Why Common Drugs don't ease our pain.

Discussion in 'Fibromyalgia Main Forum' started by gapsych, Jun 15, 2009.

  1. gapsych

    gapsych New Member

    This is from an FM newsletter, can't remember which. I looked and the site says their materials it falls under the fair use act which means you can copy this information.

    This article does mention depression but if I read correctly they are saying it is caused by the fact that you are not getting the pain relief needed. Anyone else think this is what the authors are saying?


    Research May Explain Why Common Drugs Don't Ease Pain From Fibromyalgia

    People who have the common chronic pain condition fibromyalgia often report that they don't respond to the types of medication that relieve other people's pain. New research from the University of Michigan Health System helps to explain why that might be: Patients with fibromyalgia were found to have reduced binding ability of a type of receptor in the brain that is the target of opioid painkiller drugs such as morphine.

    The study included positron emission tomography (PET) scans of the brains of patients with fibromyalgia, and of an equal number of sex- and age-matched people without the often-debilitating condition. Results showed that the fibromyalgia patients had reduced mu-opioid receptor (MOR) availability within regions of the brain that normally process and dampen pain signals -- specifically, the nucleus accumbens, the anterior cingulate and the amygdala.

    "The reduced availability of the receptor was associated with greater pain among people with fibromyalgia," says lead author Richard E. Harris, Ph.D., research investigator in the Division of Rheumatology at the U-M Medical School's Department of Internal Medicine and a researcher at the U-M Chronic Pain and Fatigue Research Center.

    "These findings could explain why opioids are anecdotally thought to be ineffective in people with fibromyalgia," he notes. The findings appear in The Journal of Neuroscience. "The finding is significant because it has been difficult to determine the causes of pain in patients with fibromyalgia, to the point that acceptance of the condition by medical practitioners has been slow."

    Opioid pain killers work by binding to opioid receptors in the brain and spinal cord. In addition to morphine, they include codeine, propoxyphene-containing medications such as Darvocet, hydrocodone-containing medications such as Vicodin, and oxycodone-containing medications such as Oxycontin.

    The researchers theorize based on their findings that, with the lower availability of the MORs in three regions of the brains of people with fibromyalgia, such painkillers may not be able to bind as well to the receptors as they can in the brains of people without the condition.

    Put more simply: When the painkillers cannot bind to the receptors, they cannot alleviate the patient's pain as effectively, Harris says. The reduced availability of the receptors could result from a reduced number of opioid receptors, enhanced release of endogenous opioids (opioids, such as endorphins, that are produced naturally by the body), or both, Harris says.

    The research team also found a possible link with depression. The PET scans showed that the fibromyalgia patients with more depressive symptoms had reductions of MOR binding potential in the amygdala, a region of the brain thought to modulate mood and the emotional dimension of pain.

    The study subjects were 17 women with fibromyalgia and 17 women without the condition.


    The senior author of the paper was Jon-Kar Zubieta, M.D., Ph.D., the Phil F. Jenkins Research Professor of Depression in the U-M Department of Psychiatry and a member of U-M's Molecular and Behavioral Neuroscience Institute, Depression Center and Department of Radiology. Other authors were Daniel J. Clauw, M.D.; David J. Scott, Ph.D.; Samuel A. McLean, M.D., MPH; and Richard H. Gracely, Ph.D.

    The research was supported by grants from the Department of the Army; the National Center for Research Resources, a component of the National Institutes of Health; and the NIH. Harris was supported by an NIH-National Center for Complementary and Alternative Medicine Grant. McLean was supported by an NIH grant.

    Reference: The Journal of Neuroscience, Sept. 12, 2007, 27(37):10000-10006.
  2. DemonFairy

    DemonFairy New Member

    "The study subjects were 17 women with fibromyalgia and 17 women without the condition."

    First of all, it's kind of a small study to really get much out of it. Secondly, pain meds *do* help me, so they must be binding to something. Granted, not all pain meds help (MS Contin & Dilaudid did nothing - it was an odd experience to have something that was supposedly fairly strong and have it do absolutely nothing), but Oxycodone (both IR and ER) and Fentanyl help my pain. In our household study of two women with fibromyalgia, none without, we've discovered that certain pain meds *do* help our fibromyalgia. We have slightly different symptoms, plus I have the added back problems, but we both get the all-over body pain that just feels like a toothache in every part of our bodies...and Oxycodone & Fentanyl help us. We could say that in study where one of us has chronic back pain and the other doesn't, but we both have FM, certain pain meds seem to bind to our receptors well enough to provide some pain relief. Maybe they work better on women w/o FM, but I know what it feels like to not have the pain meds, and I'd rather have them than not.

