“What is best best way to improve the pain, fatigue, and other symptoms of fibromyalgia?”

This is going to be a long discussion over many blog posts to help fibromyalgia patients better understand their problem and treatment options.

FIRST! It’s best to work with a good practitioner to help you with this painful, often debilitating condition. 

Every person is different, even with the same or very similar symptoms. There is a large variance particularly in those diagnosed with fibromyalgia syndrome.

The diagnosis itself can be incorrect in many people in that it does not identify what is causing the problem.

According to a study in the Journal of Rheumatology, 

“There is a disturbing inaccuracy, mostly observed to be overdiagnosis, in the diagnosis of FM by referring physicians. This finding may help explain the current high reported rates of FM and caution physicians to consider other diagnostic possibilities when addressing diffuse musculoskeletal pain.”

Rheumatology (Oxford). 2003 Feb;42(2):263-7. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Fitzcharles MA1, Boulos P.

Other studies have found that there may be some consensus on diagnosis, but consensus does not necessarily speak to diagnostic accuracy.

Symptoms of fibromyalgia may represent different problems in different people.

“A review of the fibromyalgia literature leads these authors to suggest that physicians need to take a hard look at the validity of the diagnosis of FMS as a single clinical entity and explore the alternate idea of multiple subsets of patients with myriad causes for their widespread pain and fatigue.”

In other words, people diagnosed with fibromyalgia may have substantially different causes of the symptoms.

Schneider MJ, Brady DM, Perle SM. Differential diagnosis of fibromyalgia syndrome: proposal of a model and algorithm for patients presenting with the primary symptoms of widespread pain. J Manipulative Physiol Ther. 2006;29:493-501.

The pain and fatigue symptoms of fibromyalgia can be caused by some disease process including cancer, multiple sclerosis, Lyme disease, autoimmune disorders, rheumatoid arthritis, hypothyroidism, and anemia.

A metabolic disorder such as occurs with thyroid problems, a mitochondrial disorder, or even diabetes can also involve widespread pain and fatigue.

These are just a few reasons why it’s important to work with a very good health practitioner.

Getting back to fibromyalgia, it’s generally a collection of symptoms that have a neurological (brain) basis which are functional in nature.

In other words, an area isn’t functioning as well as it should be – but it’s not that an area has died off like happens in stroke, a gunshot, etc.

The specific localization of the problem varies in the individual and leads to the symptoms that you experience.

The idea that true fibromyalgia is a brain based problem is supported by the myriad of symptoms. When evaluating a patient, especially in neurology, a doctor has to look for a specific area of dysfunction that is causing the pain and other problems that would explain all (or many) symptoms.

Looking at all the symptoms of fibromylagia, it can generally only be explained by looking at an area of the nervous system above the spinal cord.

Evidence from various studies also indicates that it is a brain based problem causing the symptoms.

Here are a couple of representative studies…

“Metabolic examination of muscles during isometric exercises in fibromyalgia patietns indicates the fatigue is coming from a central (brain) etiology and not the muscle itself.” Ann Rheum Dis 2013: 72: 963-956

Interestingly, the authors of this study comment that “Benefits of pharmacological treatments in FMS are of questionable clinical relevance and evidence for benefits of non-pharmacological interventions is limited.”

The unfortunate truth of this is because the people suffering are generally not treated appropriately FOR THEM as unique individuals.

It’s what appears to be the case written about in the study.

Further support that fibromyalgia is a central (brain based) problem comes the fact that biopsy of the areas of painful muscles do not demonstrate a muscular problem.  

Another study published in 2002, that used advanced brain imaging supports the idea that the widespread pain sensitivity associated with FMS is caused by central nervous system dysfunction (brain) as documented by functional MRI and positron emission tomography brain (PET) scans of patients with FMS receiving innocuous sensory stimulation.

From the study,

“The fact that comparable subjectively painful conditions resulted in activation patterns that were similar in patients and controls, whereas similar pressures resulted in no common regions of activation and greater effects in patients, supports the hypothesis that FM is characterized by cortical or subcortical augmentation of pain processing.”

Gracely RH, Petzke F, Wolf JM, Clauw DJ. Functional magnetic resonance imaging evidence of augmented
pain processing in fibromyalgia. Arthritis Rheum. 2002;46: 1333-43.

Without question, a doctor that understands pain and has looked at these studies is a great place to start when identifying the area of neurological dysfunction in a fibromyalgia patient that is causing the pain and other problems.

Identifying this allows for specific treatment to be designed to help essentially ‘rehab’ the problem over time.

This can be done, in conjunction with other treatments.

The fibromyalgia patient may be best served with a team approach that includes various doctors.

What can a fibromyalgia patient do on their own to help their pain and other symptoms?

It does depend on the cause as discussed previously.

In general, working on improving lifestyle factors can have a big impact and go a long way towards helping a person improve/recover.

Here is an important factor that you have probably never heard of that you can easily do on your own in order to help or, in some cases, resolve your symptoms.

Do You Or A Loved One In Texarkana Suffer With Fibromyalgia?

Come see us to help get your life back!