Tuesday, September 22, 2009

Some Things About The Fibromyalgia Syndrome

There are a few events that can determine the apparition of the fibromyalgia syndrome. For example, an automobile accident, a viral or bacterial infection, or a disorder like lupus, hypothyroidism, or rheumatoid arthritis. It is not sure if these factors really lead to fibromyalgia syndrome, but there is a great chance that they will awaken an underlying physiological abnormality that already exists.
In order to find out what exactly this abnormality is, there are being made investigations that concern the hormonal irregularities, immune system function, the pain-related chemical transmitters, especially some alterations are searched.


There are modern brain imaging techniques that explore various aspects of brain function. Also, it is being evaluated the body’s response to stress and exercise, and alterations in the operation of the autonomic nervous system.
It was discovered that in the spinal fluid of people having Fibromyalgia syndrome, substance P is increased threefold, and nerve growth factor is increased fourfold, and the scientists are working to find out why this situation exists.

It is known that deep level sleep is important for many body functions, for example for antibody production, tissue repair, the regulation of various neurotransmitters, hormones and immune system chemicals.
Sleep disorders are a fact that often appears in fibromyalgia syndrome patients. It is very important that the sleep disorders to be treated first, because they can contribute to the symptoms of the fibromyalgia syndrome. There can be prescribed medications that increase the level of serotonin and norepinephrine. Usually, these medications are prescribed in low doses, and we can mention here cyclobenzaprine, amitriptyline and Cymbalta.
Medications that are used to aid sleep are: clonazepam, trazodone, Ambien, and Lunesta.
Other medications, such as Ultram are being used to treat the pain, and in moderate and severe cases, stronger opioids may be needed.
There can be also prescribed muscle relaxants, anti-epileptics like Lyrica and Neurotin, and other drugs categories too.

Also, many patients will have to follow other treatment methods too, like acupuncture, acupressure, trigger point injections with lidocaine, chiropractic care, therapeutic massage, physical therapy, occupational therapy, or a gentle exercise program.

There were made long-term studies, that followed the fibromyalgia syndrome evolution. It was revealed that this disease is chronic, but its symptoms may vary, they may sometimes rise, and sometimes decrease. The fibromyalgia syndrome has different impact among patients, it affects them differently. This syndrome can affect the daily living activities, and here we must also mention that it can affect ability to work a full-time job.

In conclusion, we may say that fibromyalgia syndrome can produce harm just as rheumatoid arthritis, can affect patients differently, and first, it is necessary a treatment to improve the quality of sleep and to release the pain

Doctor, Help Me - How Do I Find Arthritis Pain Relief?

The first and most important activity a doctor must do when the patient comes in is to make an accurate diagnosis. This is done with a careful history, physical exam, laboratory tests, and imaging procedures.

In the history, we ask questions such as:

• How long have you had the symptoms?

• What joints are involved?

• Is it symmetrical? One side like the other

• Is there a family history?

• Are there other symptoms?

On physical exam, we examine a patient from the top of the head to the bottoms of the feet! We look at the skin, eyes, ears, nose, throat, internal organs, and finally the joints

The goals of treatment are straightforward. They are:

Relieve pain/inflammation

• Enhance quality of life

• Slow disease progression

• Control co-morbidity (associated diseases such as high blood pressure, diabetes, etc.)

• Minimize risks of therapy

We first start with non-medicine treatment:

• Social support: make sure the patient’s family and friends understand the problem

• Education: make sure the patient understands all the things they must do themselves to get better

• Weight-loss: many patients with low back pain, knee pain, and hip pain are overweight. All the medicines in the world aren’t going to help until weight is corrected.

• Assistive devices: splints, braces, walkers, canes, etc. all may help.

• Thermal modalities: ice or moist heat depending on the situation

• Exercise: non impact as well as stretching and strengthening play a role.

• Modification of lifestyle: sometimes habits need to change and routines need to be altered.

Medicines:

• Analgesics: These help reduce pain. They don’t block inflammation. Analgesics may be habit-forming or addictive. They offer the potential for side effects as well. Examples: Tylenol, Ultram, Darvocet, Percodan.

• Anti-inflammatory medicines: These block inflammation and help with pain. There is the potential for side-effects including the liver, kidneys, and cardiovascular systems. Examples: Naprosyn, Motrin, Celebrex.

• Disease-modifying drugs: these drugs slow down the progression of arthritis. They are used in conjunction with analgesics and anti-inflammatory medicines. Wxamples: hydroxychloroquine (Plaquenil), methotrexate, azathioprine (Imuran).

• Biologic therapies: these are lasers that target the immune abnormalities found in many forms of arthritis. Examples: Enbrel, Humira, Remicade.

Specifically for arthritis related pain we also use medicines such as GABA stimulators such as gabapentin (neurontin) and pregabalin (Lyrica).

Lidoderm patches also help as do topical agents such as Myorx.

Sometimes injections of different types will be needed. These injections may be combinations of local anesthetics and glucocorticoid or they may consist of materials such as Botox. We have used the latter quite successfully in patients with neck and low back problems.