Thursday, 27 October 2011 14:12
Fibromyalgia & the Spine: Chiari I Malformation
Or: “ Can an Operation Cure My Fibromyaglia?” Many Fibromyalgia Syndrome (FMS) patients have become aware of a neurologic condition termed “Chiari I malformation,” and the possibility of having a neurosurgical operation that could potentially reduce or even cure their FMS. This is an area that has generated considerable controversy and is a very serious matter that has even been considered by medical boards.
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Thursday, 27 October 2011 14:08
Fibromyalgia Syndrome & Other Rheumatologic Conditions
Or: “What else could I possibly have?” Physicians use the words “differential diagnosis” to mean other conditions that have to be considered when diagnosing the medical condition of interest. In the case of FMS this includes diseases that both resemble FMS in some aspects of their medical symptoms and also, in the past, were believed to have contributed to the condition of “secondary FMS.” Secondary FMS means FMS is not the medical condition that is primarily important, it is “secondary.”
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Friday, 05 August 2011 21:21
What Causes FMS - Part 3
Part 3 - Vaccinations and Infections The National Fibromyalgia Association’s 2006 Internet survey of 2596 individuals found that 26.7% of those who could trace the origin of their FMS to a specific event reported that event to be an illness and 45% felt that infections worsened their FMS symptoms. However, the reports in the scientific literature are conflicting. Only one study has been reported showing that chronic hepatitis B infection may increase the risk of FMS. In this study 25% of patients who had antibodies that were positive for Hepatitis B also had FMS. Two studies with a total of 202 FMS patients have reported an association of hepatitis C virus infection and FMS. Conversely, two studies with 267 FMS patients found no association to hepatitis C. If such an association does exist, one possible pathological mechanism may involve hepatitis C induced changes in cytokines which affect the hypothalamic-pituitary-adrenal axis. If you’re wondering just what are cytokines, then be sure to read the two short reports on cytokines and neuroendocrinology. Until you do here is an introduction to cytokines. They are cellular molecular messengers that the body uses primarily to regulate inflammatory responses. When you hear about…
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Friday, 05 August 2011 21:17
What Causes FMS - Part 2
Part 2 - Emotionally Traumatic Events Emotionally traumatic events have long been considered a cause of Fibromyalgia Syndrome (FMS). However, it has been difficult to attempt to do research in this area primarily because of a statistical peculiarity called Berkson’s bias. If you have read some of the other short reports you may have remembered reading about the odds ratio. The odds ratio is a number that simply tells you about the odds of having a disease or medical condition compared to something else. For example, if you smoke the odds ratio of developing a particular type of cancer may be 6.8 compared to someone not smoking. This simply means you are at almost seven times the risk of developing that cancer by smoking, or it appears at a frequency in smokers that is 700% greater than non-smokers – the numbers mean the same thing. Berkson’s bias applies to people with two or more separate medical conditions – say heart disease and diabetes. People with heart disease and diabetes will see their doctor more than someone with just one of those diseases simply because having both diseases usually means they have more problems with both diseases than if…
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Friday, 05 August 2011 21:12
What Causes FMS - Part 1
Part 1 - Physically Traumatic Events The role of physical trauma in the development of Fibromyalgia Syndrome (FMS) continues to be deliberated in the literature. A major difficulty has been the reliance on someone’s ability to recall events that may have occurred thirty years prior. Post-traumatic fibromyalgia is also known as reactive fibromyalgia syndrome and the first paper on the subject was published in 1992. Those researchers reported that 23% of 127 FMS patients reported a specific event – trauma, surgery, or medical illness preceded their FMS. Patients in this group were significantly more affected with 70% losing their job, 34% receiving disability, and 45% having reduced physical activity. Shortly thereafter, in 1994, another study reported a follow-up of 176 FMS patients; 61% reported symptoms after a motor vehicle accident, 12.5% after a work injury, 7% after surgery, 5% after a sports related injury, and 14% after some other type of traumatic injury. A 2002 case-control study was published, which is a type of study where people with FMS are matched to healthy, normal individuals in as many characteristics as possible except for their disease, FMS. Then researchers try to find out what was different about people who…
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Friday, 05 August 2011 21:04
Cytokines and Fibromyalgia Syndrome
