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I've been trying to keep up with the latest information on fibromyalgia. I get several newsletters on fibromyalgia and I read every twitter I can from other people with this problem. Is it true that scientists are close to finding a cure for this problem?
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Fibromyalgia is described as a neurohormonal mediated chronic pain syndrome. That simply means it is believed that the nervous system and the endocrine (hormone) system are somehow both involved in creating the pain signals that don't seem to get turned off or even turned down.
But as a fibromyalgia sufferer yourself, you know the best way to describe it is pain everywhere. The muscles are stiff, sore, and tender. The joints ache. There are headaches, difficulty sleeping, numbness and tingling, and problems with bowel and bladder function. In fact, up to 50 or more other distressing symptoms have been reported in association with fibromyalgia.
So what causes this problem and is there a cure coming? Scientists agree that chronic pain of this type is centrally mediated meaning the problem isn't coming from the muscles, joints, skin, or other soft tissues. It is originating within the systems.
Most likely it gets started in the central nervous system (brain and spinal cord) and then affects on all the peripheral tissues. Since most people with fibromyalgia experience pain with input or stimuli that isn't usually painful, it is suspected that there's a problem with pain or sensory processing, rather than some disease, inflammation, or impairment of the area that actually hurts (e.g., the back, the hips, the wrists).
New information is now available on chronic pain mechanisms because of advances in technology (e.g., functional imaging), genetics, and experimental pain testing. Although there is a link between brain function and somatic (body) illnesses like fibromyalgia, this condition is no longer considered a psychiatric (mental) illness like it was in the past.
Functional brain imaging shows areas of the brain that light up when pressure is applied to painful areas of the body. All indications are that once the central pain mechanisms get turned on, they wind up until there's pain even when the stimulus (e.g., pressure, heat, cold, electrical impulses) is no longer there. This phenomenon is called sensory augmentation. There is some evidence that people with fibromyalgia have a decrease in their reactivity threshold. In other words, with a low threshold, it only takes a small amount of stimuli before the pain switch gets turned on.
We still don't know why this happens. Many theories are being tested. It looks like the area of the brain that is in charge of sensory integration (taking in, processing, and making sense of all sensory stimuli) is hyperactive. Instead of properly processing the messages, it amplifies (turns up the volume) on them. Several studies using Single-Photon-Emission Computed Tomography (SPECT) have shown changes in the blood flow to certain areas of the brain. In some places of the brain, there was increased blood flow, while in other areas, the tests showed decreased blood flow. These altered patterns of blood circulation could be part of the problem.
MRIs of the brain have confirmed that patients with fibromyalgia process pain in the same areas of the brain as individuals without fibromyalgia. The difference is again with the amount of stimuli needed to activate those pain mechanisms. People with fibromyalgia have a narrow range of pain tolerance. And because women are affected much more often than men, it is suspected that the endocrine (hormone) system must be involved somehow.
Because there are so many variables and factors involved in chronic pain syndromes like fibromyalgia, treatment has evolved over time to become multidisciplinary. Besides medication and cognitive behavioral therapy, patients are also encouraged to stay active and exercise. Studies now show that exercise can be as helpful as medications for chronic pain conditions. Aerobic or cardiovascular training seems to be the most helpful. Low-impact activities like walking or biking, or even better, nonimpact exercise such as swimming are advised. Patients seem to do best when they progress slowly but gradually.
Our updated understanding has changed treatment approaches more toward this multidisciplinary model. Evidence supports finding the right combination of medications along with modifying thoughts and actions. Recent breakthroughs in understanding of pain, brain function, and the details of chemical and biologic responses in patients with fibromyalgia suggest better treatments are on the horizon -- perhaps even a cure for or prevention of this painful condition. But right now, there still is no instant cure or pill that will prevent it.
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