A FIBROMYALGIC EPEDEMIC?

Discussion in 'Fibromyalgia Main Forum' started by COOKIEMONSTER, Jun 6, 2003.

  1. COOKIEMONSTER

    COOKIEMONSTER New Member


    Q: When I first learned eight years ago that I had fibromyalgia I had barely even heard of it. Since then, at least three of my friends have been diagnosed with the condition and I have been reading and hearing more and more about it. Is fibromyalgia reaching epidemic proportions? Could it, like Lyme disease, be caused by an infectious agent that scientists have yet to identify?

    A: To chat with friends and read the latest health magazines, you certainly would think that fibromyalgia is becoming increasingly common. But many physicians and researchers, including myself, suspect it's the diagnosis of fibromyalgia — not necessarily the condition itself — that's becoming more common.

    Most adults will experience fibromyalgia symptoms at some point in their lives. For most, the symptoms — widespread muscle pain, often accompanied by fatigue — are short lived. Symptoms may appear during a time of prolonged stress or after a period of sleep deprivation or unaccustomed physical activity, and then subside. But for reasons not completely understood, these symptoms can become chronic in some people.

    Although such symptoms have probably existed since the beginning of time, it has been only in recent years that doctors have connected this specific collection of symptoms, given the condition a name, and developed the criteria to diagnose it. As more doctors become familiar with fibromyalgia, more and more are diagnosing the syndrome. And savvy consumers, armed with information from medical journals and popular magazines, are making their own diagnoses and then asking their doctors for confirmation and help with management. As a result of this increased awareness, people who previously might have suffered in silence or accepted muscle pain as an unfortunate part of life are probably now seeing their doctors and wanting diagnosis, relief and sometimes disability benefits. Others — who might have had to travel from doctor to doctor years ago to find out what was wrong — are getting a diagnosis earlier. Those factors, more than an increase in the incidence of the syndrome itself, are probably why you're discovering more people with fibromyalgia.

    To answer your second question, I very seriously doubt that fibromyalgia is caused by an infectious agent. Lyme disease, which you mentioned, is certainly a success story. Scientists have found a single bacterium that causes Lyme disease, which can be cured if treated with antibiotics. Unfortunately, the understanding and treatment of most chronic, painful conditions are much more complicated. Fibromyalgia is likely to be the result of many factors, and the factors probably vary among different people. Some of the numerous theories about the cause of fibromyalgia pain include: abnormalities in the muscles, an imbalance of chemicals in the body that control our sensation of and response to pain, or an imbalance in the natural body hormone called cortisol.

    But actually proving any of these physiologic factors to be a cause of fibromyalgia is difficult; instead, it is likely that some of these factors are associated with, or are a result of chronic pain.

    In addition to these physiologic factors, many studies have shown an association between psychological factors and fibromyalgia. As an extreme example, at least a couple of studies have shown an association in some people between fibromyalgia and sexual abuse. The theory is that psychological trauma somehow may lower the pain threshold and allow painful conditions to persist.

    While you may never know exactly what caused your fibromyalgia, you can take heart in the fact that the condition won't result in damage to joints or other organs, and it certainly isn't fatal. The good news about fibromyalgia is that it can be treated and managed, and the person in the best situation to help your condition is you.

    Although certain medications (for example, antidepressants to promote more healthful sleep patterns) can be helpful for fibromyalgia, perhaps the best ways to manage the syndrome are those things you can do yourself. These include getting an appropriate balance of rest and exercise and maintaining a positive attitude. Exercise boosts the production of natural body chemicals called endorphins that help ease pain and promote an improved sense of well-being. Your physician or physical therapist can tailor an exercise program for you. Initially, you will start with mild exercise, but will build to increasingly vigorous exercises to improve physical conditioning. Although any new level of exercise may be difficult or unpleasant at first, with time, repetition and perseverance, you will feel better.

    Keeping focused on what's positive in your life and the things that you can do will help, too. No matter how difficult it may seem now, you can live with a certain amount of pain and fatigue. Remember that you always have some control — control over what you are doing and thinking. Change these two components of your behavior in a positive way and you'll indirectly improve how you feel.

    DOYT CONN, MD
    Rheumatologist