I am one of many of the Arthritis Foundation‘s Ambassadors to Congress and I’ve tried to get through their training and babysit with a most adorable little boy, and of course it’s tax time and I’ve had to get things ready for the accountant my husband has do our taxes every year (to complicated for either of us), and do the research for the articles I write, and then write my articles so that you may have the information to help you to cope or change your arthritis and fibromyalgia problems.  Then several weeks ago my computer crashed and I lost all the research I had already done along with every article I had ever written.  I hadn’t been able to back anything up because my computer wouldn’t let me.

Any way all is well now I will have a new article for you by Monday the 6th of February and I’ll have one new article each week for you.

It seems that my life has suddenly taken a turn and I am busier than usual.

I love y’all.

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Researchers working on the puzzle of fibromyalgia syndrome (FMS) are adding more and more pieces.  While we don’t yet have a complete picture, we’re getting closer.  Many experts believe the condition is brought on by complex, abnormal responses to stress and could be linked to a genetic predisposition.  Studies also show, with FMS, the parts of your brain and central nervous system that deal with pain signals work differently from other people’s.  This is called central sensitization.

Experts are learning a lot about what leads to FMS, but they’re still not clear on why these things lead to FMS in some and not in others.

Fibromyalgia is grouped into two categories — primary and secondary. Primary FMS is the most common and is also called “idopathic” FMS, meaning it has an unknown cause.  Secondary FMS is associated with other conditions.

PRIMARY (IDIOPATHIC) FIBROMYALGIA

Suspected causes of primary FMS include chronic sleep disturbance, abnormalities in brain chemicals and hormones, psychological and social effects, and muscle abnormalities.   Some researchers are looking at nitric oxide levels.

• Chronic sleep disturbance                                                                                                                                                                 Sleep disturbances and fibromyalgia go hand in hand, and some experts believe sleep disturbances come first.  You can have restless leg syndrome, periodic limb movement disorder (PLMD) and sleep-related breathing disorders.                                                                                                                                                                                                                  In one study, people with FMS had faster rates of cyclic alternating sleep pattern (CAP), which leads to a non-refreshing sleep.  Researchers concluded the increased rate leads to serious sleep problems that make FMS symptoms worse.                                                                                                                                                                                            Some sleep problems of FMS may be linked to levels of the nervous-system chemicals serotonin and melatonin, which help regulate sleep-and-waking cycles.

• Brain chemical & hormonal abnormalities                                                                                                               Researchers know when you have fibromyalgia you can have many abnormalities in your hormonal, metabolic and brain-chemical activity, but they’re not sure whether these are causes of fibromyalgia or the effect of pain and stress on the central nervous system.  If you have FMS you may have imbalances in any of the following brain chemicals:

 Serotonin: low levels

Serotonin impacts your sleep cycle, pain level and feelings of well-being.  Low levels are linked to depression, migraine and irritable bowel syndrome, all of which often occur in people with FMS.

Melatonin: low levels

Your body makes melatonin from serotonin.  Typically, serotonin levels increase in the morning to help you wake up, then drop at night as your body converts it into melatonin, which helps you sleep.  Some studies show taking melatonin supplements can cut pain levels, improve sleep and improve depression symptoms in people with FMS.  But then again there are other studies showing little or no improvement.

Stress hormones: low levels

Deficiencies in the stress hormones cortisol and norepinephrine make your body less able to cope with psychological or physical stress. (Physical stress includes infection or strenuous activity.)

IGF-1 growth hormone: low levels

This hormone promotes bone and muscle growth.  Low levels are related to problems with thinking, low energy, muscle weakness an intolerance to cold.  This level may be a marker of FMS rather than a cause.

Substance P: high levels

Substance P is a chemical messenger in the nervous system associated with pain perception.  If you have too much, your brain gets too many pain signals.  People with FMS can have up to three times the normal amount in their spinal fluid.

Abnormal pain perception: high activity levels

Some studies and brain scans suggest fibromyalgia patients have too much activity in the parts of the brain and central nervous system that process pain.

