Although there are many speculations going on about what triggers fibromyalgia, its causes are not yet definitively identified and confirmed. Recent research has generally found that fibromyalgia is most likely the result of what scientists call the central consciousness, or unusual reactions in the nervous system in terms of perception of pain.
- biochemical triggers of fibromyalgia
- physical and emotional triggers of fibromyalgia
What makes the path of nervous system dysfunction? Scientists are not sure, but a number of conditions have been linked to the development of fibromyalgia. These include:
Infection. The influenza and hepatitis causing the Epstein-Barr virus B and C have been implicated in the development of fibromyalgia. “These viruses can have [long-term] effects on the immune system. Tambien can viral particles bind to glial cells, which are cells in the brain that affect the transmission of [and influence the response to pain],” says the author. Dr. Solitar.In addition, there is a well-established relationship between Lyme disease (caused by a bacterium called Borrelia burgdorferi) and Fibromyalgia: Some patients who have been treated for Lyme – and apparently recover from it – still face a abnormally high frequency pain without provocation It characterizes fibromyalgia.
Trauma. Sometimes the development of fibromyalgia is related to a physical lesion, especially in the upper column (cervix). In other cases, it is associated with high emotional stress, such as death of a family member or loss of a job. The possible relationship between these types of self-injury are neurohormonal changes physical injuries and emotional stress can trigger. Psychological processes can change – and can be modified – alterations in the function of regulating hormone centers such as the hypothalamus and pituitary and adrenal glands, which in turn can affect the nervous system.
- Other common cases of fibromyalgia
“Fibromyalgia is associated with all age groups, although women between the ages of 30 and 50 have a higher incidence of the disease,” says Dr. Solitar. Although this increase in prevalence among young women suggests a hormonal relationship, he says it is also possible that it is related to the diagnosis. “Women tend to [Natural] offer [or sensitive to pain] than men, so if you base your diagnosis on sensitive issues, it is likely that the diagnosis of fibromyalgia with more women than men. ”
In addition, fibromyalgia often develops in several members of the same family, but it is difficult to know if this is the result of genetic or environmental effects. “The parents of people with fibromyalgia seem to be more sensitive than others,” says Dr. Solitar “but not much more conclusive genetic research there.”
In many cases, the reason fibromyalgia strikes is still largely unknown. “For many patients, does not come with a good explanation for the development of fibromyalgia,” says Dr. Solitar. “We are all exposed to stress regularly. And while injuries and infections seem to be a common theme [fibromyalgia], there are many people who come gradually to develop a feeling of discomfort. ”
and its variable distribution of symptoms zone often deflection, patients and doctors. There is no blood test yet or widely accepted biomarker of the disease, although people with physical limitations report a change in life. Now a new study from the University of Michigan joins the wide range of symptoms of fibromyalgia in a molecule in the brain called glutamate, opening the door to new treatment options and the most accurate methods of diagnostic testing .
- Fibromyalgia: New Evidence Could Help Diagnose
the symptoms of fibromyalgia are extreme fatigue and flu like digestive diseases and migraine pain. Due to the lack of specific quantitative or qualitative evidence, however, physicians have been compelled for a long time to rely on a patient’s self-assessment to help diagnose this difficult condition to achieve. Because of this, some doctors do not take the disease seriously.
Pioneering research conducted in 2002 by Daniel Clauw, MD, professor of medicine and associate dean of the University of Michigan Medical School, provided the first strong biological and physical evidence that fibromyalgia patients really feel intense pain when they said they did. A form of brain imaging called functional magnetic resonance imaging (fMRI) showed that people with fibromyalgia are more sensitive to pain than those in a control group; Similar levels of pain also caused different areas of the brain to light FM group studies than the control group.
The generalized nature of chronic pain associated with fibromyalgia – the pain is not specific to any group of muscles or joints – is being revised. “Most doctors believe that fibromyalgia is a secondary issue, which involves muscles and joints, as well as experienced and informed patients,” said Richard Harris, Ph.D., research investigator in the Division Department. Rheumatology of Internal Medicine at the University of Michigan Medical School and Chronic Pain Researcher University and Fatigue Research Center; and a colleague of Dr. Clauw. “The results of this study suggest that fibromyalgia may be a condition of the central nervous system. This makes it harder for critics to explain the results,
- Fibromyalia: The glutamate of pain related
Dr. Harris and other researchers at the University of Michigan found that pain levels in patients with fibromyalgia were positively correlated with levels of glutamate, an amino acid and neurotransmitter (brain chemical) responsible for the stimulation of nerve cells. “When patients received treatments designed to reduce pain, glutamate levels were reduced accordingly,” says Harris.
Previous research has shown a link between activity in a part of the brain called the insula (insular cortex) and pain in people with fibromyalgia. Around the island, he is also involved in the muscles and stimuli of the skin, in addition to internal sensations such as the intestine. This association may help to explain the increased incidence of digestive problems such as irritable bowel syndrome, fibromyalgia. Other related conditions, such as anxiety and fibromyalgia migraines, may also be related to central nervous system involvement, according to Andrew Holman, MD, a rheumatologist and assistant clinical professor of medicine at the University of Washington.
- the search for fibromyalgia leads to new drugs
new drugs are now available for use in treatment defibromyalgiasymptoms through this research. “The recently approved Food and Drug Administration pregabalin (Lyrica) and duloxetine (Cymbalta), two drugs that both work in the center as a direct result of the new research,” says Dr. Holman. “Fibromyalgia has its own process, but autonomic nervous system problems causing stage 4 sleep deprivation [a symptom of fibromyalgia] come in the same areas of the brain that are responsible for such issues as bowel lamotility [which relates with SII] and wrestling or basic steal syndrome [regarding anxiety symptoms]. ”
Despite these findings validating the most subtle symptoms observed in fibromyalgia patients, more research is needed before the fMRI test becomes part of a routine diagnosis Harris says. Until then, Harris emphasizes the importance of being aware of their symptoms and managing appropriately. “Fibromyalgia is not one of those conditions where you can do one thing and do it,” he says. “It’s all about symptom management with a multi-faceted approach.”
