Fibromyalgia: definition, causes and treatment

  1. Fibromyalgia: definition, causes, prevention and treatment

Fibromyalgia is a widespread pain disease that is characterised by 11/18 tender points (9 pairs). These tender points are in the neck, shoulder, chest, elbow, the lower back, the hip and the inside of the knee.

There are psychological deficits associated with fibromyalgia. These includes fatigue, depression and sleep problems.

There are also some physical symptoms:

-nausea
-irritable bowel
-numbness
-dizziness

Causes

The cause of fibromyalgia is thought to be because of the brain interpreting stress and pain signals abnormally. It may be due to the effect of the pain signals on the central nervous system and the secondary changes it makes to the brain.

Stress Hormones

Abnormalities in the hypothalamic pituitary adrenal (HPA) axis can cause fibromyalgia. The HPA axis is responsible for the stress response (fight or flight), depression and sleep.
Lower levels of norepinephrine and cortisol are seen in people with fibromyalgia and this is linked to inappropriate stress responses to:

– Infections
– Accidents
– Stress
– Hormonal disorders such as Cushings
– Medications

Central sensitisation

Some research suggests that in people with fibromyalgia, the brain interprets pain differently to non – fibromyalgic people. Overactivity of the pain processing areas of the CNS have been seen in people with fibromyalgia, as well as high levels of substance P which is associated with a high level of pain awareness.

Treatment

Food such as eggs, cheese, pineapple, tofu, turkey, nuts and seeds and salmon can boost serotonin levels. Sun, exercise, probiotics and a positive mental attitude can also increase serotonin.

CBT (cognitive behavioural therapy)

Cognitive behavioural therapy is is a form of treatment for being with mental health issues such as depression and anxiety. It focusses on changing dysfunctional, habitual, subconscious thought processes into healthier ones in order to effect behaviour positively.
In fibromyalgia, behaviour and what action is taken (I.e exercising) is crucial to recovery. Altering maladaptive thought processes which stop people from exercising, may relieve fibromyalgia.

Psychotherapy

Emotional trauma is a potentially a cause of fibromyalgia, therefore psychotherapy may be beneficial in dealing with unresolved conflicts in the psyche. It may also act as a preventative treatment.

Massage, Physical therapy, Yoga and Pilates

As physical injuries can trigger fibromyalgia, physical therapy from an osteopath, chiropractor, physiotherapist or sports masseuse may be of great benefit in preventing fibromyalgia from occurring. Yoga and Pilates taught by a recommended instructor may also act as a preventative.