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Alexa Alene | alexaalene120

Fibromyalgia: Causes & Treaments

Dec 17th 2013 at 9:30 PM

Researchers believe that there isn’t one single cause of fibromyalgia; rather, a number of factors may contribute. These factors may include:

Chemical changes in the brain – Some people with fibromyalgia appear to have alterations in the regulation of certain neurotransmitters, particularly:

Serotonin—which is linked to depression, migraines, and gastrointestinal distress;
Substance P, a brain chemical associated with pain, stress and anxiety, as well as depression.

Sleep disturbances – Some researchers theorize that disturbed sleep patterns may be a cause rather than just a symptom of fibromyalgia. Studies have shown abnormally low levels of a hormone called somatomedin C in the blood of people with fibromyalgia. Somatomedin C is thought to be essential for the body to rebuild itself and is secreted only during stage 4 sleep.

Injury –
Infection – Some researchers believe that a viral or bacterial infection may trigger fibromyalgia. Although no single viral or bacterial agent has been implicated, it may be that a number of such agents are capable of triggering fibromyalgia. Another possibility is that fibromyalgia may involve the reactivation of the immune response to previous viral infections. In other words, the immune system may be fighting the “ghosts” of past viral infections. This model was originally presented in an article published in the Lancet entitled “Cause and Prevention of Postinfectious and Postvaccinal Neuropathies in Light of a new Theory of Autoimmunity.” In this model, the basic hypothesis is that three requirements must be met to induce the disease state:

There must be an antigen present which is the same as or similar to some fragment of self tissue. We can call this the primary lesion.
There must be a second antigen which is chemically complementary to the first antigen.
Both antigens must be present and immunologically active in the host at the same time.

The presence of the second complementary antigen probably confuses the immune system and causes an inappropriate response to the first antigen. Once this process is triggered, it becomes self-sustaining due to the inflammation and tissue damage which occurs. This tendency for the immune system to respond inappropriately can be called a state of immune dysregulation.

Abnormalities of the autonomic (sympathetic) nervous system–The autonomic nervous system is divided into the sympathetic and parasympathetic systems. The sympathetic nervous system releases norepinephrine and influences the release of epinephrine from the adrenal gland. The sympathetic nervous system also controls bodily functions that aren’t consciously controlled, such as heart rate, blood vessel contraction, sweating, salivary flow, and intestinal movements. Several studies have looked at the responses of the sympathetic nervous system in people with fibromyalgia. There are reports of reduced epinephrine responses to low blood sugar levels and exercise. Other reported abnormalities include decreased responses to cold and altered heart rate and blood pressure responses during tilt-table testing — a noninvasive procedure normally used to help diagnose a common form of fainting (syncope). During the test, the subject lies on a bed that moves from a horizontal to a vertical position while blood pressure and heart rate are monitored.

Changes in muscle metabolism – For example, deconditioning and decreased blood flow may contribute to decreased strength and fatigue. Differences in metabolism and abnormalities in the hormonal substance that influences the activity of nerves (neuroendocrine), may play a role.

Other considerations – Psychological stress and hormonal changes also may be possible causes of fibromyalgia.

Since any combination of the aforementioned factors may play a role in the etiology of fibromyalgia, a multifaceted treatment approach may be necessary. First, let’s examine conventional medical treatments.
Conventional medical treatments

Despite the prevalence of fibromyalgia, no drugs have been developed or approved specifically for its treatment. However, researchers are currently studying at least two drugs to treat the condition’s multiple symptoms. In clinical trials, interferon alpha (Veldona) shows promise as a treatment for fibromyalgia pain and stiffness. Another drug, pregabalin, has been show to ease pain, promote sleep, and relieve fatigue.

Until these or similar drugs are approved, doctors prescribe a wide variety of medications to treat specific symptoms of fibromyalgia. For example, because sleep disturbance is common in fibromyalgia, some of the most effective drugs are those that promote restful sleep. But traditional sleep aids aren’t necessarily the answer. Many doctors and patients find that some antidepressants, including tricyclic antidepressants, as well as benzodiazepines can promote deep, restorative sleep when taken at bedtime. Also, the selective serotonin reuptake inhibitors (SSRIs) may be taken along with the tricyclics to increase energy.

Muscle relaxants and other medications may be used to decrease muscle pain and spasms experienced by many people with the condition, and a seizure medication called gabapentin (Neurontin) may ease the leg pain, numbness, and tingling sensations that come with the condition.

In addition to the drugs included in this chart, people with fibromyalgia may also benefit from pain-relievers such as NSAIDs and analgesics.

Although these drugs are the most common, there are many different medications that have been used to treat fibromyalgia. Individual clinicians may try a “hit and miss” method with fibromyalgia patients until they find the right combination that seems to work for each individual.

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