Fibromyalgia: Difference between revisions
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=== Drugs === | === Drugs === | ||
There are approved and off-label drugs for treating FM. ''Please Note: The information under "Drugs" is not meant to promote any Rx drug for Fibromyalgia or its comorbidities but to inform you of these drugs both approved and off-label. Always consult your doctor for guidance on Rx drug use for any illness or disease. Always check with your doctor and | There are approved and off-label drugs for treating FM. ''Please Note: The information under "Drugs" is not meant to promote any Rx drug for Fibromyalgia or its comorbidities but to inform you of these drugs both approved and off-label. Always consult your doctor for guidance on Rx drug use for any illness or disease. Always check with your doctor and pharmacist for drug interactions.'' | ||
Always review a drug company's prescription drug's side effects with your doctor and pharmacist. Always review a drug's possible interactions with your doctor and pharmacist. ''This may not be a full list of side effects as this is the list that appears on Drugs.com, checking with your doctor and pharmacist for side effects and drug interactions is always necessary.'' | |||
Pregnant women must always consult with their doctor and pharmacist when taking any drug, supplement, or herbal remedy for side effects, drug interactions, and possible injury, defect, miscarriage, or death to the embryo, fetus, or baby. Breastfeeding women should always talk to their doctor and pharmacist for information about breast milk being laced with the drug she has taken causing side effects, injury, or death, and drug interactions to the baby consuming her breast milk. | |||
Check with your doctor and pharmacist for children's side effects that may not be listed and for drug interactions. Lyrica or it's active ingredient Pregabalin may not be approved for the use in very young children. | |||
==== FDA approved==== | ==== FDA approved==== |
Revision as of 19:11, July 17, 2018
Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. Pain is widespread, on both sides of the body, and above and below the waist.
Sufferers are fatigued and tired even when sleeping for long periods of time, and sleep is often disrupted by pain. Many FM sufferers have sleep disorders like sleep apnea and Restless leg syndrome. Cognitive impairment, when one cannot focus or pay attention and the patient has difficulty concentrating on mental tasks, is known by FM sufferers as "fibro fog". Some experience depression, headaches, and lower abdominal pain or cramping. Other symptoms include tingling or numbness in hands and feet, pain in jaw and disorders of the jaw such as temporomandibular joint disorder (TMJ), menstrual cycle cramps, and digestive problems like irritable bowel syndrome (IBS).[1][2]
Prevelance[edit | edit source]
FM is the second most common rheumatic disorder behind osteoarthritis and is "now considered to be a lifelong Central nervous system disorder."[3] An estimated 10 million people in the US and 3-6% of the world population have fibromyalgia. It is seen in women, men, children, and all ethnic groups. It is often seen in families and diagnosed between the ages of 20 to 50 years; incidence increases with age.[4]
FM has a female:male 7:1 ratio under the American College of Rheumatology (ACR) 1990 Diagnostic Criteria and 2:1 when the ACR 2010 Preliminary Diagnostic Criteria is used.[5] See: Fibromyalgia (American College of Rheumatology (ACR) Criteria section).
Fibromyalgia in ME/CFS[edit | edit source]
Dr. Jarred Younger has said that many patients that meet the criteria for FM also meet criteria for Chronic Fatigue Syndrome (CFS) but the reverse is not necessarily true as a lot of people with CFS do not have chronic pain.[6] However, the Canadian Consensus Criteria (CCC) requires the symptom of pain to diagnose ME/CFS. It is the pattern and significant degree of chronic pain in FM that sets it apart from other diseases that have pain.
Health complications[edit | edit source]
FM is not a progressive disease but according to Dr. Dan Clauw the "slow gradual worsening of chronic pain patients over time is due to downstream consequences of poorly controlled pain and other symptoms, wherein individuals then progressively get less active, sleep worse, are under more stress and unknowingly develop bad habits which worsen pain and other symptoms."[7]
Fibromyalgia complications
- People who have fibromyalgia frequently complain of a variety of symptoms that affect other parts of the body. Many people complain of gastrointestinal issues and restless legs syndrome (RLS). Additionally, the chronic pain and discomfort of fibromyalgia may lead to depression.[8]
Can fibromyalgia cause other medical conditions?
