 Fibromyalgia, Chronic Fatigue Syndrome, and Migraine
Frequently
Asked Questions
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Fibromyalgia, Chronic Fatigue Syndrome, and
Migraines
(by
MHNI Staff)
What is fibromyalgia?
Fibromyalgia is a condition involving
painful muscles, ligaments, and tendons. It is not disfiguring or life threatening
or progressive (i.e., does not necessarily worsen over time). It is not related
to tissue inflammation like arthritis. Similar to migraine headache, fibromyalgia
affects mostly women in middle age, and less often affects children and the elderly.
The pain from fibromyalgia may occur
in four or more distinct areas of the body, and may be related to distinct "trigger
points". "Trigger points" or "tender points" in the body can affect pain and muscle
spasm when pressure is applied. Trigger points are often found in the elbows, shoulders,
back of the head, knees, and the sides of the breast bone. The presence of widespread
pain and trigger points, occurring for three or more months, is necessary for the
diagnosis of fibromyalgia. Migraine headache is a common associated problem. Other
associated symptoms include fatigue, sleep disturbance (especially feeling tired
in the morning after a night's sleep), depressed and anxious mood, poor concentration and memory, and gastrointestinal symptoms such as spastic colon.
In July, 1996 the National Institute
of Health sponsored a scientific workshop entitled "The Neuroscience and Endocrinology
of Fibromyalgia". The latest scientific findings on fibromyalgia were presented
by prominent
medical researchers. One goal of the workshop was to inform the public
of sophisticated research which is identifying the causes of fibromyalgia and to
stimulate other scientists to do this research. Fibromyalgia may be related to brain
chemical changes resulting in abnormalities in the central pain process and disturbances
in biological rhythms such as sleep cycles.
Recently, at MHNI's monthly Multidisciplinary
Meeting, Drs. Biondi and Silverman updated clinical staff on the current methods
of diagnosis and treatment of fibromyalgia. Because the causes of fibromyalgia are
not known, there is no cure, but effective treatments have been identified. Dr.
Biondi stated that "a graduated stretching, exercise and fitness program may be
a critical treatment intervention. A variety of medications have been shown to be
effective in controlling the symptoms and can be prescribed. I also instruct patients
to improve dietary and sleep habits and consider
learning biofeedback skills. With
a positive attitude and proper therapy most people suffering from fibromyalgia can
improve and lead a productive, active life."
Is there a relationship between chronic fatigue syndrome, fibromyalgia, and migraine
headaches?
Many patients with fibromyalgia
suffer from migraine-like headaches. It is currently believed that fibromyalgia
may be the result of disturbances in the brain's "pain center," a theory very similar to that which explains migraine. In fact, there are many who believe that chronic
pain disorders, including migraine and fibromyalgia, may arise from the same type
of disturbance. Though the pain of fibromyalgia is frequently found throughout the
body, it is associated with a variety of other symptoms, including sleep disturbance,
depression, anxiety, and headaches. Migraine is associated with many of these symptoms
as well. Many patients who are successfully treated for migraine find that their
fibromyalgia is improved.
Chronic fatigue syndrome remains an uncertain clinical entity. Many believe that it is due to a virus that affects
the central nervous system which can produce a variety of symptoms which overlap
migraine and fibromyalgia. This includes pain, depression, sleep disturbance, and
of course recurrent and persistent fatigue. If it is a virus, then it is likely that the virus affects the production of neurotransmitters or their connecting sites
(the receptors) on brain cells. Thus, the brain malfunctions, and the symptoms of
fatigue, pain, depression, and sleep disturbance develop. Some authorities believe
that low blood pressure accounts for its symptoms. Because depression, headaches,
and sleep disturbance are common to chronic fatigue, fibromyalgia, and migraine,
there may well be overlap in the origin of these. Much more must be known, however,
before a definitive solution is available.
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