From the Back Cover
What is fibromyalgia—and how do I know if I have it?
How can I break the cycle of chronic pain and fatigue?
What do doctors know about this condition?
What are my treatment options?
Can diet and exercise relieve my symptoms?
Learn how to ease your pain, increase your stamina, improve your health—and take charge of your life—with…
THE COMPLETE GUIDE TO HEALING FIBROMYALGIA
· The most comprehensive, up-to-date information available—including the latest preliminary diagnosis guidelines from the American College of Rheumatology
· A-to-Z lists of prescription medications, herbal remedies, and natural supplements
· Proven strategies for relieving symptoms—muscle pain, stiff joints, fatigue, sleep problems, depression, irritable bowel syndrome, fibrofog, sexual dysfunction, and more
· Alternative mind/body therapies—acupuncture, acupressure, chiropractic, hypnotherapy, light therapy, massage, neurofeedback, and other methods
· Crucial information on dealing with doctors, health insurance, employment issues, disability, getting pregnant, child rearing, weight control, support groups, and much more
· Plus an easy-to-follow program of diet, exercise, and sleep that will help relieve your pain and restore your quality of life
About the Author
Deborah Mitchell is a widely published health journalist. She is the author or coauthor of more than three dozen books on health topics, including the Healthy Home Library’s 52 Foods and Supplements for a Healthy Heart, 25 Medical Tests Your Doctor Should Tell You About, A Woman’s Guide to Vitamins, Herbs, and Supplements, The Complete Book of Nutritional Healing, The Concise Encyclopedia of Women’s Sexual and Reproductive Health, and How to Live Well with Early Alzheimer’s. Her other titles include The Wonder of Probiotics (coauthored with John R.Taylor, N.D.), Foods That Combat Aging, Your Ideal Supplement Plan in Three Easy Steps, and What Your Doctor May Not Tell You About Back Pain (coauthored with Debra Weiner, M.D.).
Excerpt. © Reprinted by permission. All rights reserved.
An Introduction to Fibromyalgia
“I wish I didn’t feel so exhausted and in pain all the time.”
“It’s a struggle to even get out of bed in the morning. I have kids to take care of, but I can’t even get it together to make breakfast half the time.”
“I used to have a great job, and then I had to quit because the fatigue and the lack of concentration made it impossible for me to keep working.”
“I don’t know which is worse, the fatigue or the depression or the pain. All I know is, I’m sick and tired of feeling sick and tired.”
Do any of these statements describe you? If so, you may be one of the millions of people in the United States who is living with fibromyalgia. We say “millions” because it is difficult to obtain an accurate number of people who have fibromyalgia. Depending on the source, the numbers range from 6 to 12 million. According to the Mayo Clinic, for example, 2 percent of the American population has the syndrome, which places the figure at around 6 million. The National Fibromyalgia Association estimates the number to be 10 million in the United States and that this syndrome affects 3 to 6 percent of the world’s population. If you check with WebMD, a popular Web site among Internet surfers looking for health-related information, you will see the high figure of 12 million Americans.
Why is there such a large range in estimates? One reason is that fibromyalgia is difficult to diagnose; another is that it can take several years of going to doctors before an individual is finally given a diagnosis. Many cases are believed to go unreported or undocumented because some people just give up seeking a medical reason for their symptoms. Quite simply, they are sick and tired of being sick and tired, and that no one can seem to tell them why.
Then there is the controversy among some physicians: does fibromyalgia really exist? It would be hard to convince the millions of people who have it that it does not, and indeed there is plenty of evidence that it does exist. However, a few physicians still shake their heads whenever the topic comes up. On January 14, 2008, The New York Times had a front-page story entitled “Drug approved. Is disease real?” with the subtitle, “Some doctors dispute existence of pain.” The drug referred to was pregabalin (Lyrica), the first prescription medication approved by the Food and Drug Administration (FDA) for treatment of fibromyalgia—the “nonexistent” disease. (Actually, fibromyalgia is a syndrome and not a disease, but we explain that below.)
Although fibromyalgia is admittedly a challenge to diagnose and to treat, it is also a challenge to live with. We want to assist you in taking on these challenges and help you manage your “relationship” with this syndrome and with yourself.
So do not worry about the numbers: the number you should be concerned with is one, whether it is you or a loved one who has fibromyalgia or who is displaying symptoms. Regardless of how many millions of people are affected by fibromyalgia, the important thing for you to do is to gather all the information you can and seek help. And there’s no better time to begin than right now.
WHAT IS FIBROMYALGIA?
The word “fibromyalgia” comes from “fibro,” referring to fibrous tissue such as ligaments and tendons; “my” which refers to muscles; and “algia,” which means pain. Fibromyalgia is a common, chronic pain disorder that impacts an individual on every level: physical, mental, emotional, social, and spiritual. Along with the persistent pain, individuals with fibromyalgia experience fatigue that can often be overwhelming, and a multitude of other physical and psychological symptoms that can affect all the organ systems in the body.