- Fibromyalgia is not known to cause other medical conditions. However, people who have fibromyalgia seem to be at high risk for developing other painful conditions, including osteoarthritis (the common type of arthritis caused by wear and tear on the joints) as well as other related conditions, such as rheumatoid arthritis, lupus, and ankylosing spondylitis. Also, people with fibromyalgia are frequently diagnosed with chronic fatigue syndrome, irritable bowel syndrome (IBS), and temporomandibular joint (TMJ) disorder.[9]
Risk factors[edit | edit source]
Lupus and Rheumatoid arthritis (RA) are risk factors in developing FM. Car accidents, Post-traumatic stress disorder (PTSD), repetitive injuries, illness such as a viral infection, family history, and obesity have all been linked to FM.[10][11][12]
Diagnosis[edit | edit source]
Tender points, not trigger points, are used to diagnose Fibromyalgia.[13] Tender points will be above and below the waist and on both sides of the body. (See: Illustrations of the 1990 and 2010 American College of Rheumatology (ACR) Criteria depicting tender points near the top of this page.)
United States[edit | edit source]
American College of Rheumatology (ACR) Criteria[edit | edit source]
- 1990, The American College Of Rheumatology 1990 Criteria For The Classification Of Fibromyalgia "American College of Rheumatology guidelines suggest that people with fibromyalgia have pain in at least 11 of these tender points when a doctor applies a certain amount of pressure."[14] [15]
- 2010, The 2010 American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia: Overview was proposed and modified in 2011[16] with the modification being validated in 2013 and published in 2014.[17] September of 2016, another revision has been made.[18]
- Men do not seem to form the tender points needed for diagnosis under the 1990 criteria,[19] the 2010 proposed criteria diagnoses more men with a F/M ratio of 2:1.[20]
- Tender points were used to diagnose with the 1990 criteria, however "considerable skill is needed to correctly check for a patient’s tender points (i.e., digital palpation that is done with certain amount of applied pressure), yet this technique is not typically taught at most medical schools."[21]
- The new standards were designed to:
The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose fibromyalgia.[24]
Sleep study[edit | edit source]
Sleep dysfunction is often involved in fibromyalgia. Treating a sleep disorder can help with fibromyalgia symptoms. A diagnosed sleep disorder is also helpful if one needs to file for disability.
Diagnostic code[edit | edit source]
World Health Organization[edit | edit source]
The World Health Organization (WHO) International Classification of Diseases (ICD) lists fibromyalgia as a "disease of the musculoskeletal system and connective tissue", under the code M79.7 (WHO ICD-10 2016).[25]
Medical coding[edit | edit source]
Pathophysiology[edit | edit source]
"Fibromyalgia (FM) is a chronic pain disorder with unknown etiology and unclear pathophysiology. There is no evidence that a single event “causes” FM. Rather, many physical and/or emotional stressors may trigger or aggravate symptoms. These have included certain infections, such as a viral illness or Lyme disease, as well as emotional or physical trauma."[28] The widespread pain is severe, debilitating, and abnormal in processing its pain. There is also sleep disturbance and fatigue. Cause or causes are unproven.[29]
- 2012, Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management Oman Medical Journal
- Pathophysiology: Although the etiology remains unclear, characteristic alterations in the pattern of sleep and changes in neuroendocrine transmitters such as serotonin, substance P, growth hormone and cortisol suggest that regulation of the autonomic and neuro-endocrine system appears to be the basis of the syndrome. Fibromyalgia is not a life-threatening, deforming, or progressive disease. Anxiety and depression are the most common association. Aberrant pain processing, which can result in chronic pain, may be the result of several interplaying mechanisms. Central sensitization, blunting of inhibitory pain pathways and alterations in neurotransmitters lead to aberrant neuro-chemical processing of sensory signals in the CNS, thus lowering the threshold of pain and amplification of normal sensory signals causing constant pain.
- The frequent co-morbidity of fibromyalgia with mood disorders suggests a major role for the stress response and for neuroendocrine abnormalities. The hypothalamic pituitary axis (HPA) is a critical component of the stress-adaptation response. In FMS, stress adaptation response is disturbed leading to stress induce symptoms. Psychiatric co-morbidity has been associated with FMS and needs to be identified during the consultation process, as this requires special consideration during treatment.
- 2018, A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management PDF Table 1 pg. 28
Immune system research[edit | edit source]
Dr. Jarred Younger believes an overactive immune system is the cause and will be conducting a study to test this hypothesis.[30][31]
Dr. William Pridgen's research of HSV-1 (cold sore virus) as being involved in FM has conducted a successful Phase III clinical trial, which had been fast-tracked by the Food and Drug Administration (FDA), of a combination drug that suppresses this virus and also helps with pain. See: Fibromyalgia (Drugs: Trials: IMC-1 section).