Researchers are working to understand what these abnormalities mean and how this knowledge can lead to treatments.

•  Psychological & social effects                                                                                                                                                 According to studies, people with FMS are more likely than others to have experienced severe emotional and physical abuse.  This suggests that post-traumatic stress disorder (PTSD) or chronic stress could play a strong role in the development of FMS in some people.  Evidence shows that PTSD actually leads to changes in the brain, possibly from long-term over-exposure to stress hormones.

• Muscle abnormalities                                                                                                                                                                            Though these things can’t be tested at your doctor’s office or clinic, some research has shown that people with FMS have three kinds of muscle abnormalities:

 Biochemical

 Some FMS patients have low levels of muscle-cell chemicals that make sure you have enough calcium in your muscles.  When levels are low, the muscles stay contracted rather than relaxing.

 Structural & blood flow

 Researchers have found people with FMS have especially thick capillaries (tiny blood vessels). This could mean your muscles don’t get enough oxygen-rich blood or other compounds you need for proper muscle function.

 Functional

 Experts don’t know why this is but speculate that the pain and stress of the disease itself may harm muscle function.

Sources:

2007 About, Inc., a part of the New York Times Company. All rights reserved. “Fibromyalgia”

2007 ProHealth, Inc. All rights reserved. “Melatonin Deficiencies in Women”

1995-2007 Life Extension Foundation. All rights reserved. “Fibromyalgia”

SECONDARY FIBROMYALGIA

Secondary fibromyalgia appears either after or at the same time with other medical problems, usually one of the following:

•  Physical injury, especially to the neck
• Ankylosing spondylitis (arthritis that affects the spine)
• Surgery
• Lyme disease (May trigger FMS even after Lyme has been treated)
• Hepatitis C (some studies hint at this association)
• Endometriosis

When there’s another condition at work, it can give doctors a real a challenge when it comes to diagnosing secondary FMS.  First, it can be difficult to sort out what condition is causing what symptoms.  Second, FMS is considered a diagnosis of exclusion because anything reversible has to be treated before a doctor can diagnose it.

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There are more than 6-million people in the U.S. alone who have fibromyalgia syndrome (FMS), and the condition reaches all cultures around the world.  Anyone can get it, but some people are more at risk than others.

What are the risk factors?

Both men and women can develop FMS, although between 80 and 90% diagnosed with it are women.  Experts don’t know why, but some believe it could be tied to a hormonal difference.  It seems that most men are less likely to seek treatment or even admit they could have it, and therefore aren’t diagnosed as often as women.

It’s most common in people between 20 and 55, and women are most likely to develop it during their childbearing years, but, older people also can develop Fibromyalgia.  Children can, but rarely do.  So it can be said that Fibromyalgia knows no age.

Research shows that women closely related to a fibromyalgia sufferer is more likely to develop FMS themselves, indicating a possible genetic defect that predisposes some people from the beginning.

• Sleep Disorders:                                                                                                                                                                                               Some experts say sleep disorders could be a cause of fibromyalgia.  If you have a long history of sleep problems, and if you have been diagnosed with disorders such as sleep apnea you may have an increased risk.  Some doctors recommend sleep studies for their fibromyalgia patients.
•  Stress                                                                                                                                                                                                                         If you are always in stressful environments or you are particularly vulnerable to stress (either physiological or psychological) you can develop FMS more often that those affected less by stress.  Studies have suggested that post-traumatic stress disorder (PTSD) or chronic stress may play a strong role in the development of fibromyalgia.  High stress levels are also known to trigger flare-ups if you have FMS.  Studies also show low cortisol (stress hormone) levels and dysfunction in the HPA axis, which deals with physiological reactions to stress can trigger fibromyalgia.
•  Scoliosis/Low Back Pain:                                                                                                                                                                          In one study, about 25% of people with low back pain eventually developed FMS, and scoliosis or other postural disorders made FMS more likely.  Other research confirms the link between scoliosis and FMS.  Interestingly, low levels of melatonin, which can cause sleep disorders, are also believed to contribute to scoliosis.
•  Joint Hyper-mobility                                                                                                                                                                                            Some research shows that if your joints bend beyond the normal range (“double jointed”) you are more likely to develop fibromyalgia, possibly because you’re more prone to repeated minor injuries.
• Other chronic-pain conditions:                                                                                                                                                                  If you suffer with frequent headaches/migraines, lupus, osteoarthritis, rheumatoid arthritis and ankylosis spondylitis (a type of arthritis) you have an increased risk for developing FMS, possibly because your chronic pain causes desensitization of the central nervous system, which is believed to be the cause of FMS pain.

