fibromyalgia: it's not all in your head

by Barbara Cacia

• Do your muscles ache all over?
• Do you feel like you have the flu all the time?
• Do you go to bed at night and wake up in the morning feeling fatigued?
• Does your short-term memory quit on you?
• Do you have Irritable Bowel Syndrome and chronic headaches?

If you have these symptoms, you may have Fibromyalgia. This chronic syndrome is difficult to diagnose, but blood tests can help eliminate other diagnoses with similar symptoms.

In 1990, the American College of Rheumatology defined Fibromyalgia (FMS) as pain in 11 of 18 tender points, unrefreshing sleep, and fatigue that has lasted for more than 3 months. However, most people’s symptoms have been with them for years. Fibromyalgia affects 3-6 percent of the population, and 9 out of 10 sufferers are women. Researchers report that this is not a disease of the muscles and soft tissue; rather, there are abnormalities in the central nervous system. Neurotransmitters (brain chemicals) are at abnormal levels, causing difficulties in the pain processing center and the sympathetic nervous system. Substance “P” is the neurotransmitter that delivers the message of pain to the brain, and FMS patients have abnormally high levels of this neurotransmitter in their spinal fluid. A second major issue is that the sympathetic nervous system is out of control and can set off the stress response at any time. This system controls the “fight or flight response” as well as automatic functions in our bodies such as heart rate, breathing, and gastro-intestinal operation. As you can see, this can be a difficult diagnosis to live with.

Treatment of FMS requires a good working relationship with your doctor. Your primary care physician will most likely treat you, as there are a limited number of rheumatologists in the Rochester area. Expect your doctor to offer medication for sleep and pain. Many physicians will prescribe antidepressants for sleep. While not everyone with FMS is depressed, pain and depression run in the same central nervous system pathway so the antidepressant will treat the pain too. In addition, doctors often prescribe anti-inflammatory medication for pain. There are many available, so it may take time to find the one that works best for you.

Effective treatment also includes gentle stretching and cardiovascular exercises, sleep hygiene, good nutrition, and managing stress and worry. These lifestyle changes are not in your doctor’s prescription pad, but they are as important as the medicines they prescribe.

One thing I have learned over years of teaching people with FMS how to live their lives is that one day you may feel like you can accomplish a level 10 activity, and the next day you may be flat on your back in bed. There is no predicting what will happen. This is the nature of this diagnosis. However, learning about FMS and understanding your body can help you reclaim your life.

ABOUT THE AUTHOR Barbara Cacia, BSEd, is a Health Educator in the Rochester area and provides group classes and individual wellness counseling for people who have Fibromyalgia and Arthritis. Most group classes are covered by insurance. You can reach her at (585) 760-6659 or visit her website at www.restoringyourenergy.com. She encourages you to come to the group classes she offers.