ProHealth reports that an old Tuberculosis vaccine, Bacille Calmette-Guerin (BCG), may be researched for treatment of Fibromyalgia spearheaded by EpicGenetics and Massachusetts General Hospital.[32]
EpicGenetics has a blood test that is identifying the presence of specific white blood cell abnormalities of patients diagnosed with FM and has partnered with two universities to offer whole exome sequencing free of charge to those who test positive with their FM/a® test.[33] Concerns have been raised in regards to the FM/a EpicGenetics Blood Test, however.[34]
Comorbidities[edit | edit source]
- Allodynia
- Allodynia "Allodynia is pain, generally on the skin, caused by something that wouldn't normally cause pain." [35]
- Painful to Touch: Fibromyalgia & Tactile Allodynia - Does Your Skin Hurt? Here's Why! "It's another one of those fibromyalgia symptoms that just doesn't make sense -- pain, sometimes severe pain, from a simple touch. The closest thing it compares to is having a sunburn all the time. A lot of people don't understand this symptom, including those who have it, because while it's common in fibromyalgia, it's rare in the general population."[36]
- Body temperature
- Temperature Sensitivity in Fibromyalgia & Chronic Fatigue Syndrome "When you're exposed to heat, does it feel like you're burning up? Does it seem impossible for you to cool off? Or maybe it's cold that bothers you, chilling you to the bone, leaving you unable to warm up.
- Or are you one of those people with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS) who is cold all the time, or hot all the time, or alternately hot or cold while out of sync with the environment?"[37]
- Brain fog
- What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction "Mental confusion along with difficulty in concentration and loss of memory is often termed “fibro fog”".[38]
- Costochondritis (Chest and ribcage pain.)
- https://www.verywell.com/costochondritis-in-fibromyalgia-716178 Costochondritis in Fibromyalgia]
- Gastrointestinal system
- Irritable bowel syndrome: Irritable Bowel Syndrome in Fibromyalgia & Chronic Fatigue Syndrome - Why Do They Go Together? "Fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome (IBS) frequently go together. No one really knows why, but we do know that all three conditions can include imbalances of serotonin -- although in fibromyalgia (FMS) and Chronic Fatigue Syndrome (CFS or ME/CFS) it's an imbalance in the brain, while with IBS it's in the gut."[39]
- Interstitial Cystitis (Painful bladder)
- Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis "Fibromyalgia, chronic fatigue syndrome and interstitial cystitis (IC) -- a painful bladder condition -- frequently occur together. Women may be up to 10 times more likely than men to develop it."[40]
- Language Impairment
- Impaired Language in Fibromyalgia & Chronic Fatigue Syndrome - Talking, Reading & Writing "How often do you find yourself searching your brain for a simple word that you just can't remember?"[41] "The diagnosis of Aphasia is a condition that robs you of the ability to communicate. It can affect your ability to speak, write and understand language, both verbal and written"[42] but with dysphasia you will have those symptoms and trouble listening and doing numeral calculations."[43] Word-finding problems is also a symptom of ME/CFS.
- OBGYN
- Menstrual Periods with Fibromyalgia: Personal Stories
- Fibromyalgia is tied to Hysterectomy and Gynecological Disease and Endocrine and Autoimmune Disorders. "Did you have a gynecologic surgery, such as a hysterectomy, in the few years before you developed fibromyalgia?"[44]
- Orthostatic intolerance
- Orthostatic Intolerance - Very Well By: Adrienne Dellwo
- Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM Symptoms can include low blood pressure and/or sudden high blood pressure, dizziness, fainting.
- An Overlooked Issue in Fibromyalgia? Study Highlights Problems Standing (Orthostatic Intolerance)
- Sleep dysfunction
- Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia. "The present results of this study suggest that long-term, comorbid pain and sleep disturbance may be associated with increased activation in core default mode brain areas that is above and beyond long-term pain disturbance alone."[45]
- Fibromyalgia and Sleep "Most people with fibromyalgia have an associated sleep disorder that makes it difficult for them to get the deep, restorative sleep they need."[46]
- Thyroid disease
- Chronic Fatigue Syndrome, Fibromyalgia, and Autoimmune Thyroid Disease "CFS, FMS and HAIT patients often visit their doctors complaining of a host of symptoms. (See sidebar.) Since symptoms are similar, there is a risk of misdiagnosis. Some doctors still fail to even acknowledge the existence of CFS and FMS."[47]
- Thyroid Disease in Fibromyalgia & Chronic Fatigue Syndrome "Fibromyalgia and chronic fatigue syndrome are multi-system illnesses. They hit you hard in multiple ways, and confuse doctors of all specialties because not everything can be explained by the one system they focus on."[48]
- Other comorbidities and symptoms.
