Fibromyalgia, many symptoms, few answers

What is Fibromyalgia?

If you opened this article, you probably have an interest in knowing more about Fibromyalgia treatment (Yes, we know. We are great guessers!) An obvious question that comes up is, ‘What is Fibromyalgia?’ This is a long misunderstood disease for many cultural and medical reasons. There are still many things to be understood about Fibromyalgia, and we try to make clear which things are known and which are hypotheses.

Fibromyalgia: A cluster of symptoms

One of the things that make Fibromyalgia hard to understand is that there are a lot of people who have Fibromyalgia, but display very different intensities of the different symptoms. The following is a list of symptoms associated with Fibromyalgia. We have tried to rank them in order of likelihood of occurrence.

Fibromyalgia Symptoms

- Muscle tenderness (Also known as allodynia)
- Trigger points
- High muscle tonus
- Low energy/Chronic Fatigue
- Brain Fog/Low alertness
- Anxiety
- Sleep problems
- Depression/Irritability

Now, that is quite a long list! Not only are there a number of different symptoms, but some of the symptoms, such as chronic fatigue and depression, are considered diseases in their own rite. Although there are key differences, these diseases are related. They are all primarily what are known as affective disorders, a more general term to describe diseases that affect mood and emotions. Usually, what clinically separates Fibromyalgia from these other disorders is the presence of extreme muscle tenderness.

Why do Symptoms Differ?

This is a common question that a lot of people who have or know someone with fibromyalgia have. Sometimes, by people who don’t know better, this fact is used as a way to marginalize fibromyalgia sufferers. All diseases vary in the degree of symptoms they show. This just happens to be more true of fibromyalgia.

Neurological symptoms of Fibromyalgia

This still doesn’t entirely answer the initial question. ‘What is Fibromyalgia?’ We don’t claim to have a full answer for you, but we do have some information that may be helpful. Like depression, people diagnosed as having fibromyalgia have lower levels of serotonin, dopamine, and norepinephrine. These chemicals play a powerful role in affecting mood in complex ways that are beyond the scope of this article. One thing that separates fibromyalgia from depression is that people diagnosed with fibromyalgia have very high levels of a chemical known as cholecystokinin. Like all neurotransmitters, in isolation, one can’t say a chemical is good or bad. Here, however, cholecystokinin is overproduced in certain parts of the brain. One of the things this chemical does is cause increased tolerance to both naturally produced and artificial opiates. This not only increases sensitivity to pain, but decreases the effectiveness and increases the rate of tolerance build up for those who use opiates for whatever reason.

Why has it taken so long for Fibromyalgia to start to become accepted as a disease?

Fibromyalgia seems to be primarily a neurological disease, not unlike depression or chronic fatigue syndrome. Unlike both of those diseases, which Fibromyalgia most closely resembles, Fibromyalgia does not seem to have a marked affect on the immune system. What we mean is, both depression and chronic fatigue syndrome both seem to have a correlation with a high amount of pro-inflammatory substances in the blood. This is not always the case with Fibromyalgia. And, unlike Parkinson’s or Alzheimer’s disease, there are not clear structural, physical changes in the brain. This doesn’t mean it is not a real disease, but rather it seems to primarily be a change in the way the brain functions. Again, this is also true of depression and chronic fatigue syndrome, which both seem to be primarily neurological diseases.

Another reason Fibromyalgia has always been questioned as a disease is that there are no structural changes in the muscle or joint where the trigger points and/or the extreme allodynia are taking place. Newer strategies are making it easier to find a basis for fibromyalgia however. Several neuro-chemical markers of pain, such as substance P, are found in elevated levels in the spinal cord with those suffering from fibromyalgia. Similarly, although devices such as EMG have typically not found there to be any activation of muscles as one would initially expect there to be to account for trigger points, muscle spindles near trigger points are sensitized, making them extra responsive to passive changes in muscle length. Again, the main point here is to explain some of the reasons why it has historically been hard to categorize and understand fibromyalgia.

Who gets Fibromyalgia?

People from all walks of life can develop fibromyalgia. No one is sure exactly why it occurs. It may, in fact, be initially caused by a number of different reasons. The chances of developing this disease seem to depend upon both lifestyle and genetics. Like many other affective disorders, high stress seems to be an important trigger in the diseases development. Most people who become diagnoses as having fibromyalgia don’t have this occur until later in life. Women seem to be significantly more likely to develop this disease than men, although it is not understood why. Although this goes a little bit beyond a clinical explanation of fibromyalgia, my personal view is that because fibromyalgia has typically been associated with women, and has been lumped in with hysteria and other so called ‘women’s diseases’, there has, unfortunately, been a tendency for it to be marginalized, ignored, and dismissed. As we have explained earlier in the article, this is no longer the case and there is clear evidence that a disease is occurring. This has also created a terrible double edged sword, where men, because they don’t want to be known for having a ‘women’s disease’ will often times avoid treatment, ultimately making them worse off. This has to end. Fibromyalgia is a disease, and anybody from any walk of life or demographic group can develop it.

Another group for whom fibromyalgia is common is people who have, for whatever reason, used opiates for a prolonged period of time, either to recover from injury or sickness, or as part of a habitual recreational drug habit. This goes back to an earlier point, where we mentioned that opiate tolerance is heavily correlated with an increase in the likelihood of developing fibromyalgia. Again, this is not the only reason it occurs however. There is no group of people who are immune from the possibility of developing fibromyalgia. Fit and unfit, rich and poor, it does not matter. What matters is finding a way to deal with it. Just as an aside, if this describes you, don’t feel guilty. No matter who you are or why you are interested in learning more about fibromyalgia, find a way to improve your life and live it to the fullest!