Fibromyalgia Information: Part 1
Fibromyalgia, a complex and often confusing disorder, does not immediately come to mind when thinking about electrostimulation of the brain. However, in our experience using Clarity Direct Neurofeedback, we have had unexpectedly positive results in at least half our patients. Fatigue lessened, “foggy” brains cleared up, depression and anxiety resolved, sleep sometimes improved. And while all the symptoms did not just disappear, the improvements made marked differences in the lives of these patients. My very first patient with fibromyalgia was a 44 year old woman who couldn’t get out of bed for days at a time, suffered chronic pain, poor sleep and a “foggy” brain. As with the large majority of patients treated with direct neurofeedback, initial and temporary changes were noticed the first session. Then, over the next 4 months we saw all the improvements listed above. She was ecstatic.
This will be a 2-part blog on fibromyalgia. Part 1 will be an overview and probably quite familiar to those of you with much knowledge of fibromyalgia. Much of this material is taken from the NIH National Institute of Arthritis and Musculoskeletaland Skin Diseases. Part 2, however, will address some of the controversies with fibromyalgia, including recent data on what causes and what does not cause the disorder. Part 2 will also specifically review recent data on the effectiveness of electrostimulation on fibromyalgia, the part I am most interested in.
Fibromyalgia generally has some combination of widespread pain, diffuse tenderness, and fatigue. These are often accompanied by one or a variety of other issues, including:
cognitive and memory problems
irritable bowel syndrome
painful menstrual periods
numbness or tingling of the extremities
restless legs syndrome
sensitivity to loud noises or bright lights
Who Gets Fibromyalgia?
Fibromyalgia affects around 5 million adults in this country. Between 80 and 90 percent of those are women; however, men and children also can be affected. Most people are diagnosed during middle age, although the symptoms can present earlier. Women who have a family member with fibromyalgia are more likely to have fibromyalgia themselves, but it’s not known whether it is heredity, shared environmental factors, or both.
What Causes Fibromyalgia?
The cause is unknown, but there are probably a number of factors. Many people associate the development of fibromyalgia with a physically or emotionally stressful or traumatic event, such as an automobile accident. As will be covered in Fibromyalgia Part 2, studies do not bear this out. Some connect fibromyalgia to repetitive injuries. Others link it to an illness. And for still others, fibromyalgia seems to occur spontaneously.
Some of the problem may be with how the central nervous system processes pain. It may be that a person’s genes may regulate how painful stimuli are processed. People with fibromyalgia may react strongly to stimuli that most people would not consider painful.
How Is Fibromyalgia Diagnosed?
There are no lab tests for fibromyalgia. Because there is no generally accepted objective test for fibromyalgia, some doctors might think that patient’s pain is not real, or they may tell the patient there is little they can do.
A doctor familiar with fibromyalgia, however, can make a diagnosis based on criteria put forward by the American College of Rheumatology (ACR): widespread pain lasting more than 3 months, and other general physical symptoms including fatigue, waking un-refreshed, and cognitive (memory or thought) problems. In making the diagnosis, doctors also consider the number of areas throughout the body in which the patient has had pain in the past week.
How Is Fibromyalgia Treated?
Fibromyalgia is often difficult to treat. Not all doctors are familiar with fibromyalgia and its treatment, so it is important to find a doctor who is.
Fibromyalgia treatment ideally requires a team approach, with your doctor, a physical therapist, possibly other health professionals, and most importantly, yourself, all playing an active role. Many with fibromyalgia put together an informal team through trying out various clinicians and modalities.
Only three medications, duloxetine, milnacipran, and pregabalin are approved by the U.S. Food and Drug Administration (FDA) for the treatment of fibromyalgia.
Duloxetine was originally developed for and is still used to treat depression.
Milnacipran is similar to a drug used to treat depression but is FDA approved only for fibromyalgia.
Pregaballin is treats neuropathic pain (chronic pain caused by damage to the nervous system).
Doctors also treat fibromyalgia with a variety of other medications initially developed approved for other purposes.
These range from over-the-counter products to prescription medicines. For some people with fibromyalgia, narcotics are prescribed for severe muscle pain. However, there is no solid evidence showing that for most people narcotics actually work to treat the chronic pain of fibromyalgia.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs also relieve pain. The drugs work by inhibiting substances in the body called prostaglandins, which play a role in pain and inflammation. These medications, may help ease the muscle aches of fibromyalgia. They may also relieve menstrual cramps and the headaches often associated with fibromyalgia.
Complementary and Alternative Therapies
Many people with fibromyalgia also try, with varying degrees of success, complementary and alternative therapies, including massage, movement therapies (such as Pilates and the Feldenkrais method), chiropractic treatments, acupuncture, and various herbs and dietary supplements for different fibromyalgia symptoms.
Although some of these supplements are being studied for fibromyalgia, there is little, if any, scientific proof yet that they help. FDA does not regulate the sale of dietary supplements, so information about side effects, proper dosage, and the amount of a preparation’s active ingredients may not be well known. If you are using or would like to try a complementary or alternative therapy, you should first speak with your doctor, who may know more about the therapy’s effectiveness, as well as whether it is safe to try in combination with your medications.
Will Fibromyalgia Get Better With Time?
Fibromyalgia is chronic; it lasts a long time—maybe a lifetime. However, fibromyalgia is not a progressive disease that inevitably gets worse. It is never fatal, and it will not cause damage to the joints, muscles, or internal organs. In many people, fibromyalgia does improve over time.
What Can I Do to Try to Feel Better?
Besides taking medicine prescribed by your doctor, there are many things you can do to minimize the impact of fibromyalgia on your life. These include:
Getting enough sleep. Getting enough sleep and the right kind of sleep can help ease the pain and fatigue of fibromyalgia. Even so, many people with fibromyalgia have problems such as pain or restless legs syndrome.
Exercising. Although pain and fatigue may make exercise and daily activities difficult, it is crucial to be as physically active as possible. Research consistently shows that regular exercise is one of the most effective treatments for fibromyalgia. People who have too much pain or fatigue to do vigorous exercise should begin with walking or other gentle exercise and build their endurance and intensity slowly.
Making changes at work. Most people with fibromyalgia continue to work, but they may have to make big changes to do so. For example, some people cut down the number of hours they work, switch to a less demanding job, or adapt a current job.
Eating well. Although some people with fibromyalgia report feeling better when they eat or avoid certain foods, no specific diet has been proven to influence the course of fibromyalgia. Of course, it is important to have a healthy, balanced diet. Proper nutrition will give you more energy and make you generally feel better
The next blog will be Fibromaylgia Information Part 2, focusing more on controversies and the use of electromagnetic stimulation as a treatment modality.
For more Fibromylagia information and/or how Direct Neurofeedback can help reduce the symptoms associated to Fibromylagia contact the Dubin Clinic for a FREE consultation and session at (323) 825-3554.