- Fibromyalgia Symptoms - The Monster List! " ...the list of possible symptoms is far-reaching and body-wide."[49]
Treatment[edit | edit source]
United States[edit | edit source]
Rheumatology and primary care providers: Diagnosing and treatment
- 2012, Mayo Clinic published A Framework for Fibromyalgia Management for Primary Care Providers. Rheumatologists stopped treating fibromyalgia patients and primary care providers began treating although rheumatologists are most often the specialist to diagnose. (Please see disability heading about primary provider and specialists for disability cases.)
Drugs[edit | edit source]
There are approved and off-label drugs for treating FM. Please Note: The information under "Drugs" is not meant to promote any Rx drug for Fibromyalgia or its comorbidities but to inform you of these drugs both approved and off-label. Always consult your doctor for guidance on Rx drug use for any illness or disease. Always check with your doctor and pharmacist for drug interactions.
Always review a drug company's prescription drug's side effects with your doctor and pharmacist. Always review a drug's possible interactions with your doctor and pharmacist. This may not be a full list of side effects as this is the list that appears on Drugs.com, checking with your doctor and pharmacist for side effects and drug interactions is always necessary.
Pregnant women must always consult with their doctor and pharmacist when taking any drug, supplement, or herbal remedy for side effects, drug interactions, and possible injury, defect, miscarriage, or death to the embryo, fetus, or baby. Breastfeeding women should always talk to their doctor and pharmacist for information about breast milk being laced with the drug she has taken causing side effects, injury, or death, and drug interactions to the baby consuming her breast milk.
Check with your doctor and pharmacist for children's side effects that may not be listed and for drug interactions. Lyrica or it's active ingredient Pregabalin may not be approved for the use in very young children.
FDA approved[edit | edit source]
- Lyrica (generic will be Pregabalin)
FDA approved Side effects[edit | edit source]
Not all side effects of brand names or generic names are listed or linked, review EACH brand name and EACH generic name medication's possible side effects with your doctor. Interactions of drugs must always be checked by your doctor and pharmacy.
- Cymbalta is facing lawsuits due to severe withdrawal symptoms.[50] There is a Facebook group dedicated to questions about the drug and tapering off of it; Cymbalta Hurts Worse. Eli Lilly has settled hundreds of personal injury lawsuits with patients experiencing severe withdrawal symptoms.[51]Cymbalta side effects and (generic side effects).
- Lyrica is causing weight gain. Lyrica side effects and (no generic available)[52] until after 2018 when Pregabalin will be marketed.
- Savella has a list of side effects. Savella side effects and (generic side effects).
Off-label[edit | edit source]
- Florinef: (Fludrocortisone) Off-label use for Orthostatic intolerance (OI) and Postural orthostatic tachycardia syndrome (POTS)
- Low dose naltrexone: Taken at bedtime for sleep. Helps pain due to better sleep.
- Neurontin Gabapentin: Is gabapentin (Neurontin, others) an effective fibromyalgia treatment? Used for pain, sleep.
- Low dose Seroquel (Generic name Quetiapine): Tackling Pain and Depression in Fibromyalgia: Quetiapine Scores Some Benefits in Clinical Trial Taken at bedtime for sleep.
- Zanaflex (Generic name Tizanidine): Muscle relaxer for pain, sleep.
Off-label Side effects[edit | edit source]
Not all side effects of brand names or generic names are listed or linked, review EACH brand name and EACH generic name medication's possible side effects with your doctor. Interactions of drugs must always be checked by your doctor and pharmacy.
- Florinef: Florinef side effects. Weight gain, interacts with many other medications. (Fludrocortisone) is generic. Fludrocortisione side effects.
- Low dose naltrexone: Insomnia, the drug must be stepped up slowly. Naltrexone side effects.
- Neurontin (generic available): Neurontin side effects.
- Low dose Seroquel (generic available]): Weight gain, suicidal ideation. Side effects of Seroquel .
- Ultram: (generic available) Ultram side effects.
- Tramadol (Generic of Ultram): Having Seizures or Blackouts? The Tramadol Connection Tramadol side effects.
- Zanaflex (generic available): Zanaflex Side Effects.
