Fibromyalgia

Introduction

Fibromyalgia is a common musculoskeletal disorder, which mostly affects women (in 90% of all cases). Fibromyalgia pain (described under " signs and symptoms") is the main symptom, but sleep disturbance is also common. Among women in postretirement age the frequency is as high as 7%. In industrialized nations about 2 to 4% of the poplation at large suffers from this condition (Ref. 1). It is characterized by wide spread pain, by fatigue, a sleep disorder and painful tenderspots in various anatomical locations.

When more than 12 out of 18 defined tender spots are positive, the diagnosis of primary fibromyalgia can be made.

However, there are also fibromyalgia symptoms that can accompany other rheumatic illnesses and medical diseases, in which case the physician calls this type secondary fibromyalgia. Common medical illnesses that need to be delineated from fibromyalgia are: diabetes mellitus, hypothyroidism, depression, hepatitis, multiple sclerosis, electrolyte disturbances such as hypokalemia etc., or cancer (Ref. 2).

According to Dr. Lichten (Ref. 8) a consistent finding in various publications is the fact that the normal sleep pattern is interrupted. Sleep studies show that there is a specific pattern called alpha-delta sleep, where the deep sleep required for the regeneration of growth hormone is interrupted by wakefulness (measured as alpha sleep waves). EEG recordings further show that REM sleep (sleep stage 3 and 4) is reduced leading to muscle stiffness and pain, inability to concentrate, brain fog and fatigue. This becomes important when treatment of fibromyalgia is considered (see treatment link).

Fibromyalgia belongs into the psychosomatic disease category. With fibromyalgia there is bottled up anger (usually subconscious) and muscle aches and pains occur due to an accumulation of lactic acid in the muscles (Ref. 9). Dr. Platt points out that there is a connection between ADHD (Attention-Deficit Hyperactivity Disorder) and fibromyalgia. Both Ref. 9 and 10 point out that with fibromyalgia there is a brain hormone dysbalance and a hormone dysbalance in the body that is responsible for the multifaceted presentation of symptoms. Many patients are not diagnosed properly or have only been partially treated with regard to this chronic condition. This would also account for some of the bottled-up anger, which in turn leads to more adrenalin production in the adrenal glands with subsequent lactic acid accumulation in the muscles causing more pain. As is discussed further under treatment of fibromyalgia the anti-aging medicine approach addresses the hormone dysbalance based on saliva hormone tests. With fibromyalgia there are often multiple hormone deficiencies that are affecting the thyroid, adrenal glands (DHEA and cortisol), growth hormone production (anterior pituitary gland), and testosterone and progesterone production. With the combination therapy of conventional medicine the underlying hormone dysbalance is not treated leading to a failure with long-term therapy. This will be discussed further under "treatment of fibromyalgia".

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Fibromyalgia

Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. G.Littlejohn Aust Fam Physician 2001 Apr;30(4):327-333.

2. LS Brecher et al. J Am Osteopath Assoc 2001 Apr;101(4 Suppl Pt 2):S12-17.

3. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 59.

4. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999. Chapter 6. Fibromyalgia Syndrome.

5. B Mukerji et al. Angiology 1995 May;46(5):425-430.

Last Modified: May 27, 2010