Lowering Your Risk

You can’t do much to stop most of these risk factors, but, if you feel you’re at risk you can work to effectively lower or manage your stress. You might be able to lower your risk (and improve your life) by getting regular exercise, eating a healthy diet, and getting proper medical treatment for pain, sleep disorders, past emotional trauma, or PTSD.

Sources:

2007 About, Inc., A part of The New York Times Company. All rights reserved. “Fibromyalgia”

Gerwin RD.A review of myofascial pain and fibromyalgia — factors that promote their persistence.

Lapossy E, et al.The frequency of transition of chronic low back pain to fibromyalgia.

Machida M, et al.Serum melatonin levels in adolescent idiopathic scoliosis prediction and prevention for curve progression — a prospective study.

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Introduction

Fibromyalgia is a syndrome of unknown causes that results in lasting, sometimes debilitating, muscle pain and fatigue. Fibromyalgia is also known as fibrositis or fibromyositis.

General Description of Fibromyalgia Symptoms

Pain.

The primary symptom of fibromyalgia is pain. The pain can be in one place or all over the body. The exact locations of the pain is called tender points. Fibromyalgia pain is often described as:

• Tender point pain that occurs in local areas, usually in the neck and shoulders.                                                                                                                                            The pain then spreads out from these areas.  The actual pain starts at the muscles.  The joints are not affected. There are no lumps or nodes associated with these pain points, and no signs of inflammation (swelling).  You have  fibromyalgia when you feel pain in at least 11 of 18 specific tender points.
• Widespread stiffness, burning, and aching pain.                                                                                                                   The pain also “radiates,” or spreads, to nearby areas. You always feel some pain all the time. You may describe it as “exhausting.”  The pain can vary depending on the time of day, changes in the weather, physical activity, and if you happen to be experiencing anything stressful in your life at the time.  The pain is often more intense after you have been woke up before you are ready.

Fatigue and Sleep Disruptions.

Another major fibromyalgia complaint is fatigue. Your fatigue is more distressing than your pain. Sleep disruptions, specifically restless legs syndrome, is also very common. Fatigue and sleep disruptions are almost universal when you have fibromyalgia. Some experts believe that if these symptoms are not present, the condition may not be fibromyalgia.

Depression and Mood.

Up to a third of you will have depression. Disturbances in mood and concentration are also very common and often go undiagnosed.

Other Symptoms.

You might experience the following symptoms as well:

• Digestive problems, including irritable bowel syndrome with gas, and alternating diarrhea and constipation
• Dizziness
• Painful menstrual periods
• Tension or migraine headaches
• Tingling or numbness in the hands and feet
• Urinary frequency caused by bladder spasms

Symptoms in Children.

In general, children with fibromyalgia most often have sleep disorders and widespread pain.

Causes

In the most common type of fibromyalgia, the causes are not known. Physical injuries, emotional trauma, or viral infections such as Epstein-Barr may trigger the disorder, but no one trigger has proven to be a cause of primary fibromyalgia.

Many experts believe that fibromyalgia is not a disease, but is rather a chronic pain condition brought on by several abnormal body responses to stress. Areas in the brain that are responsible for the sensation of pain react differently when you have fibromyalgia than the same areas in healthy people.

People with fibromyalgia have been found to have decreased activity in opioid receptors in parts of the brain that affect mood and the emotional aspect of pain. This reduced response might explain why fibromyalgia patients are likely to have depression, and are less responsive to opioid painkillers, researchers say.

