate, an amino acid and neurotransmitter (brain chemical) responsible for nerve cell stimulation. “When patients received treatment to reduce pain, glutamate levels were reduced accordingly,” said Harris.
Previous research has shown a link between activity in a part of the brain called the insula (insular cortex) and pain in people with fibromialgia.Em around the island is also involved in muscles and stimulating the skin and internal sensations, like the intestine. This association may help to explain the increased incidence of digestive disorders such as irritable bowel syndrome, fibromyalgia. Other related conditions such as anxiety, fibromyalgia and migraine may also be related to central nervous system involvement, according to Andrew Holman, MD, rheumatologist and assistant clinical professor of medicine at the University of Washington.
- Fibromyalgia research leads to new drugs
new drugs are now available for use in the treatment of defibromyalgiasymptoms through this research. “The Food and Drug Administration recently approved pregabalin (Lyrica) and duloxetine (Cymbalta), two drugs that both work in the center as a direct result of new research,” says Dr. Holman. “Fibromyalgia has its own process, but autonomic nervous system problems causing sleep deprivation stage 4 [symptoms of fibromyalgia] come in the same areas of the brain that are responsible for problems such as intestinal lamotility and basic escape [on anxiety symptoms]. ”
Despite these findings validate the more subtle symptoms seen in patients with fibromyalgia, further study before the fMRI test is part of a routine Harris diagnosis is necessary, he said. In the meantime, Harris stresses the importance of being aware of their symptoms and managing them appropriately. “Fibromyalgia is not one of those situations where you can do one thing and do it,” he said. “It’s a symptom control issue with a multi-faceted approach. ”
- ous MedicaFibromyalgie
The exact cause of fibromyalgia is still a matter of speculation, so the current treatments are FDA-approved not specific at best. Many pharmaceutical options, however, are available for the treatment of various symptoms of fibromyalgia, which can range from muscle pain and sleep disorders, to depression and anxiety.
To date, the antidepressant duloxetine (Cymbalta) and milnacipran (Savella) and pregabalin (Lyrica), an anticonvulsant, which is also used for certain types of pain are the only prescription drugs approved by the FDA specifically for treatment fibromyalgia. However, doctors are using drugs approved for other conditions associated with the treatment of specific fibromyalgia symptoms. Many of these medications treat more of a problem with fibromyalgia. Like all medicines, most of the drugs listed here have significant side effects and interactions. You should discuss all prescription drugs with your doctor and pharmacist before taking.
Pain relief and sleep enhancement are the main goals of treating fibromyalgia and medications, but doctors also prescribe various medications to treat depression and fatigue.
The following drugs are commonly used in the treatment of fibromyalgia.
Analgesics
over the counter medications for pain does not work very well for fibromyalgia because the disease does not have much swelling. Localized opioid disinjections and can sometimes be helpful, depending on the specific symptoms.
- against painkillers. Tylenol (acetaminophen) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Anaprox) may help some patients. However, it is generally recommended for patients with peripheral pain (involving the muscles and connective tissue and / or the peripheral nervous system, as opposed to fibromyalgia, a central nervous system disorder), and more the syndrome lafibromyalgia.
- . Opioid Therapies Some pain relief reported with opioids such as tramadol (Ultram), and the combination of tramadol and paracetamol (Utracet) – can also relieve sleep disorders. Although they are effective against acute and severe pain, opioids such as hydrocodone / acetaminophen (Vicodin), propoxyphene / acetaminophen (Darvocet), oxycodone / acetaminophen (Percocet) and oxycodone (OxyContin) do not work. not well with general chronic pain LELONG-tert. The terms of the spoken language carry the risk of addiction and have been associated with other side effects – for example by increasing the body’s sensitivity to pain and constipation and drowsiness.
- injections of trigger points. Injections of local anesthetics (such as lidocaine and laprocaine) and / or cortisone (steroids) can help treat muscle pain, tendons, ligaments, we break the cycle of pain and muscle spasms.
Antidepressants
These medications help regulate certain chemicals in the brain called neurotransmitters, which are involved in various symptoms of fibromyalgia, including muscle pain, sleep disorders, and fatigue. For best results, they are sometimes used in combination. Among the most commonly prescribed include:
- Tricyclic antidepressants. Amitriptyline (Elavil), nortriptyline (Pamelor), and doxepin (Sinequan) and tetracyclic antidepressant trazodone (Desyrel), which increases the levels of serotonin and norepinephrine, a brain neurotransmitter that affect the signs of depression and pain and sedation often induces sleep.
- selective reuptake inhibitors (SSRIs). This group includes citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), paroxetine (Paxil).
- selective serotonin noradrenaline reuptake inhibitor (SSNRI) inhibitors. This new class of antidepressants, also known as ADbleble Absorption Inhibitors, regulates the neurotransmitters serotonin and norepinephrine. They include venlafaxine (Effexor), desvenlafaxine (Pristiq), duloxetine (Cymbalta) and Savella (milnacipran).
Muscle relaxants
such as medications and cyclobenzaprine (Flexeril Cycloflex Flexib), carisoprodol (Soma) and methocarbamol (Skelex) are often prescribed to treat painful muscle spasms, but are generally used for short and long-term relief.
Anticonvulsants
These medications are used for fibromyalgia because these drugs also help treat the neuropathic pain that occurs when the nerves are excited and insensitive. Drugs in this category include pregabalin (Lyrica) and carbamazepine (Carbatrol, Epitol, EQUETRO, Tegretol, Tegretol XR-y) and lagabapentin (Gaborone Neurontin).
Sedatives / hypnotics
for sleep is essential for relieving the symptoms of fibromyalgia. If other drugs (especially muscle relaxants and antidepressants) are not effective, doctors may prescribe short-term sleeping pills such as zolpidem (Ambien) and zaleplon (Sonata), and eszopiclone (Lunesta), slow work on the brain for allow sleep. . However, these drugs often lose their effectiveness in the long run.
Stimulants
Some doctors are already prescribing medications used for Attention Deficit and Deficit Hyperactivity Disorder such as Methylphenidate (Ritalin), Sulfate, Dextroamphetamine (Dexedrine) and Modafinil (Provigil) to relieve symptoms of fatigue and “brain fog” (difficulty of thinking and concentration) of fibromyalgia patients often experience.
On the horizon
new drugs for the treatment of fibromyalgia is provided sodium oxybate (Xyrem), also known as GHB. This central nervous system depression is currently approved for the treatment of narcolepsy, but has shown resultsprometteurs to relieve pain and improve function of fibromyalgia patients. The application for approval was submitted to the FDA on December 15, 2009.
Finally, in addition to medications, doctors often recommend other pain treatments exploring. Among the most effective are massage and myofascial release therapy, a technician used to relieve tension in the body that can help relieve discomfort and reduce muscle spasms.
