About Fibromyalgia |
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| Question: What
is fibromyalgia? |
| Answer:
Click here. |
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| Question: Who
gets fibromyalgia? |
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Answer: Demographically
(what we call "patients by the numbers"), it's usually
females, age 30-50, usually white, who tend to be bright,
and have had some type of life event or life stressor.
This might be a car accident, etc. I, myself, believe
there is a genetic predisposition as well as a hormonal
influence involved here.
A certain percentage of men do suffer from this disease,
as well.
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| Question: Can
children get fibromyalgia? |
| Answer:
I have very strong feelings about children with fibromyalgia.
At this time, I do not believe that young children experience
fibromyalgia. There is a threshold age. I don't think
you can have the reactive seconardy changes of fibromyalgia
at a young age. This is just a personal opinion. I don't
have any hard science to back this up. It's a gray area.
I plan to cover more on this topic in the book. |
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| Question: Where
are the 18 tender points? |
| Answer:
See the Fibromyalgia Tender
Points page for reference. |
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| Question: What
are its symptoms? |
| Answer:
See the Fibromyalgia
Symptoms page. |
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| Question: How
do I know if I have fibromyalgia? |
| Answer:
There is no specific test at this time. Fibromyalgia might
be considered at this juncture a disease of what we call
"exclusion". We need to rule out other problems that fibromyalgia
might be similar to in presentation. Many times physicians
will order thyroid studies, inflammatory panels (arthritis-like
tests), and overall health analysis work-ups. Most times,
these are unrewarding. An occasional abnormal blood test
frequently leads to more testing, chasing the venerable
cat up the wrong tree. As is imperative with any fibromyalgia
patient, ruling out other diseases (examining the differential
diagnosis) is an absolute necessity. We want to first
identify easily treatable or potentially damaging organic
disease, and a medical doctor should do this. Alternative
providers are eventually fine, especially if they help,
but they are not trained in medical diagnosis and, unfortunately,
I've seen many tragic cases of misdiagnosis and late diagnosis
of serious disease. |
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| Question: What
causes fibromyalgia? |
| Answer:
See the Fibromyalgia
Causes page. |
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| Question: What
are the Fibro Five? |
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Answer: The "Fibro
Five" is a term referring to:
Fibromyalgia and the rest of The Fibro 5 share a common
pathophysiologic mechanism. To make this gross generalization,
I must reach a little, but to obtain a better understanding
in where this disease evolves is important to understanding
the disease and its progression.
Physicians commonly look for a disease process that
is presented by symptoms. In the case of the Fibro 5,
pain is
the symptom. Pain is experienced in muscle groups described
as "tender points" and sometimes in joints. These symptoms
were actively reported in the mid 1800's and have been
termed numerous syndromes such as [myositis],
[myofascial
pain syndrome],
[fibromyositis],
etc. In actuality, these processes are likely of the
same [etiology].
The Concept of Central Sensitization ...
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| Question: Fibromyalgia
syndrome? |
| Answer:
See the Fibromyalgia
Syndrome page from my Pain Diaries Book. |
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| Question: How
do I know I don't have another disease besides fibromyalgia? |
| Answer:
As I've mentioned before, the Fibro 5 is what I emphasize,
but fibromyalgia has a whole list of cascading symptoms
that throw the overall diagnosis into a quagmire of misunderstanding.
Stick with the understanding that this disease causes
a central amplification of pain, much like turning up
the stereo amplifier. Your central nervous system (brain
tissue and spinal cord tissue) are responding inappropriately
to pain and conveys that to you as headache, sometimes
irritable bowel, sometimes muscular pain, interstitial
cystitis, [vulvodynia],
etc. |
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| Question: What
about Lupus or Multiple Sclerosis? |
| Answer:
[Lupus]
and [Multiple
Sclerosis] (MS)
must be ruled out. A general medical workup will help
define if this is a problem. The yield of chasing diagnosis
such as MS and Lupus in the average fibromyalgia patient
is very, very small. It is unlikely, but should be tested
if the physician finds symptoms that might be suggestive.
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| Question: What
about Epstein Barr? |
| Answer:
Everybody is looking at [Epstein
Barr], but no
one is finding anything that I can see is particularly
useful. Epstein Barr may trigger a pathway that may turn
on the pain amplifier centrally, but that's a reach. Fibromyalgia
itself, irrespective of Epstein Barr, causes flu-like
symptoms, joint pain, etc., but I do not believe that
this is a clear etiology of fibromyalgia. Patients that
have Epstein Barr virus do not always have fibromyalgia
or chronic fatigue. There is an association epidemiologically,
but it is weak. |
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| Question: My
doctor said Fibromyalgia turns into Lupus after three
years. Is that true? |
| Answer:
This is ludicrous. Fibromyalgia is a problem with the
central nervous system. Some patients do have an association
with Lupus. Some do have rheumatic disease and some people
can get better through management, but this disease does
not just go away, and it certainly does not disappear
and turn into Lupus after three years. |
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| Question: Is
fibromyalgia an arthritic disease? |
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Answer: Fibromyalgia
is not an
arthritic disease. It is listed by the Arthritis Foundation,
but this is a historical association.
Fibromyalgia is not a relationship to an inflammatory
disease. It is not an inflammatory disease. NSAIDS or
non-steroidal anti-inflammatory medications and steroids
do not work.
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| Question: Is
there a causative link between Lyme Disease and Fibromyalgia? |
| Answer:
Maybe. I might reach on this one, but the process of central
activation could be caused by the organism that causes
Lyme Disease. I do know that long-term joint problems
can be activated and this can lead to a central sensitization
syndrome (the central pain amplifier being turned up).
I have thought about this and done my homework. I still
can't give you a positive "yes" or "no" but I suspect
there is a potential for a link. |
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| Question: Can
fibromyalgia affect the outcome of successful surgery?
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| Answer:
Fibromyalgia does affect the outcome of successful surgery.
Mostly what I'm speaking of is the recuperative phase
where getting up and moving and returning to function
is paramount. You need to discuss this with your surgeon
and don't let him "pooh-pooh" this. His (and your) result
is going to be based on your ability to cooperate with
postoperative instructions. Straighten this out before
you have surgery. |
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| Question: How
might Fibromyalgia affect my pregnancy? |
| Answer:
Probably not adversely. Don't let it. Make sure you get
as much exercise as you can for the fetus and yourself.
Don't overeat and watch your weight. Your obstetrician
is going to be your best friend, and he or she must be
supportive. As far as treatments such as chiropractic
or massage therapy during pregnancy, I really don't have
a problem with chiropractic adjustment therapy or massage
therapy when used appropriately. All procedures and techniques
have risk during pregnancy, just so you're informed. This
is best settled through your chiropractic office. Find
a good chiropractor. You'll be able to check that out
on our physician referral web-site -- hopefully soon.
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