Articles and blogs on drugs[edit | edit source]
- Patients Say Fibromyalgia Drugs Make Things Worse, Rest is Best - Graph of Patient-Rated Drugs - Cure Together Blog
Sleep medications[edit | edit source]
Review EACH brand name and EACH generic name medication's possible side effects with your doctor. Interactions of drugs must always be checked by your doctor and pharmacy.
Disordered sleep is a prominent symptom in FM. There are four types of sleep medications used in FM; antihistamines, benzodiazepines, nonbenzodiazepines, sedating antidepressants.[53]
Low dose naltrexone and low dose seroquel (see under the heading: Drugs) can also help with sleep when taken at bedtime.
Drug trials[edit | edit source]
- ASP8062
- 2017, ClinicalTrials.gov A Phase 2a, Randomized, Double-Blind Placebo-controlled, Parallel-group Study to Assess the Analgesic Efficacy and Safety of ASP8062 in Subjects With Fibromyalgia
- Cannabinoid-based therapy
- 2017, Intec Pharma Launches Phase 1 Trial of Cannabinoid-based Therapy for Fibromyalgia, Lower Back Pain.
- IMC-1
- 2016, The Pridgen Revolution? Dr. Pridgen on Bringing His Antiviral Approach to Fibromyalgia To Market "Almost three years ago, Dr. Pridgen threatened to turn the world of fibromyalgia treatment on its head. Few had connected fibromyalgia with viruses or even immune problems when Pridgen announced that a) FM is caused herpes simplex virus reactivation and b) that it could be treated with antivirals."[54]
- 2016, Novel Fibromyalgia Treatment Granted FDA Fast Track Designation "In the successful Phase II trial in fibromyalgia, IMC-1 was studied to confirm the hypothesis that chronic tissue-resident herpes simplex virus type 1 (HSV-1) may be one of the underlying causes of fibromyalgia and causally related to fibromyalgia symptoms or recurrence. IMC-1 is a novel fixed-dose oral combination antiviral medication designed to suppress this suspected virus and thus alleviate fibromyalgia symptoms."[55]
- 2017, Through the “Valley of Death”: Dr. Pridgen, Fibromyalgia and the Looming Trials "First there were the anecdotal reports – FM patients were not just getting better but some, and not just a few, were getting well using something entirely new – an antiviral protocol, of all things, created not by a pain specialist or rheumatologist but by a surgeon."[56]
- 2017, A famciclovir + celecoxib combination treatment is safe and efficacious in the treatment of fibromyalgia "IMC-1 was efficacious and safe in treating symptoms of fibromyalgia, supporting the hypothesis that herpes virus infections may contribute to this syndrome. Improved retention rates, decreased adverse event rates, and evidence of efficacy on a broad spectrum of outcome measures are suggestive that IMC-1 may represent an effective, novel treatment for fibromyalgia."[57]
- Bacille Calmette-Guerin (BCG) vaccine
Drug trials failed[edit | edit source]
- TNX-102
- 2016, The drug failed in its primary goal in providing pain relief and Tonix Pharmaceuticals will not be moving forward in developing a Ffbromyalgia drug.[58]
- DS-5565
- 2016, Three New Fibromyalgia Drugs Could Be On The Way "Japanese drugmaker Daiichi Sankyo is now testing what could be Lyrica 2.0."[59]
- Phase III clinical trial of DS-5565 found ineffective
- 2017, The Big Hurt: Second Major Fibromyalgia Drug in a Year Fails "In the three 13-week, double-blind, global, phase 3 ALDAY clinical trials evaluating Mirogabalin for the treatment of pain associated with fibromyalgia, Mirogabalin did not meet the primary efficacy endpoint to demonstrate a statistically significant reduction in the weekly average of worst daily pain score from baseline to Week 13."[60]
Therapies[edit | edit source]
Exercise[edit | edit source]
Please Note: These recommendations are for fibromyalgia patients and not ME/CFS sufferers.
- Moderate aerobic exercise and weights with as fewer reps possible with a day or two of rest in between. Do not start a program if you are in a flare.[63]
- Easy fibromyalgia exercises and motivation to keep you healthy! Videos on YouTube from Eric Suarez, CPT.
- Fibromyalgia Myth vs. Fact Heading: Myth #3: People With Fibromyalgia Need More Exercise. Appropriate exercise, which each patient needs to gauge for themselves.