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Key Points:

Causes

Researchers have discovered an unusual increase in blood flow (called “brain per-fusion”) in an area of the brain that separates pain intensity, and a decrease in blood flow in areas thought to be associated with the emotional response to pain after using brain scans. These differences have nothing to do with your depression and anxiety levels. Therefore the research supports the idea that fibromyalgia is a real disorder, and isn’t a result of depression.

You seem to be more sensitive to sounds than those without the condition. This increased sensitivity may be due to an irregularity in the sensory processing by the central nervous system.

Prognosis

You experience a greater psychological upset and fibromyalgia has a greater impact on your quality of life than those with other conditions, such as chronic low back pain.

Treatment

The U.S. Food and Drug Administration (FDA) has approved the drug duloxetine (Cymbalta) for treating fibromyalgia. In studies, duloxetine reduced fibromyalgia pain by more than 30%.

Lifestyle

Exercising in a warm swimming pool is a cost-effective therapy that improves quality of life in women with fibromyalgia.

Waon therapy may help reduce the pain of fibromyalgia, according to one small study. Below you will find the details of that study.

Waon Heat Therapy for Fibromyalgia

A recent article from Japanese researchers has shown that Waon Therapy, a specific kind of soothing warmth therapy, can be effective at helping to treat Fibromyalgia Syndrome (Fibro).

For the Waon therapy, 13 women with Fibromyalgia, spent 15 minutes relaxing in an infrared-ray dry sauna controlled at an even temperature of 60 degrees C, then they were moved to a room controlled at 26-27 degrees C and covered with a blanket from the neck down to keep them warm for 30 minutes.

The pain Visual Analog Scale (VAS) and the Fibromyalgia Impact Questionnaire (FIQ) was used to check the personal pain levels and outcome of the symptoms due to Fibromyalgia. After the first session of Waon therapy, all the women had important decreases in pain of 11-70% and after 10 sessions of the therapy, the effects settled at 20-78% of decreased pain. These significant decreases in pain and symptoms were determined using the pain Visual Analog Scale (VAS) and the Fibromyalgia Impact Questionnaire (FIQ), and these decreases were seen throughout the study period.

The researchers concluded that:

“Waon therapy is an effective treatment for Fibromyalgia Syndrome.”

Heat therapies in different forms are often used by those with fibromyalgia, with heated pool treatment being included in the EULAR evidence-based recommendations for managing Fibromyalgia. Heat was also rated as one of the most effective management therapies for Fibromyalgia by an internet survey of 2,596 people with Fibro last year.

References for this study:

Matsushita K, Masuda A, Tei C. Efficacy of Waon therapy for fibromyalgia. Intern Med. 2008;47(16):1473-6. Epub 2008 Aug 15.

Reference: Carville SF, Arendt-Nielsen S, Bliddal H, Blotman F, Branco JC, Buskila D, Da Silva JA, Danneskiold-Samsøe B, Dincer F, Henriksson C, Henriksson KG, Kosek E, Longley K, McCarthy GM, Perrot S, Puszczewicz M, Sarzi-Puttini P, Silman A, Späth M, Choy EH; EULAR. EULAR evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis. 2008 Apr;67(4):536-41. Epub 2007 Jul 20.

Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L. An internet survey of 2,596 people with fibromyalgia. BMC Musculoskeletal Disord. 2007 Mar 9;8:27

Reference site: http://fibroaction.org

Medications

The anti-epileptic drug pregabalin is effective at improving pain and sleep in three different doses (300 mg, 450 mg, and 600 mg), and the drug is well tolerated by fibromyalgia patients.

A synthetic drug derived from marijuana may prove an effective addition to fibromyalgia treatment. In one study, nabilone (Cesamet), which is typically used to treat severe nausea and vomiting in chemotherapy patients, much relieved fibromyalgia pain compared to placebo.

Here’s an excerpt:

A San Francisco cable car holds 60 people. This blog was viewed about 1,700 times in 2011. If it were a cable car, it would take about 28 trips to carry that many people.

Click here to see the complete report.