    I've seen lots of sites quote the, "pain meds don't help FM patients" thing, and from what I've seen on this board, lots of us certainly do get help from them, although there are also lots of us who have doctors who "don't believe in" pain meds for FM patients. Yeah, I'll bet they'd "believe in" the pain meds if THEY had the pain.
  3. TeaBisqit

    TeaBisqit Member

    The only time in all the years I've been sick that I had any relief from the fibro pain was when I was put on Ortho Tri Cyclen birth control pills. ALL the fibro pain went away on them. But only for the time I took the pills. When I went off them, it all came back.

    Over the years, many women have claimed that when they got pregnant, all the fibro symptoms disappeared during the pregnancy. But as soon as they had the baby, it all came back. Birth control pills are a form of fake pregnancy.

    From my experience, I fully believe there is a hormone connection to our pain and none of the blood tests are accurate. Doctors don't even really look for hormone imbalances for Fibro. And this really needs to be looked into.
  4. jasminetee

    jasminetee Member

    That's amazing that the BCP helped you so much. Why did you go off of them?

    My symptoms are totally tied to my menstrual cycle. My fibro also got much worse when I went into peri-menopause. Peri-meno shares 33 of the same symptoms as FMS and I have them all. They aren't in nearly the same amount of pain though. However, many women with Peri-meno feel better on the BCP. They're put on it to regulate their hormones instead of HRT (hormone replacement therapy) because they're cycle is still regular.

    I'm going to look into the BCP.

    Gap, I think this explains a lot, "Patients with fibromyalgia were found to have reduced binding ability of a type of receptor in the brain that is the target of opioid painkiller drugs such as morphine."

    Thanks for posting that article.

    [This Message was Edited on 06/16/2009]
  5. gapsych

    gapsych New Member

    Yes the study only had a small number of people. This probably means that other studies need to be done before referring to it as the gospel.

    But it is very interesting. The more we find out what makes one person do fine on a medication and another not, maybe someday there will be a drug taylored to each persons system to get the maximum amount of benefit and a minimal amount of downfalls. Maybe far out, maybe not.

    Please do not think I posted this to say people with chronic pain should not take pain meds. (maybe I should have put that in the originl post :D ) I would not have the quality of life without my tramadol.

    I do not feel guilty about taking pain medication. This is something I talked to my doctor about, read about before going on the medication. I am not an addict. I have been on the same dosage for a long time and even if I did need to up the dosage I have wiggle room. I have weighed the risks and benefits and this decision is what has helped me.

    Jam, I guess I am curious why you keep posting that you only have to take two aspirins and you are fine when you do not even know if you have FM. I am sure that you don't mean to but people may read into your post that if you can get through the pain we all should be able to.

    We are all individuals here who have different severity of pain. Great that this works for you but please realize what works for you is not going to be benefical for others.

    This message is similar to what we too often get from doctors and people who do not believe us. It can be hurtful to some.

    Many of us have pain to such an extent that we can't just grin and bear it. There is a reason we are feeling pain. A physical reason.

    This is diffrent than popping a pill for every little ache and pain nor is this drug seeking.

    What information you have from 1999 is outdated as some of these treaments do work.

  6. TeaBisqit

    TeaBisqit Member

    After about a year and a half on the BCP's, my body started to reject them badly. My blood pressure skyrocketed, I was swelling up with fluid. My doc was afraid I'd have a stroke and I felt like I was going to. I had to go off them. But for the time I was on them, I was better on those pills. I'm hoping that I'll be able to stay on them for awhile this time round.
  7. jasminetee

    jasminetee Member

    I hope they work for you this time too. Thanks for sharing what happened to you when you were last on them. I am not going to try them now because I read more about their side-effects and I have become so super-sensitive to everything.

    Plus, I was reading that our bodies are meant to do what they're doing with peri-meno and we can pay more later by using hormones to delay it. I read that even low-dose BCP can have way more hormones than HRT.

  8. Mikie

    Mikie Moderator

    Back before the Guai Protocol and Klonopin helped my FMS pain, I was on Morphine and it was a God send. I also get relief from Vicodin. We vary so much in our reaction to treatments that it is difficult to say what may or may not help. I think we just have to try different things and pick, through trial and error, what works for us.