Massage[edit | edit source]
Acupuncture[edit | edit source]
- 2004, U.S. Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS) ruled April 16, 2004, a noncoverage determination for acupuncture.[64]
- 2005, Acupuncture Good for Fibromyalgia? "acupuncture gave no significant pain relief to fibromyalgia patients."[65]
- 2016, Short-term complementary and alternative medicine on quality of life in women with fibromyalgia "There was no significant improvement in pain or reduction of tender points in any of the groups studied, at the end of the 8th session."[66]
Disability[edit | edit source]
United States[edit | edit source]
Please Note: The following is NOT legal advice and it should not be relied upon in taking steps for a disability case. Only Social Security and a Disability Lawyer practicing Disability Law can provide the most up to date and the correct legal avenue for bringing a disability case.
In theUnited States, Social Security Insurance and Social Security Disability (SSI) and (SSD) benefits are available for Fibromyalgia. Generally for SSI/SSD, notes and tests from a Primary Provider may be allowed for submission but Specialists such as a rheumatologist, neurologist, rpychiatrist, etc. are required for diagnosis, ongoing treatment and completing SSI/SSD paperwork.
The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose Fibromyalgia. (See: "Policy Interpretation" for the POLICY INTERPRETATION RULING.)[67]
- Applying for Disability With Fibromyalgia One patient's success of applying, denial, successful appeal, and a breakdown of what SSI/SSD requires for the medical determination of a favorable decision of disability.
Examinations and Tests[edit | edit source]
For documentation of symptoms and providing proof of a fibromyalgia (FM) diagnosis, you and your doctor should consider the following examinations and tests:
- Fibromyaglia Diagnostic Examination
- Rheumatologist examination and diagnosis of FM. (Consider having a rheumatologist order tests and coordinate and order other specialists' tests and complete the paperwork for Social Security. A primary doctor cannot complete disability paperwork but may be able to forward test results.)
- Arthritis
- Whole body bone scan to rule out treatable arthritis.
- Blood Tests
- Routine blood tests for diabetes (fasting sugar, A1C) and a full Thyroid disease panel (TSH, T3, Free T3, T4 and Free T4).
- Rule out Rheumatoid arthritis, lupus, Lyme disease and other diseases that can share some of the same symptoms of fibromyalgia and may be treatable.
- Vitamin and mineral deficiencies such as B12 and Vitamin D which are treatable with over the counter supplements and prescription treatments improving fatigue and pain.
- Irritable bowel syndrome diagnosis which may require blood, upper endoscopy to rule out celiac disease and fecal tests to check for bacteria (SIBO) and intestinal parasites.
- Mental Health and Cognition
- Psychiatric evaluation as depression and anxiety can be treated.
- Cognitive dysfunction tests. Sleep dysfunction
- Sleep study for Restless legs syndrome, Sleep disturbance and rule out Narcolepsy.
- Tilt table test for Orthostatic intolerance. Other examinations and tests
- An ear, nose, and throat specialist (ENT) (Otorhinolaryngology) examination and imaging may be ordered for Temporomandibular joint disorder (TMJ). (Ear, sinus, throat/lymph infections, and tinnitus can also be documented.)
Of course, one can have arthritis, sleep apnea, chronic Lyme disease or other diseases and still have FM, but there may be a treatable condition where a patient's overall health, including their FM, improves.[68][69][70]
There have been cases of Vitamin D deficiency being misdiagnosed as fibromyalgia as a D deficiency can cause pain. Supplementation or prescribed D treatments may alleviate this pain. However, it is possible to have both a D deficiency and fibromyalgia and correcting the deficiency will only resolve the pain stemming from it.[71][72]
[edit | edit source]
- Resources for getting approved for disability include this Guide to Social Security Disability for People with Myalgic Encephalomyelitis and Chronic Fatigue Syndrome, available on the #MEAction website.
Notable studies[edit | edit source]
- 2017, The degree of cardiac baroreflex involvement during active standing is associated with the quality of life in fibromyalgia patients. (Orthostatic Intollerance)
Awards and current research[edit | edit source]
Psychiatric paradigm[edit | edit source]
Hyperbaric oxygen therapy[edit | edit source]
- 2016, Hyperbaric Oxygen Therapy for treating Fibromyalgia: An update An unsuccessful therapy experience by Donna who writes the blog February Stars.