Looking at Lupus
An Attack from Within

Lupus is a complex and mysterious disorder. It arises when the cells that are supposed to protect your body from disease mistakenly assault your own healthy cells and tissues. This attack from within can damage your joints, skin and most other parts of your body. NIH-funded scientists are working to uncover the causes of lupus and find better ways to diagnose and treat the disease.

“Just about anyone can get lupus, but it mostly affects young women. It can rob them of the prime years of their lives,” says NIH’s Dr. Mark Gourley, an expert on lupus and related disorders. The disease often strikes between the ages of 15 and 44. Lupus afflicts about 9 times more women than men. For unknown reasons, African American women are at especially high risk.

No one knows what causes lupus. But researchers suspect that a combination ofgenes and the environment is to blame.

Lupus comes in different forms. The most common and serious type is called systemic lupus erythematosus. It can cause severe problems throughout the body. Other types can cause temporary skin sores after sun exposure or long-term rashes that may lead to scarring.

Lupus can be difficult to diagnose because its symptoms vary so widely. People with mild lupus may have just a few symptoms, such as skin rashes or achy joints. In other cases, lupus can harm essential organs, including the kidneys and brain.

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Myth:  Fibromyalgia is rare

Fact:

Fibromyalgia is one of the most common types of chronic pain.  It affects over 5 million patients in the United States alone.

Myth: Fibromyalgia is “ALL IN THE HEAD”

Fact:

Fibromyalgia has been described for centuries.  But it wasn’t until 1981 that the first scientific study actually confirmed fibromyalgia symptoms and tender points in the body.

Since then, researchers have done more testing on the pain reactions of people with fibromyalgia.  Imaging studies show that the brains of people with fibromyalgia have more activity in reaction to pain.  Studies also have shown that people with fibromyalgia feel pain more intensely at lower levels than people without the condition.

Fibromyalgia is thought to be the result of overactive nerves that cause chronic widespread muscle pain. Although, fibromyalgia is not just “in the head,” it is important to understand that the condition is stressful—especially when it goes without being diagnosed.  Stress can also make fibromyalgia worse.

 Myth: Doctors diagnose  Fibromyalgia when they can’t find a “REAL” diagnosis

Fact:

Diagnosis of fibromyalgia can take time and there isn’t any specific lab test for it. Your doctor isn’t able to see it on an x-ray or do a blood test to confirm it. Instead, he or she has to listen to what you are telling them about your symptoms and a physical exam. What’s really bad is that the symptoms can mimic the symptoms of several other conditions.  Your doctor will want to test for these other conditions also.

Fibromyalgia is a real condition.  In 1990, the American College of Rheumatology developed guidelines for diagnosing fibromyalgia.  Today, these guidelines are widely used.

Something else, there are now thousands of studies validating this form of chronic widespread pain.  In 1990, there were only about 200 published studies on fibromyalgia.  Today there are more than 4,000 published fibromyalgia studies.

Myth: Fibromyalgia is  a “Women’s Disease”

Fact:

The majority of people with fibromyalgia are women (about 80%).  Fibromyalgia is a common condition and that means men are also diagnosed.

Studies have shown that women with fibromyalgia tend to have a lower pain tolerance and more symptoms than men.  But both genders responded about the same to fibromyalgia treatment and other non-drug treatments like exercise.

Fibromyalgia knows no age group, teenagers and the old can be affected.  But the symptoms are more likely to begin in someone in their 30s.  Fibromyalgia occurs in all ethnic groups and cultures.  It knows no borders.

Myth: The pain of Fibromyalgia is mild

Fact:

You may only experience mild symptoms, especially if you’re getting the right treatment.  For others, the pain can be very severe.  It can impact on your quality of life significantly. The simplest of things you once took for granted, like working, going for a walk, the everyday chores of your household, and taking care of your family can become difficult.  Symptoms will often get worse under stress or even under certain weather conditions.

More information about fibromyalgia and chronic widespread pain can be found at http://www.Fibrocenter.com

Myth:  There is nothing that can be done to treat Fibromyalgia

Fact:

Although fibromyalgia can’t be cured,  just getting a diagnosis can be a great relief.  It can, however, signify the beginning of a new and possibly a long  journey toward relief of some of your symptoms.  With lifestyle changes and prescription treatments as well as alternative treatments, you may be able to reduce your fibromyalgia symptoms.  Not long ago there was no FDA-approved treatment for fibromyalgia, there are medication in existence now to help relieve the unique pain of this condition.

