A growing number of people complaining of inexplicable aches and pains, memory loss, depression and fatigue has puzzled doctors worldwide. Called Fibromyalgia, very little is known about the cause or cure, while many debate whether the condition actually exists. Jacqueline Head takes a look at this mysterious problem.
"There came a point at which just getting up in the morning, and getting ready for work and driving there in the car, was calling on reserves of determination and energy I just no longer possessed. Some mornings I made it half way and turned back. Other days I couldn't get it together at all."
This excerpt was taken from an Australian support group site for people suffering from Fibromyalgia. Many writers describe how the condition has forced them to leave work and has prevented them from leading a normal life. They all report frustration at the difficulty in being diagnosed and how little is known about FMS.
What is Fibromyalgia?
Fybromyalgia Syndrome (FMS) is largely defined as chronic pain including symptoms such as musculoskeletal pain, fatigue, insomnia, and memory loss. Its symptoms are similar and cross over with Chronic Fatigue Syndrome and there is wide speculation that the two may be linked.
Rheumatologists and other experts estimate that between one to 3.5 per cent of the population suffer from Fibromyalgia. One in eight sufferers are women and mostly between the ages of 20 to 50.
FMS is not easily diagnosed and there is no standard diagnostic test in Australia for the condition. Many sufferers report seeing up to 20 different doctors before a diagnosis of FMS is reached. A doctor will look at a range of issues in diagnosing FMA, including an extensive history of the patient's symptoms, and a thorough physical examination where the body needs to be tested for tender points.
Major symptoms:
Musculoskeletal aches and pains
Fatigue
Non-restorative sleep
Morning stiffness
Cognitive and memory problems
Irritable bowel syndrome
Jaw pain and headaches
Sensitivity to light, some odours, medications and foods
Numbness and tingling sensations
Dizziness or lightheadedness
These symptoms must last for at least three months, and pain must be experienced in all four quadrants of the body.
The difference between Fibromyalgia and Chronic Fatigue Syndrome, is that people with FMS suffer pain in theor joints and muscles at rest and at play, and is associated with total body tenderness, whereas CFS is a condition where the patient experiences severe fatigue. However there are many similarities between the two and often people appear to have both conditions.
Causes - is it all in the brain?
Although little is known about what causes Fibromyalgia, many studies have suggested that the condition is a caused by psychological factors. Although more recent research has proved otherwise, many people with FMS report suffering major depression.
According to a study in the Archives of Internal Medicine, 50 to 70 per cent of patients with FMS have had a lifetime history of depression, and many patients find their condition improves with the use of antidepressants. Despite this, only 18 to 36 per cent of patients with FM were found to have current major depression, suggesting that most patients with FM do not have a current psychiatric illness.
But recent research conducted in Australia has shed new light over possible causes of the condition.
Following a study which examined blood flow to the brain in FMS sufferers in the US, rheumatologists in Adelaide took a look at how the brain works by SPECT scanning, which measures the distribution of blood flow in the brain.
The researchers performed the study on women, 17 with clear cases of fibromylagia and 22 normal people.
They found that blood flow to the brain stem and to the middle region of the brain were significantly reduced. The brain stem connects the forebrain with the spinal chord.
This research contradicts previous beliefs that both CFS and FMS are psychological conditions. It suggests that the condition is actually a physical one, a most likely something connected with nerve cells in the brain.
Leader of the research team, Dr. Richard Kwiatek said the findings also suggest that people may need to be biologically predisposed to suffer either chronic fatigue syndrome or fibromyalgia. He told an Adelaide radio station that the disorder could also be related to some form of stress, either psychological or physical, and that some people could develop it over many years, if not decades.
Further research has also shown that CFS and FMS can run in families, enhancing the evidence that the disorders could be related to genetic makeup.
Other possible causes have been linked to Lyme disease; low levels of some hormones and neuro hormones, as well as disturbed sleep patterns.
Treatments
Increasingly sufferers of Fibromyalgia are resorting to alternative medicine to beat their condition. Many take herbal remedies, practise meditation, yoga, and relaxation techniques to improve the quality of sleep and reduce pain.
However other treatments such as cardiovascular fitness training, hypnotherapy and electroacupuncture have been reported. Medication therapy such as antidepressants have brought back positive results in approximately 30 to 50 per cent of patients, but many report the effects of the drug begin to wane off after some time.
References:
Canberra Fibromyalgia and Chronic Fatigue Syndrome Pages
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