Painful and puzzling, fibromyalgia primarily strikes women. Why?
Researchers don't know. And with details scarce about its cause and treatment,
dealing with the condition can be maddening. We have answers to 10 common
questions, just in time for National Fibromyalgia Awareness Month…
1. What causes fibromyalgia?
Genetics may play a role in developing
fibromyalgia. But no one really knows what causes the syndrome and there are no
known risk factors.
The most prevalent theory is that fibromyalgia results from a disturbance in
the central nervous system called central sensitization, which may
intensify pain signals.
Linked to that theory is the notion that patients have higher amounts of a
compound called substance P in their spinal fluid, which increases their
sensitivity to pain.
Another theory: There may be two types of fibromyalgia: “primary”
fibromyalgia, which occurs spontaneously, and “secondary” fibromyalgia, which
may be triggered by trauma – such as a car accident – or by certain infections,
such as Lyme disease and hepatitis C.
Some researchers think that the primary type is caused by a sleep
disturbance, but it’s also possible that the sleep disturbance is a symptom of
fibromyalgia.
2. I often hear fibromyalgia, chronic fatigue syndrome and lupus
mentioned together. Are they similar?
Although the three are separate
conditions, symptoms of fibromyalgia and chronic fatigue syndrome overlap. And
fibromyalgia and lupus both involve the muscle and bone network in our bodies,
which can cause confusion between the two illnesses.
Fibromyalgia is characterized by many symptoms including muscle pain,
fatigue, sleep disturbances, irritable bowel syndrome and, in some people,
depression. Despite its consistent general characteristics, it can be tough to
diagnose because symptoms vary from patient to patient.
The main symptoms of chronic fatigue syndrome (CFS) include:
Overwhelming fatigue
Memory loss
Muscle soreness
Sore throat
Swollen glands.
Symptoms can coincide or come and go in individual cycles. Doctors usually
diagnose CFS through a process of elimination: They rule out other potential
causes of long-term fatigue.
Lupus is an autoimmune disease in which the body attacks itself. It may start
with joint pains, which patients can confuse with the muscle pains of
fibromyalgia. Diagnosed by blood tests that show a high level of certain
antibodies, lupus can be progressive and cause serious illness throughout the
body. People with lupus appear more prone to develop fibromyalgia and chronic
fatigue, although researchers don’t know why.
3. Why do more women than men get fibromyalgia?
The majority of
people with fibromyalgia (80-90%) are women, as is the case with lupus and CFS.
No one knows why women are affected more often than men.
4. Is it age-related?
Fibromyalgia occurs most commonly in
people between 20 and 55 years old, although it may arrive at any age, including
childhood.
5. Is it an autoimmune disease or a form of arthritis?
Neither. In
fact, unlike inflammatory arthritis and autoimmune disease, which cause joint
destruction and inflammation, fibromyalgia causes neither, despite symptoms of
joint and muscle pain.
6. What are warning signs or symptoms of fibromyalgia?
Alas, the
symptoms arrive without warning. They can, as mentioned earlier, include muscle
and joint soreness, fatigue, sleep problems, irritable bowel symptoms, morning
stiffness, depression and brain fog.
7. How is it diagnosed?
Unfortunately, it’s not uncommon to be
misdiagnosed or have to see several doctors before a diagnosis is made. Your
best bet is to see a rheumatologist, a doctor who specializes in conditions
affecting muscles and joints. He or she will look for symptoms and physical
findings that meet a specific definition of fibromyalgia established by the
American College of Rheumatology.
For instance, a patient must have 11 out of 18 specific tender points on her
body (neck, shoulders, back, hips, and upper and lower extremities), and she
must have had widespread pain in her muscles and joints lasting for three months
or more without explanation.
The doctor will also work to rule out other diseases that have similar
symptoms, such as lupus and polymyalgia rheumatica (another autoimmune disease).
8. What lifestyle changes can I make to help alleviate the
symptoms?
Get plenty of gentle aerobic exercise (like swimming or walking
briskly), working up to at least 30 minutes most days of the week. Weight gain
commonly accompanies fibromyalgia (thanks to the fatigue, muscle pain and poor
sleep). Regular exercise will give you more energy, boost your mood, lower your
weight and help you sleep better.
Eating a healthy diet with lots of vegetables, fruits, whole grains, lean
meats and dairy also will energize you, lower your weight and improve
your overall health as you battle fibromyalgia. You can also try eliminating the
following foods, which appear to bother some people with fibromyalgia:
Aspartame (NutraSweet)
Food additives like MSG and nitrates (the preservative in hotdogs and bacon)
Sugar
Caffeine drinks.
But remember, what works for one person may not work for another.
9. What are the latest treatments?
Pregabalin
(Lyrica), a fairly new medication, is the first to be approved by the Food and
Drug Administration (FDA)for fibromyalgia. Studies suggest that it prevents pain
and improves sleep by slowing the release of chemicals associated with pain.
Older standbys can help too. Anti-inflammatories such as ibuprofen and muscle
relaxers can relieve pain. Antidepressants – especially tricyclics
(amitriptyline or Elavil) – boost mood as well as lessen pain and improve sleep.
Supplements such as 5-HTP and SAM-e (S-adenosylmethionine) may also be
useful. An amino acid, 5-HTP, converts to serotonin, a feel-good
neurotransmitter that helps boost mood and sleep. SAM-e is an enzyme already
present in the body that affects mood and lessens pain.
D-Ribose, a simple sugar in powder form, may lessen pain and fatigue when
dissolved in water and taken two to three times daily.
Cognitive behavioral therapy, acupuncture, hypnotherapy and biofeedback may
also be worth trying.
10. What is the long-term outlook for a woman with
fibromyalgia?
The good news is that fibromyalgia does not cause damage to
muscles and joints that can lead to debilitation, immobility or joint
replacement.
The bad news is that the symptoms typically don’t resolve.
Many women simply must learn to live with fibromyalgia.
The key is finding individual or combination therapies that help. Not all
treatments help all patients with fibromyalgia; discovering which help you is a
matter of trial and error. But scientists continue to work on finding the cause
of fibromyalgia and, ultimately, a cure or effective treatment.
Want to learn more? Get your own copy of The Smart Woman's Guide to Midlife and Beyond. Plus, meet
Dr.
Robin Miller and Dr. Janet Horn.
Women’s Health: How Much Do You Know?
As a woman, your health
concerns are as unique as your body. Test your smarts with this women's health
quiz.
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