Seeing the “Invisible” in Fibromyalgia

2009-07-31 |

Long considered an “invisible syndrome” because attempts to “see” the pain where it was felt showed nothing, medical science is starting to slowly remove some of mystery associated with fibromyalgia. Though some in the medical community have been slow to accept the diagnosis of fibromyalgia as valid, the recognition of the condition as a real disease is finally gaining traction because of new research that is dropping proof into the laps of the remaining skeptics.

For many years, those with fibromyalgia have often been treated as suffering from depression and treated according to this inaccurate assessment. Without diagnostic tests or a simple means to properly confirm the presence of the disease, those with the disease were forced to endure the non-life threatening, but significantly debilitating symptoms. Sufferers of fibromyalgia experience body-wide pain, localized very sensitive tender points as well as headaches, concentration difficulties, ongoing fatigue, and an inability to sleep well. They may also experience irritable bowel syndrome and persistent flu-like symptoms. In general, the variability of symptoms has made the condition hard to diagnose, hard to understand and hard to treat.

The general lack of understanding of the disease is evident when we consider that the estimates on the numbers of people affected by the disease in the US varies considerably from 3 to 15 million people depending on which studies are examined. As well, even in 2008, the average estimated time for which a fibromyalgia patient was expected to wait before getting an accurate diagnosis was 5 years. These bits of information show that our health care providers generally lack sufficient understanding of the condition in order to effectively assist their patients.

One piece of information that is known about fibromyalgia is that roughly 80 to 90% of those suffering from the condition are female. Other information that is known about the condition is that it seems to have a genetic component since those who develop the condition often have relatives who are also afflicted. Though no definitive genetic identification of the disease has been made, related research regarding pain has identified that sensitivity to pain is partially dependent on genetic factors. Those with fibromyalgia do have higher sensitivity to pain caused by their condition so this information is quite important.

Some of the pieces of newer research that have finally given skeptics of the disease reason to reconsider come from a variety of sources. One interesting study from the University of Michigan’s sleep laboratory that was not conclusive, but still valuable, showed a correlation between levels of pain described by patients and the amount of disruption in sleep that was actually measured as these patients slept. These finding provide evidence that the pain experienced is not simply something that patients imagine.

Another interesting recent finding regarding fibromyalgia has come from image analysis performed in France regarding blood flow in the brain. The results of the study showed that patients with fibromyalgia had high levels of blood flow to the area of the brain where pain is processed and low levels of blood flow in other areas. This finding suggests that the sensitivity to pain experienced by those with fibromyalgia can be associated with abnormal brain and nervous system function.

A number of recent studies also looking into brain function, including one from Louisiana State University, have found that the density of gray brain matter in patients with fibromyalgia is lower than that of healthy patients and shows that these patients have lost brain material. The study also found, interestingly, that the levels of dopamine, a well known chemical used in nerve transmission, were abnormal. While not yet yielding treatment options, these studies do suggest ways in which the condition might be diagnosed such that patients need not wait so long for some form of treatment for their symptoms.

Of the interesting treatments being investigated, one such treatment involves providing patients with a low dose of naltrexone, a medicine long used to treat specific forms of drug addiction. The Stanford University School of Medicine started a clinical trial on the use of the drug in 2008 based on continual feedback from patients already taking the drug that it was working for their pain. Although preliminary, the study results currently show promise with 30% reduction in pain levels according to patients.

Interestingly enough, another medicine being investigated is also associated with narcotics. A clinical study performed in Manitoba, Canada used synthetic marijuana, called nabilone, and was able to yield what was described as a significant pain relief and functional improvement for the fibromyalgia treatment. Unfortunately, the study did not provide any description of the percentage improvement experienced by patients, but it is still encouraging.

In addition to these university and government researched drugs, the drugs launched by pharmaceutical companies just this year, such as Sodium Oxybate and milnacipran HCl offer hope for the treatment of the special pain associated with fibromyalgia. These drugs successfully passed many of the phases of the clinical trials so that is good news.

While fibromyalgia patients have long suffered without effective diagnosis of their condition and without the benefits of modern pain medications, this issue appears to be changing with the new knowledge being gained regarding the disease. While none of the current research suggests options for eliminating all pain or curing the condition, making life bearable for sufferers is immensely valuable in of itself.

Many thanks go out to FightingFatigue.org for inclusion of this article in the September 2009 installment of their blog carnival:
http://www.fightingfatigue.org/?p=7760

Related Links:

http://www.mayoclinic.com/health/fibromyalgia/DS00079
http://www.prometheusbooks.com/index.php?main_page=product_info&cPath=28_123&products_id=1921
http://www.mayoclinic.org/news2007-mchi/4348.html
http://www2.med.umich.edu/prmc/media/newsroom/details.cfm?ID=791
http://www.mtu.edu/news/stories/2008/september/story10312.html
http://adsabs.harvard.edu/abs/2007NIMPA.571…85G
http://med.stanford.edu/news_releases/2009/april/fibromyalgia.html
http://interactive.snm.org/index.cfm?PageID=8246
http://news.prnewswire.com/DisplayReleaseContent.aspx?ACCT=104&STORY=/www/story/06-15-2009/0005043707

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