Although there are many speculations on what triggers fibromyalgia, its causes are not permanently 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 pain perception.
- biochemical triggers of fibromyalgia
- Physical and emotional triggers of fibromyalgia
The infection. the flu virus and the Epstein-Barr virus causing hepatitis B and C have been involved in the development of fibromyalgia. “These viruses may have [long – term] effects on viral system inmunológico.También particles can bind to glial cells, which are cells of the brain that affects laneurotransmission [and influence the response to pain],” says Dr. Solitar. In addition, there is a well – established relationship between Lyme disease (caused by the bacterium Borrelia burgdorferi) and Fibromyalgia: Some patients were treated for Lyme – and apparently recovered – still face an unusually high frequency of pain that characterizes fibromyalgia without provocation.
Trauma. Sometimes the development of fibromyalgia is related injury, inparticular in the upper spine (neck). In other cases, it is associated with emotional stress such as the death of a family member or loss of a job. The possible relationship between these types of self-injury is that the neurohormonal changes physical injuries and emotional stress can trigger. Psychological processes can change – and can be modified – change the function of regulating hormones centers such as the hypothalamus and pituitary and adrenal lesglandes, which can affect the nervous system.
- Other current fibromyalgia business
“Fibromyalgia is associated with all age groups, although women aged between 30 and 50 have a higher incidence of the disease,” says Dr. Solitar. Although this increase in prevalence among younger women suggests a hormonal relationship, he said it is also possible that this is related to the diagnosis. “Women tend to have competition [Natural] [or sensitive to pain] than 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 unclear if this is the result of genetic or environmental effects. “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 come up with a good explanation for the development of fibromyalgia,” says Dr. Solitar. “We are all exposed to stress regularly. And there are many people gradually develop injuries and infections seem to be a common theme [fibromyalgia] a sense of unease. ”
and symptoms of variable distribution area, often confused, patients and physicians. There is no blood test or diagnostic biomarker still widely accepted disease, although people with physical limitations report a change of life. Now a new study from the University of Michigan joins the wide range of symptoms of fibromyalgia in a molecule in the brain called glutamate, opening the door to new treatment options and the most accurate methods of diagnostic tests .
- Fibromyalgia: New evidence could help diagnose
Fibromyalgia symptoms are extreme fatigue and digestive disorders like the flu and pain of migraine. Due to the lack of however, specific quantitative or qualitative data, doctors have been forced for a long time for self-evaluation of a patient to help diagnose this condition difficult. For this reason, some doctors do not take seriously the disease.
Pioneering research conducted in 2002 by Daniel Clauw, MD, professor of medicine and associate director of the University of Michigan Medical School, provided the first physical and biological evidence strong that fibromyalgia patients feel intense pain when made a they said they did. A brain images call way functional magnetic resonance imaging (fMRI) has shown that people suffering from fibromyalgia are more sensitive to pain than those of a control group; pain caused similar brain areas as different levels with light FM group study than the control group.
The widespread nature of chronic pain associated with fibromyalgia – pain is not specific to one group of muscles or joints – is being revised. “Most doctors believe that fibromyalgia is a secondary issue, which involves the muscles and joints, as experienced and informed patients,” said Richard Harris, Ph.D., research investigator in the rheumatology department internal medicine division at University of Michigan medical School and researcher at the chronic pain University and research center of fatigue; and a colleague of Dr. Clauw. “The results of this study suggest that fibromyalgia may be a condition of the nervous system central.Cela makes it harder for critics to explain the results, patients can not fake the results of an MRI test. ”
- Fibromyalia: pain glutamate Ile
Dr. Harris and other researchers from the University of Michigan have found that levels of pain in patients with fibromyalgia were positively correlated with the levels of glutamate, an amino acid and neurotransmitter (brain chemical) responsible stimulation of nerve cells. “When patients have received treatment to reduce pain, glutamate levels have been 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 the muscles and stimulating the skin and internal sensations, such as the intestine. This association may help 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 linked to the involvement of the central nervous system, according to Andrew Holman, MD, a rheumatologist and Clinical Assistant Professor of Medicine, University of Washington.
- Fibromyalgia research leads to new drugs
new drugs are now available for use in the treatment 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 problems of the autonomic nervous system causing stage of sleep deprivation 4 [of the symptoms of fibromyalgia] come in the same brain areas that are responsible for problems such as intestinal lamotilité [which relates SII] and fight or basic leak syndrome [on anxiety symptoms]. ”
Despite these results validate the more subtle symptoms seen in fibromyalgia patients, further investigation before the fMRI test is part of a routine diagnostic Harris is needed, he said. Until then, Harris stresses the importance of being aware of their symptoms and manage appropriately. “Fibromyalgia is not one of those situations where you can do one thing and done,” he said. “It is a symptom control question with a multifaceted approach. ”
- ous MedicaFibromyalgia
The exact cause of fibromyalgia is still a matter of speculation, so that 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 vary from muscle pain and sleep disorders, depression and anxiety.
