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Fibromyalgia—Real or Imagined?

 

I often get calls or emails from people who have been diagnosed with Fibromyalgia and are very confused and frustrated.  The frustration comes from some medical providers not believing that the diagnosis of Fibromyalgia is a real condition.  I ran across an article “New Approaches to Treating Fibromyalgia” by Katherine Hobson - U.S. NEWS AND WORLD REPORT – Updated: 01/22/08. To go to this article please go to http://www.buffalonews.com/185/story/257658.html. I also want to highlight some of this article and comment on Ms. Hobon’s insightful perspective.

Sufferers of fibromyalgia experience a suite of symptoms: chronic pain throughout the body, sleep problems and fatigue. In some, this syndrome starts with no warning; others get it after a traumatic physical injury, a viral infection, or stressful life event. Symptoms can come and go.

For years, doctors thought the problem must be at the tissues or nerve endings — that is, at the places where it hurt. When they couldn’t find hallmarks of injury such as inflammation or nerve damage, many threw up their hands and chalked up symptoms to depression, anxiety, or that all purpose grab bag for female complaints: hysteria. Over the past decade or so, doctors have come to understand that fibromyalgia is actually a problem of the central nervous system — the brain and the spinal cord — not the peripheral nerves that branch into organs, limbs and skin.More recently, researchers using functional MRI scans have found that people with fibromyalgia have increased activity in areas of the brain dealing with where and how much it hurts. In other words, far from being whiners, they are wired to be exquisitely sensitive to pain. What also happens for many people suffering with this condition is they are prescribed opiates by well meaning doctors who want to help.  Unfortunately, due to the type of pain opiates don’t really address the real problem.  In fact most of the pain symptoms with this condition are neuropathic or burning type pain.  One of my patients described it like a lava flow going through different parts of her body.  I was very happy that in June of 2007 the FDA approved Lyrica for treatment of Fibromyalgia.  Several of my medical colleagues had been using it off label before but most insurance companies wouldn’t cover it and now many of them will.

Another problem is that many people do not realize that medication alone is not the answer either.  The best outcomes in fact are when the patient has a multidisciplinary approach.  This includes diet, nutrition, exercise, yoga or stretching, dealing with the psychological/emotional symptoms and an effective medication management plan.  For some people this may be Lyrica and for others one of the SSRI Antidepressants or the new SSNRI Antidepressant Cymbalta, which is also approved for some types of neuropathic pain management.

To learn more about Fibromyalgia please go to http://www.fibromyalgia.com.

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