The Life and Times of Fibromyalgia

In my last post I joked that given the commonality of some of the symptoms of fibromyalgia, we all have it.  Actually it’s estimated that 1-2% of the population has it which would be millions and millions of Americans. 

The history of the disease is interesting.  Years ago, I can remember when I first started medicine, it was a huge question of whether this was just malingering or what this was.  That may have something to do with the fact that most of the primary doctors back then were male and most of the people who get this are female.  Women were widely told “This is all in your head.  Go home.  You’re just depressed.  Take an anti-depressant.”  We blew them off.  That was not a good period of time in the medical field.  We needed to recognize that there was an honest problem.  We may not know what to do about it, but giving people recognition that, yes, there’s an actual problem here has some benefit in and of itself.

It was ignored by medicine for a lot more years because we didn’t really have anything to do for it and still don’t have a lot to do for it today.  Doctors don’t like to admit they can’t help people with their problems.  Patients don’t like to be told there is no help.  Still, today, there is some denial or a lot of ignoring. Because of its insidious and slow onset, it is frequently not even recognized.  A person might be coming in complaining of TMJ (temporal mandibular joint) pain and not have read an article or put the rest of the pieces together.  The doctor is rushing from one patient to the next and he doesn’t ask questions.  It can go unrecognized for long periods of time.  It’s frequently under-diagnosed and misdiagnosed.  There are a lot of pitfalls there from the medical side of things.   

It’s also interesting that people in Africa or India or other places don’t seem to get fibromyalgia.  It’s kind of a European/American disease.  What is it? What causes it?  Is it stress?  Is it microwaves in the air?  Is it fluoride in the water?  We don’t really know what causes it or where it comes from.  We do know that there is disturbance of sleep patterns.  We do know that there are different alterations of neuro-hormones in the brain.  There is low growth hormone.  There is a derangement of things in the brain.  We know that some of those things can be diagnosed, but part of the diagnosis is that all of your blood tests and X-rays will be normal even if you do have fibromyalgia.  It’s important for us to have a diagnosis in case it’s something else medically that we can treat.  

But it’s very interesting to note that there is a continuum of fibromyalgia.  That continuum is directly related to the amount of stress the patient is in.  The more stress they have the worse their fibromyalgia is.  

The one thing that we can universally prescribe that we know that helps is not a drug.  It is not a pill that medicine knows to prescribe; it is simply exercise.  That’s a hard thing to get somebody to do who is stiff in the morning and hurts all over.  But that’s the one thing that we can consistently encourage patients to do is exercise.  

In the alternative medical field there are certain things we’ve tried:  alpha lipoic acid, B12, and magnesium certainly should be tried. Also acetylcysteine, glutathione, and Omega-3’s are always important and particularly important for fibromyalgia because of it’s anti-inflammatory needs.  It is an inflammation of sorts.  L-arginine can be beneficial because it increases nitrous-oxide and that helps control pain out there. 

Medically things that doctors try are P3, thyroid supplements; doxaphene as kind of an anti-depressant; and oxytocin shots can be beneficial.  Testosterone may be of some benefit.  There are some things to try medically. 

The huge thing, the real take-home note here is the continuum of stress and it’s relationship to fibromyalgia.  The more stress, categorically, the more pain and the more significant a problem this is going to be on a daily basis.  And that's the skinny on fibromyalgia.