    Love, Mikie
  9. Bunchy

    Bunchy New Member

    are benzos and sometimes codeine combined with a muscle relaxer.

    Since most of my pain is from severe muscle stiffness, it makes sense to me that benzos help my pain.

    Nothing helps my ME/CFS achy fluey type pain though :(

    I guess it depends on the type of pain that is worse for one as to what type of med will or won't work for them.

    Love Bunchy x
  10. green-eyed lady

    green-eyed lady New Member

    You'are right what works for one may not work for another. I have what is more than unbearable pain. I have tried everything and I am on "narcotic" pain reliever's (???) and I also take Advil Liquagels. I can't handle the pain if I don't take them. neither am I an addict. I have taken these pain meds for 20 yrs. Needless to say, I am very weary of this disease--FM/ME. But there are at least 5 different reasons that you feel Pain. I don't think you want to get into the exact reasons right now, but ask if you do. One thing that took one type of pain away and that was Lyrica. It took the "electrical" pain away, which made me "glow" with pain and i had to lay down all of the time. It felt like pain was coming out of every nerve-ending in my body, which is your whole body. It has been the only thing that could take that type of pain away. Narcotics take the edge off the rest of the pain.
    [This Message was Edited on 07/15/2009]
  11. ckm

    ckm New Member

    Thanks to Gap for clarifying to Jam about only having to take two aspirins and be fine, not knowing if FM is there or not. I read into that post the exact thing that you, Gap, said some people would. I would do anything to only have to take 2 aspirin and be fine. That wouldn't touch me! I take 3-4 vidodin (used to be 5-6 before my back surgery two years ago) just to get through a day and sometimes still have pain. Some people should be careful what they say on here, I think.
  12. cathugs

    cathugs New Member

    about the aches and pains .I would love to take a couple of otc pain relievers and go on about my business.

    Some times I hurt so bad that I feel like all my nerve endings are raw
    and my body throbs with every heart beat. If I did not have my Vicodin
    and muscle relaxers and meloxicam I don't think I could stand it.

    I am now taking the new drug Savella and it is helping a lot. I have tried
    every thing and the Savella is the only thing that has showed any promise.

    Sure, I would like to wake up in the morning and not have to take a handful of pills, but if I want to make it through the day I have no
    alternative. And some days I still have to stay in bed because the fatigue is so mind numbing.

    I know I am dependent on my meds, but I am not an addict.

  13. msSusan

    msSusan Member

    I have been on vicodin, tramadol, nucynta and oxycodone and none of these control my FM, neck pain and daily headaches.

    I usually get VERY hyper on low doses taken earlier in the day. I don't get pain relief just the energy to overdue things so then I usually flare-up for a few days. I also have trouble sleeping when I take these meds.

    I have tried most types of meds without much pain relief or I can't tolerate side affects. Valium helps with my headaches/sleep.
  14. HarleyRidingGal

    HarleyRidingGal New Member

    Demon, you are so right about the pain meds. They do help me as well. Not all of it, but some of it to help me at least be able to walk around and have some functional days. You are so right on the money about doctors and pain meds and if they had the pain, they would be the first in line, I suspect, to get whatever help they could. Sometimes I wish, just for one day, that some of the medical dum-dums (as in the suckers we got in our Halloween candy bags as kids), would experience a day in my shoes to know that it DOES exist.

    I had a doctor that would hand them to me like candy but would do nothing else except pass me on to whatever specialist was handy at the time.

    Then I had a doctor that thought I was drug seeking even though that was totally false and drug tests proved otherwise. Naproxyn was his idea of dealing with severe pain. I almost wanted to put them in a Pez dispenser. That's how effective they were for me. A dispenser with a cute Disney character on the top, just for added flair! :)

    And Tee, this happened to me. My pain was gone, my allergies (to shrimp and perfumes) disappeared and I never felt better than when I was pregnant. Of course this was years ago but I am certain my FM goes way, way back.

    As soon as my pregnancy was over, the pain started up and the gyno-related issues started all over again. So did my joint and muscle pain. Luckily, I had a hysterectomy. Thank God!

    I do believe that hormones play a part. Especially those of us with imbalances.

    This is a great thread. Interesting to know that all these little puzzle pieces fit so much better once you know there are others not afraid to talk about even the strangest connections to FM. I'm learning more and more just from reading on here.

    For that I am grateful.

    Blessings all.