The exact causes of fibromyalgia is still a subject of speculation, so the current treatments, even approved by the FDA, are not specific at best. Many pharmaceutical options, however, are available to treat various symptoms of fibromyalgia, which can range from muscle pain and sleep disorders to depression and anxiety.
To date, duloxetine antidepressant (Cymbalta) and milnacipran (Savella) and pregabalin (Lyrica), an anticonvulsant drug that is also used for certain types of pain, are the only prescription drug approved by the FDA specifically for the treatment of fibromyalgia. However, doctors use other drugs approved for related conditions, to treat the specific symptoms of fibromyalgia. Many of these medications treat more of a problem related to fibromyalgia. As with all medications, most of the medications listed here have significant side effects and side interactions. You should discuss all prescription drugs with your doctor and pharmacist before taking.
Pain relief and improved sleep are the main goals of treating fibromyalgia and drugs, but doctors also prescribe several medications to treat depression and fatigue.
The following drugs are commonly used in the treatment of fibromyalgia.
plus over-the-counter pain medications do not work very well for fibromyalgia because the disorder does not have a lot of swelling. Prescription opioids and localized injections can sometimes be helpful, depending on the specific symptoms.
- counter painkillers. Tylenol (acetaminophen) and anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Anaprox) may help some patients. However, it is generally recommended for patients with peripheral pain (involving muscles and connective tissue and / or the peripheral nervous system, as opposed to fibromyalgia, a central nervous system disorder), and more from fibromyalgia syndrome.
- . Opioid Therapies some pain relief reported with desopioids such as tramadol (Ultram), and the combination of tramadol and acetaminophen (Utracet) – both of which can also help alleviate sleep disturbances. Although it is effective for acute and severe pain, opioids such as hydrocodone / acetaminophen (Vicodin), propoxyphene / acetaminophen (Darvocet), oxycodone / acetaminophen (Percocet) and oxycodone (OxyContin) do not work so well LELONG in chronic pain system, generales.Además terms of language, carry the risk of addiction and have been associated with other side effects – for example, by increasing the body’s sensitivity to pain and drowsiness and constipation.
- trigger point of the injections. Injections of local anesthetics (such as lidocaine and laprocaine) and / or cortisone (a steroid drug) can help treat sore muscles, tendons, ligaments, I break the cycle of pain and muscle spasms.
These drugs help regulate certain chemicals in the brain, called neurotransmitters, which are involved in various symptoms of fibromyalgia, including muscle pain, sleep disturbances and fatigue. For best results, they are sometimes used in combination. Among the most commonly prescribed include:
- Tricyclic antidepressants. Amitriptyline (Elavil), nortriptyline (Pamelor), and doxepin (Sinequan), and tetracyclic trazodone antidepressant (Desyrel), which increases the levels of serotonin and norepinephrine, brain neurotransmitters that affect the signals and pain of depression, and often a sedative, induces sleep.
- Selective reuptake inhibitors (SSRIs). Included in this group are citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), paroxetine (Paxil).
- Selective inhibitors of serotonin noradrenaline inhibitor (SSNRI). This new class of antidepressants, also known by the name Absorption Inhibitors, helps regulate the neurotransmitters serotonin and norepinephrine. They include venlafaxine (Effexor), desvenlafaxine (Pristiq), duloxetine (Cymbalta) and Savella (milnacipran).
medications such as cyclobenzaprine (Flexeril and Cycloflex Flexiban), carisoprodol (Soma) and methocarbamol (Skelex) are often prescribed to treat painful muscle spasms, but is commonly used for short-term relief.
These drugs are used for fibromyalgia because these drugs also help treat the neuropathic pain that occurs when the nerves are excited and must be desensitized. Drugs in this category include pregabalin (Lyrica) and carbamazepine (Carbatrol, Epitol, Equetro, Tegretol, Tegretol-XR y) and lagabapentin (Gaborone, Neurontin).
Sedatives / Hypnotics Restorative
sleep is essential to relieve the symptoms of fibromyalgia.If other medications (especially muscle relaxants and antidepressants) are not effective, doctors may prescribe short-term sleeping pills, such as zolpidem (Ambien) and zaleplon (Sonata) and eszopiclone (Lunesta), which work by slowing down the brain ‘s activity to allow sleep. These drugs often lose their effectiveness in the long run, however.
Some doctors now prescribe drugs used for attention deficit hyperactivity disorder and deficiency as methylphenidate (Ritalin), dextroamphetamine sulfate (Dexedrine) and modafinil (Provigil) to relieve symptoms of fatigue and ” “Brain Fog” (difficulty thinking and concentrating) that fibromyalgia patients often experience.
On the horizon
Among the new drugs in the treatment of fibromyalgia is planned sodium oxybate (Xyrem), also known as GHB. This central nervous system depression is currently approved for the treatment of lanarcolepsy, but has shown resultsprometteurs for relieving pain and improved function in fibromyalgia patients. The application for approval was submitted to the FDA December 15, 2009.
Finally, in addition to prescription medications, doctors often recommend thatother pain treatment therapies are to be explored. Among the most effective are therapeutic massage and myofascial release therapy, a specialized technician used to soothe tension in the body that can help relieve discomfort and reduce muscle spasms.