Is The Fibromyalgia Mystery Finally Solved?

Before I begin this post I have entitled, “Is The Fibromyalgia Mystery Finally Solved?” I would like to present a real life case that presented to my practice of chronic pain management:
The young wife and her husband were waiting anxiously in the exam room,  ” What seems to be troubling you Stella…”,  I asked her?   “I am so uncomfortable Doctor.  I ache all over, I have trouble sleeping, I have no energy, and I am depressed.  

I have been to several other primary care physicians who all refer me to a psychiatrist.  I am not crazy.  I was fine just a few months ago (her husband rolls his eyes) and now I feel like I need to go on disability.” I looked at Stella’s husband who said,  “Doc, we haven’t had sex in months…you have got to do something!” 

If this sounds familiar then your have become acquainted with a common contemporary syndrome called Fibromyalgia.

WHAT ARE THE SYMPTOMS OF FIBROMYALGIA?


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Although Fibromyalgia (FM) has probably been around  since the early 1820’s (called muscular rheumatism at that time), the syndrome was officially recognized in 1990 by the American College of Rheumatology.  Guidelines were published in an attempt to help diagnose this very uncomfortable disorder.

FM is characterized by diffuse pain, fatigue out of proportion to physical activity, mental slowing, and difficulty sleeping.  FM occurs 7 times more frequently in women than men and tends to cluster in families.

An association between Depression and Fibromyalgia exists which implies a similar neurophysiological mechanism.

There is no specific diagnostic study that confirms the diagnosis of Fibromyalgia.  

HOW IS FIBROMYALGIA DIAGNOSED?


If the diagnosis of Fibromyalgia has no specific diagnostic study that confirms it, how then could it be diagnosed?

The answer is by a diagnosis of exclusion.

A diagnosis of exclusion means that other likely causes for the symptoms are excluded which would leave only the diagnosis of Fibromyalgia to explain the symptoms a patient may be having.  The following flow chart is a summary of how the diagnosis of Fibromyalgia is made:

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WHAT IS THE MECHANISM OF FIBROMYALGIA?


The location where the physiological abnormality originates is thought to be in the central nervous system.   This is because of the diffuse nature of the symptoms in FM and its association with other psychological disorders (depression for one).

Dr. Mohammed Yunus, MD has suggested that FM belongs in the category of a syndrome he calls the “Dysregulation Spectrum Syndrome” (DSS).  Essentially DSS is a disruption of the chemicals in the brain with resultant effect on hormonal and nervous function.

As the nervous system is connected to every part of the human body, the symptoms in FM are widespread and variable.

WHAT ARE THE THERAPIES FOR FIBROMYALGIA?


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The therapy of FM is non-specific and includes both pharmacologic and alternative treatments.  If you look at the treatments through a “conceptual lens” it would seem that nearly all treatments can be seen to effect the neurotransmitter levels in the human brain.

Exercise, massage therapy, diet therapy, and nutraceutical supplements are all aimed at up-regulating neuro-transmitters.

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A promising form of alternative treatment (being administered under a doctor’s care exclusively) is as structured by Dr. Hinz at www.neuroreplete.com.  His method utilizes a high dose supplement which restores the neurotransmitter balance in the brain.

I do want to emphasize that Dr. Hinz’s form of care for FM must be directed by a licensed physician. According to an article written by Dr. Stevan Cordas on this form of therapy, the results that Dr. Hinz has had with this regimen have been consistently positive.

This is in contrast to the mixed therapeutic results that most other alternative therapies yield.

THERE IS HOPE…


A person suffering with this malady must persist in trying multiple different therapies to finally discover what works for them.  

Most people with Fibromyalgia will require a combination of therapies to obtain relief of their chronic pain.  

As can be imagined, it is really difficult to search and try multiple different treatments while feeling so uncomfortable. I have observed that those who do so will eventually discover a regimen that works for them.  

The key factor is to not give up trying different combinations of therapies until you feel relief of your pain.

If you have any questions or comments, please leave them below.  I would love to hear from you and will answer you promptly.

Wishing you joy and healing,

Jeff

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