Fibromyalgia is a syndrome, not a disease. A disease is defined as a medical condition for which there is a particular cause or causes and signs and symptoms that can be recognized. This differs from a syndrome, which is a collection of signs, symptoms, and medical problems that occur together but are not related to one specific, identifiable cause.
Fibromyalgia is generally accepted as a type of arthritis, but unlike most forms of arthritis, fibromyalgia primarily affects the muscles rather than the joints. Although fibromyalgia is a chronic condition, there are a few promising facts we can say about it. One, it is not a fatal condition, and the pain generally does not worsen over time. Two, remission can occur when individuals participate in therapy and healthful lifestyle choices.
Among all the challenges that fibromyalgia patients face, there is also the frustration factor. Few people understand the condition, and it can be very difficult for family members and friends to relate to what an individual with fibromyalgia experiences every day of her or his life. If you are a mother who has fibromyalgia, you may hear “Why is mommy so tired all the time?” Your symptoms may have caused you to quit your job, stop seeing friends or entertaining, and cancel travel plans. Sexual intimacy may seem impossible. You may be too tired or depressed or uncomfortable to care much about anything except wanting to feel better.
The second part of this book goes into detail about how you can manage your symptoms and deal with the emotional and social challenges of this syndrome. For now, let’s take a closer look at the syndrome itself.
WHO GETS FIBROMYALGIA?
Fibromyalgia is typically thought of as a woman’s disease. Indeed, research indicates that 70 to 90 percent of those affected by the syndrome are females, and that the diagnosis is usually made between the childbearing ages of 20 and 50. However, according to the American College of Rheumatology’s classification of fibromyalgia, about 8 percent of adults have the syndrome by age 80. Fibromyalgia is often seen in families, among siblings or mothers and their children. Men are also affected by the syndrome, as are children.
Men and Fibromyalgia
“How did I get a woman’s disease?” That is a common question among the men who are diagnosed with fibromyalgia. In fact, men often have a difficult time getting diagnosed properly—more so than women do. As a result, it is believed many men with fibromyalgia are undiagnosed and so their cases are unreported. This has led some experts to suggest that the number of men suffering from the syndrome could be closer to 30 percent of all sufferers.
Men and women may not experience fibromyalgia in the same way. Symptoms in men tend to be milder, and men also reportedly experience fewer of the common symptoms, including fatigue, morning stiffness, and irritable bowel syndrome. At least one study, however, reported that symptoms in men were actually more severe than those experienced by women.
It is difficult to get a clear picture of how fibromyalgia affects men for several reasons: the condition is largely viewed as a woman’s disease and so some doctors do not believe that men can get the syndrome; men are often reluctant to admit to severe pain or discomfort and so don’t seek help; and men generally are expected to bear pain quietly and so do not seek active treatment for fibromyalgia even if they do get diagnosed.
Fibromyalgia in Children
It is estimated that one in six people who suffers with fibromyalgia is younger than 18. The encouraging news about childhood fibromyalgia is that children who develop the syndrome tend to have a better diagnosis than adults. Several studies report that more than 50 percent of children with fibromyalgia recover within two to three years of experiencing symptoms.
As in adults, among children fibromyalgia affects females more than males, and diagnosis is a challenge because the symptoms are often mistaken for those of other disorders and diseases. Fibromyalgia can have a major impact on a child’s health and quality of life, because the symptoms can make it difficult for him or her to attend school, play with friends, and participate in routine childhood activities. Children who have a parent with fibromyalgia are more likely to develop the condition, as fibromyalgia has a genetic component. (In Chapter 10, see “Raising a Child Who Has Fibromyalgia.”)
WHAT CAUSES FIBROMYALGIA?
This is a question that researchers would love to answer with confidence, but so far all they have are theories. For one thing, thus far no tests or physical examinations have indicated any major cause of the syndrome. For another, it affects a wide range of people: young, middle-aged, seniors, children, women, and men. Finding a clue to the cause of fibromyalgia among this immense population is a monumental task, but it is one that scientists are aggressively pursuing.
The Misfire Theory
The theory that has drawn a great deal of attention is that the brain’s autonomic nervous system, which controls various bodily processes such as digestion, metabolism, and reaction to stress, misfires. Many researchers are focusing on the idea that problems with the neurotransmitters (chemicals in the brain that allow nerve cells to communicate with each other) and hormones used by the autonomic nervous system can cause certain bodily functions to malfunction, resulting in fibromyalgia symptoms.
For example, investigators have found elevated levels of a neurotransmitter called substance P in the spinal cord of patients with fibromyalgia. Substance P works as a pain messenger, and high levels of this neurotransmitter can cause pain messages to be sent to the brain even when there is no injury or illness that might cause pain.
Another neurotransmitter called serotonin exists in very low levels in fibromyalgia patients. Low levels of this chemical may explain why fibromyalgia patients experience chronic pain. Yet another neurotransmitter, tryptophan, is associated wit...