Non-pharmacologic treatments are needed Fibromyalgia is a common and poorly understood pain disorder that afflicts an estimated 200 million or more people worldwide. Pharmacological treatments for fibromyalgia are not available to the vast majority of these individuals. Even when available, prescription treatments for fibromyalgia are often marginally effective or entirely ineffective. Standard drug treatments…
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Sodium oxybate (Xyrem) appears superior to current FDA approved medications. An 8 week trial of sodium oxybate in the treatment of fibromyalgia resulted in a significant decrease in fibromyalgia impairment as measured by the Fibromyalgia Impact Questionnaire (FIQ.) Among those receiving sodium oxybate, the 4.5 gm dose resulted in a 20.4 point reduction in…
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Growth hormone deficiency in fibromyalgia. Growth hormone is one of the many chemical mediators of the hypothalamic-pituitary-adrenal axis (HPAA,) a very complex regulatory system affecting nearly every bodily function but especially critical in homeostatic regulation of the stress response. Is growth hormone low in fibromyalgia? Some studies (including the second study referenced below) have shown…
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A 12 week trial of Savella in the treatment of fibromyalgia. Approximately 500 patients received Savella, 50 mg twice a day, for 12 weeks. Prior to the 12 week period, patients had their dose of Savella gradually increased over 4 to 6 weeks in preparation for the 12 week stable dose phase of the…
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The term ‘sickness syndrome’ refers to a constellation of non-specific symptoms that develop in connection with many ailments, especially infections. Simply stated, when you get an infection you feel lethargic, fatigued, sleepy, and somewhat depressed. You feel sick.
Fibromyalgia results in those same symptoms, not (of course) because it’s caused by a ‘bug’, but fibromyalgia might trick your brain into thinking you’ve got one doozy of an infection – an infection that never seems to go away.
To see how fibromyalgia does that, and the expected results of such trickery – read on.
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One of the more unusual symptoms of fibromyalgia is a skin rash. It’s unusual in terms of frequency (perhaps 10% of those with fibromyalgia report a skin rash?) But it’s more unusual in that it’s hard to explain why fibromyalgia should cause a skin rash. At least it’s hard to explain if you accept the…
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Fibromyalgia results from a dysfunction of the immune system.
The authors of the study briefly summarized below (full text version here) begin by mentioning the theory of central sensitization. Immediately thereafter they note its inability to account for many of the common symptoms of fibromyalgia. Specifically, “mood disorders, fatigue, specific sleep disturbances, stiffness and post-exertional pain cannot be fully explained by the abnormalities of central pain processing.”
They note the similarity of fibromyalgia to those seen in ‘sickness syndrome’ – lethargy, fatigue, somnolence, and mood disorders (primarily depression) that results from the activation of the immune system, especially the production of pro-inflammatory cytokines, and perhaps the activation of glial cells by those cytokines.
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There is substantial evidence that central sensitization plays a significant role in the pathophysiology of fibromyalgia, but several questions remain unanswered. How does central sensitization originate? How to account for the diversity of symptoms, common among those with fibromyalgia that cannot be explained by means of central sensitization?
Cytokine abnormalities may provide some basis for answering both questions. As noted in the publication briefly summarized below, cytokine abnormalities are associated with fatigue, sleep impairment, pain, stress, and aching. Cytokine abnormalities may also contribute to (or determine) the initial onset of central sensitization.
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Fibromyalgia is a chronic pain condition that affects approximately 5 million individuals in the United States. These individuals comprise an estimated 5%–6% of all patients in primary care clinics and 10%–20% of all rheumatology outpatients. Those with fibromyalgia experience significant impairment in quality of life, disability, and incur total health care costs that are three…
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Elevation of cytokines in fibromyalgia, including IL-8, provides evidence in support of an inflammatory hypothesis. With exercise, the level of circulating markers of inflammation, including IL-8, are shown to decrease in fibromyalgia. It is well established that exercise reduces inflammation generally. Fibromyalgia symptom response to exercise is consistent with, and supports, the inflammatory hypothesis in…
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