To date, the antidepressant duloxetine (Cymbalta) and milnacipran (Savella) and pregabalin (Lyrica), an anticonvulsant drug, which is also used for certain types of pain are the only prescription drug approved by the FDA specifically for the treatment of fibromyalgia. However, doctors use drugs approved for other conditions associated with treating specific symptoms fibromyalgie.Plusieurs these drugs treat more than one problem with fibromyalgia. Like all medicines, most drugs listed here have next significant side effects and interactions. You should discuss all prescription drugs with your doctor and pharmacist before taking.
Pain relief and improved sleep are the main objectives of the treatment of fibromyalgia and medication, but doctors also prescribe various drugs to treat depression and fatigue.
The following drugs are commonly used in the treatment of fibromyalgia.
more over-the-counter medicines against the pain does not work very well for fibromyalgia because the disease does not have much swelling. desinjections located opioids and can sometimes be helpful, depending on the specific symptoms.
- counter painkillers. Tylenol (acetaminophen) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Anaprox) can help some patients. However, it is generally recommended for patients with peripheral pain (involving the muscles and connective tissue and / or peripheral nervous system, as opposed to fibromyalgia, a disorder of the central nervous system), and more lafibromyalgie syndrome.
- . Opioid Therapies some pain relief reported with opioids such as tramadol (Ultram), and the combination of tramadol and paracetamol (Utracet) – both can also alleviate sleep disorders. While effective for acute and severe pain, opioids such as hydrocodone / acetaminophen (Vicodin), propoxyphene / acetaminophen (Darvocet), oxycodone / acetaminophen (Percocet) and oxycodone (OxyContin) do not work well in LELONG-tert General Purpose chronic pain. ademas terms speaking, 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.
- trigger point injections. Injections of local anesthetics (such as lidocaine and laprocaine) and / or cortisone (steroids) drug may help treat muscle pain, tendons, ligaments, we break the cycle of pain and muscle spasms.
These medications help regulate certain chemicals in the brain called neurotransmitters, which are involved in various symptoms of fibromyalgia, including desdouleurs muscles, sleep disturbances 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 trazodone tetracyclic antidepressant (Desyrel), which increases the levels of serotonin and norepinephrine, a brain neurotransmitter those affecting signs of depression and pain and sedatives often induces desommeil.
- selective reuptake inhibitors (SSRI). Included in this group are citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), sertraline (Zoloft) fluvoxamine (Luvox), paroxetine (Paxil).
- selective inhibitors of the reuptake inhibitor of norepinephrine serotonin (SSNRI). This new class of antidepressants, also known by the name of absorption inhibitors ADouble, helps regulate serotonin and norepinephrine neurotransmitters. They include venlafaxine (Effexor), desvenlafaxine (Pristiq), duloxetine (Cymbalta) and Savella (milnacipran).
such as drugs and cyclobenzaprine (Flexeril Cycloflex Flexib), carisoprodol (Soma) and methocarbamol (Skelex) are often prescribed to treat painful muscle spasms, but is usually used for short – long term relief.
These drugs are used for fibromyalgia, because these drugs also help to treat neuropathic pain that occurs when nerves are excited and to be insensitive. Drugs in this category include pregabalin (Lyrica) and carbamazepine (Carbatrol, Epitol, EQUETRO, Tegretol, Tegretol XR-y) and lagabapentine (Gaborone Neurontin).
Sedatives / hypnotics
for sleep is essential to alleviate the symptoms of fibromyalgia. If other medicines (especially muscle relaxants and antidepressants) are not effective, lesmédecins can prescribe short-term sleeping pills such as zolpidem (Ambien) and zaleplon (Sonata), and eszopiclone (Lunesta), slow work of activity on the brain to allow sleep. These medications often lose their long-term effectiveness, however.
Some doctors already prescribe drugs used for hyperactivity disorder deficit of attention and deficit as methylphenidate (Ritalin), sulfate, dextroamphetamine (Dexedrine) and modafinil (Provigil) to alleviate the symptoms of fatigue and ” brain fog “(difficulty thinking and concentration) of fibromyalgia patients often experience.
On the horizon
Of the new drugs for the treatment of fibromyalgia is supplied sodium oxybate (Xyrem), also known as GHB. This depress the central nervous system is currently approved for the treatment of narcolepsy, but showed résultatsprometteurs for pain relief and improvement of function lespatients fibromyalgia. The application for approval was submitted to the FDA December 15, 2009.
Finally, in addition to drugs, doctors often recommend thatother pain treatments exploring. Among the most effective are the massage and myofascial release lathérapie, a technician used to relieve tension in the body that can help relieve discomfort and reduce muscle spasms.