Myth:  Fibromyalgia damages my joints

Fact:

Though fibromyalgia pain can be severe at times, it doesn’t damage your bones, joints or muscles.  You may worry that when pain worsens, it means that fibromyalgia is progressing.  But that isn’t the case.  While increasing fibromyalgia pain can make it difficult to go about your daily activities, it isn’t damaging your body.

Myth:  You look fine, so there’s nothing wrong with you

Fact:

You know this isn’t true, but your friends, family and co-workers who don’t understand fibromyalgia will hang on to this belief.  It can cause tension when others wonder if you’re faking your pain because they think you don’t look sick. Resist the urge to get angry and withdraw rather than explain how you’re feeling.

Try to be as open and honest as you can be when you talk so you can help others better understand fibromyalgia.  Be honest about how you feel and let others know that if they have questions, you’re willing to listen and explain.

Myth:  Fibromyalgia is a form of Arthritis

Fact:

It was first believed that fibromyalgia might be a form of arthritis, although research over the past 10+ years has proven that to be not true.  Arthritis is inflammation of the joints, but there isn’t any inflammation with FM, and there isn’t any damage to your joints.   You might have some type of arthritis (like osteoarthritis or rheumatoid arthritis) along with FM, but it’s a completely different disorder.  Research is showing, with new brain-imaging techniques and scientific studies, that fibromyalgia can be described as a central nervous system disorder that results in your brain not being able to process the pain signals your body is sending.

Myth:  Fibromyalgia affects the muscles, joints, connective tissues.

 Fact:  There is no damage to the muscles, joints or connective tissue of people with fibromyalgia. 

In the past fibromyalgia was said to be a musculoskeletal disorder because the pain you have feels like it is coming from the muscles, joints and connective tissues.  But years of testing haven’t shown any actual damage to the muscles, joints and connective tissues.  What the research has shown is that there is a malfunction in your central nervous system causing  the signals being sent to the brain causing your pain to be magnified.   In other words, a stimulus that would not even be noticed by most people can be extremely painful to someone with fibromyalgia.

Speak to your doctor to learn more.

Research:

http://www.fibrocenter.com

http://www.fibrocheck.com

http://www.cidpusa.org/fibromyalgia_myths.htm

http://www.healthcentral.com/chronic-pain/fibromyalgia-160180-5.html

I want to thank each and every one of you for your fabulous comments about my blog and content.

I get a lot of questions about how I get my blog to load so fast.  I have no idea except that I would have to give the credit to wordpress for their excellent format.  They make it so easy for you to pick a design and format.

As for the content that I provide, my goal is to help as many people as I can to understand their arthritis.  It’s not easy to understand why you have so much pain and since I have had arthritis for nearly 14 years now, and I’ve been doing research into the why’s and what for’s for nearly that long, I just want to share what I’ve found.  It’s been my experience that the doctors, not all doctors, and the drug companies would like to not give us all the information we need to make wise health decisions so that we keep coming back and paying more to get answers.  There are answers to our pain.  We just have to dig a little deeper and that’s what my business is all about.  I do the digging for you.

I am glad to hear that I am helping so many people.   Thank you so much for all your replies!!

The three cytotoxic drugs commonly used to treat arthritis and it’s related conditions are:

GENERIC NAME                                                      BRAND NAME

Azathioprine                                                                Imuran

Cyclophosphamide                                                    Cytoxan

Methotrexate                                                                Rheumatrex

These drugs are often given in the pill form, but some may be given intravenously or by injection.

The information in this article shouldn’t be used to replace the advice and guidance given by your doctor and if you have questions about these or other medications, please contact your doctor or pharmacist.

Resources of information:

University of Washington orthopaedic

http://arthritis.about.com/od/arthritismedications/f/cytotoxic_drugs.htm