Controversies[edit | edit source]
Dr. Frederick Wolfe, the director of the National Databank for Rheumatic Diseases and the lead author of the 1990 paper that first defined the diagnostic guidelines for fibromyalgia, says he has become cynical and discouraged about the diagnosis. He now considers the condition a physical response to stress, depression, and economic and social anxiety.[73]
Learn more[edit | edit source]
Ongoing process of diagnosing and categorizing[edit | edit source]
- 2012, Personality and Fibromyalgia Syndrome Conclusion: "No specific fibromyalgia personality is defined but it is proposed that personality is an important filter that modulates a person’s response to psychological stressors. Certain personalities may facilitate translation of these stressors to physiological responses driving the fibromyalgia mechanism."[74]
- 2014, Lyme Disease, Fibromyalgia Link Evaporates (See also: Chronic lyme disease)
- 2015, Question: 'Is Fibromyalgia a Psychosomatic Illness?' Answer: "Fibromyalgia is NOT a psychosomatic illness."[75]
- 2016, The association between borderline personality disorder, fibromyalgia and chronic fatigue syndrome: systematic review BJ Psych Open states under heading Borderline Personality Disorder in patients with fibromyalgia: " ...there does not appear to be firm and consistent evidence to support the hypothesis that the prevalence of BPD (Borderline Personality Disorder) would be higher in individuals with fibromyalgia compared with the general population."[76]
- 2016, Towards a neurophysiological signature for fibromyalgia. This study has "discovered a brain signature that identifies fibromyalgia sufferers with 93 percent accuracy". (MRI images.)[77]
Blood tests[edit | edit source]
Brain scans[edit | edit source]
- 2015, The Somatosensory Link in Fibromyalgia: Functional Connectivity of the Primary Somatosensory Cortex Is Altered by Sustained Pain and Is Associated With Clinical/Autonomic Dysfunction (Study with brain images and tables.)
See also[edit | edit source]
References[edit | edit source]
- ↑ Fibromyalgia Symptoms - Web MD
- ↑ Fibromyalgia - Mayo Clinic
- ↑ Fibromyalgia now considered as a lifelong central nervous system disorder NAIDW.org
- ↑ Prevalance - National Fibromyalgia Association
- ↑ Fibromyalgia:Epidemiology - Medscape
- ↑ Webinar with Jarred Younger, Ph.D.
- ↑ Ask the Doctors: Is Fibromyalgia Progressive?
- ↑ Fibromyalgia Complications - Share Care
- ↑ Can fibromyalgia cause other medical conditions? - Honor Society of Nursing (STTI) - Share Care
- ↑ Fibromyalgia Fact Sheet - CDC
- ↑ Fibromyalgia - Questions and Answers about Fibromyalgia - NIH
- ↑ When Fibromyalgia Is More than Pain - ProHealth By Celeste Cooper
- ↑ The Difference Between Fibromyalgia Tender Points and Myofascial Trigger Points
- ↑ 18 Points Used to Diagnose Fibromyalgia - Health.com
- ↑ Tender Points might no longer be used for diagnosis of Fibromyalgia - Massachusettes CFIDS/ME FM Association
- ↑ 2011 Modification of 2010 ACR Fibromyalgia Criteria - CelesteCooper.com
- ↑ Criteria for the diagnosis of fibromyalgia: validation of the modified 2010 preliminary American College of Rheumatology criteria and the development of alternative criteria. - PubMed
- ↑ 2016 Revisions to the 2010/2011 Fibromyalgia Diagnostic Criteria
- ↑ How Fibromyalgia Affects Men - WebMD
- ↑ Fibromyalgia - Epidemiology - Sex-related differences in incidence - Medscape
- ↑ Tender Points might no longer be used for diagnosis of Fibromyalgia - Tender Points might no longer be used for diagnosis of Fibromyalgia - Massachusettes CFIDS/ME FM Association
- ↑ Tender Points might no longer be used for diagnosis of Fibromyalgia - The new criteria for FM diagnosis - Massachusettes CFIDS/ME FM Association
- ↑ Tender Points might no longer be used for diagnosis of Fibromyalgia - Tender Points might no longer be used for diagnosis of Fibromyalgia - Massachusettes CFIDS/ME FM Association
- ↑ SSR 12-2p: Titles II and XVI: Evaluation of Fibromyalgia
- ↑ World Health Organization, International Classification of Diseases - Fibromyalgia M79.7, ICD-10, 2016
- ↑ 2015/16 ICD-10-CM Diagnosis Code M79.7
- ↑ The Health Care Industry Finally Recognizes Fibromyalgia
- ↑ Pathogenesis of fibromyalgia - UpToDate
- ↑ Fibromyalgia - Open Medicine Foundation
- ↑ New UAB Study Could Radically Change Fibromyalgia Treatment As We Know It - National Pain Report By Donna Gregory Burch
- ↑ Testing the fibromyalgia immune system with lipopolysaccharide (LPS) - YouTube - May 24, 2017
- ↑ Century-old vaccine gives new hope to fibromyalgia community - ProHealth
- ↑ EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches - Business Wire
- ↑ Junk Ethics - The Fibromyalgia Perplex by Fred Wolfe
- ↑ Allodynia - about.com definition article
- ↑ Painful to Touch: Fibromyalgia & Tactile Allodynia - Does Your Skin Hurt? Here's Why!