Or, Cyto-What? Cytokines are small molecules that do not stay around very long in the body before they are either taken up or degraded. They act as chemical messengers to affect immune responses, tissue repair, or cell growth. Their production is influenced by both the central nervous system and the immune system. The sympathetic nervous system, through the secretion of catecholamines, will activate the hypothalamic-pituitary-adrenal axis (HPA) and stimulate the release of cytokines. If you don’t know about HPA axis then read the two short reports on “The Neuroendocrine Theories Behind Fibromyalgia.” Catecholamines are the “fight or flight” hormones produced by the adrenal glands – epinephrine and norepinephrine and they primarily act through the sympathetic nervous system. For more information about epinephrine and norepinephrine you can read the short reports on “Dysautonomia, ”and the two-part series on ‘The Neuroendocrine Theories of Fibromyalgia.” The most common cytokines are “interleukins,” and they are abbreviated and numbered, e.g. IL-1, IL-6, IL-8, and so on. IL-8 is a key cytokine that plays a role in inflammation. It is released by macrophages, cells that are activated in response to tissue injury. They help promote pain in laboratory animals and will cause pain in…
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Friday, 05 August 2011 20:56
The Neuroendocrine Theories Behind Fibromyalgia - Part 2
More Than Just a "Bad Hormone" Day - Part 2 The first part of this series described some basics about the hypothalamic-pituitary-adrenal axis in FMS and came to the conclusion, in 2004, that nobody quite knew what was going on. The bottom line seemed to be that there was a disruption seen in the normal circadian rhythm for plasma cortisol levels with abnormally elevated concentrations noted in the evening. Well, some researchers tried to look at things more exactly by convincing people to allow them to test their cortisol by taking a saliva sample to measure their cortisol every 10 – 20 minutes for 24 hours rather than what had been done in the past – one 24 hr measurement collected from urine. Some people even allowed researchers to use an intravenous blood sample to be taken every ten minutes – which gave even better results. Now, some more precise numbers began to appear. In this more exact study it was noted that evening levels of cortisol were slightly elevated and there was also a delay in the decline of the cortisol levels such that 50% of the FMS patients in the study never met the criteria for…
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Friday, 05 August 2011 20:45
The Neuroendocrine Theories Behind Fibromyalgia - Part 1
More Than Just a "Bad Hormone" Day Neuroendocrinology and the neuroendocrine system had their origin with Dr. Geoffrey Harris, (1931 – 1971) of Oxford University, in England, considered the father of endocrinology. Neuroendocrinology refers to how the nervous system is connected with the endocrine or hormone system. The endocrine glands are those glands in the body that secrete hormones. The components in the brain are the hypothalamus, which is deep in the brain, that connects through the blood vessels in the brain via chemical messengers called hypothalamic releasing factors to the pituitary gland, at the base of the brain. The pituitary gland then releases hormones in response to the type and concentrations of releasing factors it receives from the hypothalamus that influence the function of organs and tissues throughout the body. One of the major organs that play a role in FMS is the adrenal glands, which live above the kidneys and produce the fight or flight stress hormones, epinephrine and norepinephrine as well as other hormones, including cortisol. These chemicals, or transmitters, function in the sympathetic nervous system. If you’re not familiar with the sympathetic nervous system, read the short report on “Dysautonomia.” It would be best…
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Tuesday, 19 April 2011 09:42
Epidemiology & Fibromyalgia: How Many of Us Are Out There?
Epidemiology sounds like it has something to do with the skin, given that the word “epidermis” is mentioned in so many skin commercials. However, epidemiology is the branch of medicine that deals with diseases at the population level. It had its origins around the late 18th and early 19th century with the epidemics of influenza and cholera and derives its name from the word “epidemic.”
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Tuesday, 19 April 2011 09:20
Why a Pain Doctor Is The Best Person To Treat Fibromyalgia
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Recent Articles:
Fibromyalgia & the Spine: Chiari I Malformation
27 Oct, 11
Or: “ Can an Operation Cure My Fibromyaglia?”
Many Fibromyalgia Syndrome (FMS) patients have become aware of a neurologic condition termed “Chiari
Fibromyalgia Syndrome & Other Rheumatologic Conditions
27 Oct, 11
Or: “What else could I possibly have?”
Physicians use the words “differential diagnosis” to mean other conditions that have to be considered when diagnosing
Fibromyalgia Syndrome and Psychiatry
27 Oct, 11
Mention the words psychiatry or psychiatrist to an individual with Fibromyalgia syndrome (FMS) and you’re bound to get some raised neck hairs. However,
The Pain is in the Brain of Fibromyalgia Syndrome: Part 3
17 Oct, 11
In the first two parts of “The Pain the Brain” series the concept of descending inhibition has been mentioned. This refers to a
The Pain is in the Brain of Fibromyalgia Syndrome: Part 2
17 Oct, 11
Part 1 of this series described the pain process in the central nervous system, primarily the phenomenon called windup and how it is
The Pain is in the Brain of Fibromyalgia Syndrome: Part 1
17 Oct, 11
The International Association for the Study of Pain has defined pain as both an "unpleasant sensory and emotional experience associated with actual or
What Causes FMS - Part 3
6 Aug, 11
Part 3 - Vaccinations and Infections
The National Fibromyalgia Association’s 2006 Internet survey of 2596 individuals found that 26.7% of those who could traceWhat Causes FMS - Part 2
6 Aug, 11
Part 2 - Emotionally Traumatic Events
Emotionally traumatic events have long been considered a cause of Fibromyalgia Syndrome (FMS). However, it has been difficult
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