- ↑ Temperature Sensitivity in Fibromyalgia & Chronic Fatigue Syndrome - Very Well By Adrienne Dellwo
- ↑ What is Fibro Fog - Fibromyalgia and Cognitive Dysfunction - Medical.net
- ↑ Irritable Bowel Syndrome in Fibromyalgia & Chronic Fatigue Syndrome - Why Do They Go Together?
- ↑ Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis by Adrienne Dellwo - VeryWell
- ↑ Impaired Language in Fibromyalgia & Chronic Fatigue Syndrome - Talking, Reading & Writing
- ↑ Aphasia - Mayo Clinic
- ↑ What is Dysphasia?-Ayushveda
- ↑ Fibromyalgia Tied to Hysterectomy, Gynecologic Disease
- ↑ Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia
- ↑ Fibromyalgia and Sleep - ProHealth - By: Cort Johnson
- ↑ Chronic Fatigue Syndrome, Fibromyalgia, and Autoimmune Thyroid Disease
- ↑ Thyroid Disease in Fibromyalgia & Chronic Fatigue Syndrome
- ↑ Fibromyalgia Symptoms - The Monster List!
- ↑ Cymbalta Lawsuits - Drug Watch
- ↑ Eli Lilly Settles Cymbalta Withdrawal Lawsuits - Donna Gregory Burch - National Pain Report - October 6, 2016
- ↑ Court Blocks Sale of Generic Lyrica, Upholds Pfizer Patents by Karen Lee Richards - Health Central - July 25, 2012
- ↑ Sleep Medications For Fibromyalgia Fibrodaze.com
- ↑ The Pridgen Revolution? Dr. Pridgen on Bringing His Antiviral Approach to Fibromyalgia To Market
- ↑ Novel Fibromyalgia Treatment Granted FDA Fast Track Designation - Fibromyalgia News Today By Charles Moore
- ↑ Through the “Valley of Death”: Dr. Pridgen, Fibromyalgia and the Looming Trials - Simmaron Research By Cort Johnson
- ↑ [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328426/? A famciclovir + celecoxib combination treatment is safe and efficacious in the treatment of fibromyalgia - NCBI, Dovepress Journal of Pain - J Pain Res. 2017; 10: 451–460. Published online 2017 Feb 22. doi: 10.2147/JPR.S127288]
- ↑ Potential Fibromyalgia Treatment is Put on Hold - National Pain Report - September 2016
- ↑ Three New Fibromyalgia Drugs Could Be On The Way By Donna Gregory Burch
- ↑ The Big Hurt: Second Major Fibromyalgia Drug in a Year Fails - Health Rising
- ↑ Warm-Water Exercise for Fibromyalgia - About.com Health FMS/ME/CFS
- ↑ Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia. - PubMED
- ↑ Exercising With Fibromyalgia - By Ronenn Roubenoff, MD
- ↑ CMS.gov Regulations and Guidance
- ↑ Acupuncture Good for Fibromyalgia? Acupuncture School Online
- ↑ Short-term complementary and alternative medicine on quality of life in women with fibromyalgia - JIM, Elsevier, Science Direct
- ↑ SSR 12-2p: Titles II and XVI: Evaluation of Fibromyalgia
- ↑ Common Misdiagnoses of Fibromyalgia - WebMD
- ↑ Overlapping and Related Conditions - CFIDS & Fibromyalgia
- ↑ When Fibromyalgia Is More than Pain - ProHealth By Celeste Cooper
- ↑ What Is Fibromyalgia? Medscape Readers Weigh In - Medscape By Bret Stetka, MD
- ↑ Chronic Pain: Does Vitamin D Help? - WebMD By Gina Shaw
- ↑ Drug Approved. Is Disease Real? - New York Times
- ↑ Personality and Fibromyalgia Syndrome
- ↑ Is Fibromyalgia a Psychosomatic Illness? Med Student Asks Celeste Cooper
- ↑ British Journal of Psychiatry Open Sep 2016, 2 (4) 275-279; DOI: 10.1192/bjpo.bp.115.002808 - Sarah Penfold, Emily St. Denis, Mir Nadeem Mazhar
- ↑ Neural signature for fibromyalgia may aid diagnosis, treatment