Fw: Fighting fibromyalgia ~ NBC News

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Fighting fibromyalgia

Dr. Don Goldenberg sheds some light on this often misunderstood disorder

ÝFibromyalgia is a syndrome affecting more than six million Americans,

many of them older women. It¼s an especially painful disorder because not

only do you hurt all over, but doctors are likely to tell you that it¼s

all in your head. On NBC¼s " Today¾ show, Dr. Don Goldenberg, chief of

rheumatology at Newton-Wellesley Hospital, offers some advice. Find out

more about the disorder and how you can get help by exploring the

information below.

FIBROMYALGIA AFFECTS an estimated 6-10 million people in the U.S.

Women are 8-10 times more likely than men to have this syndrome and it¼s

particularly prevalent among women aged 60-79 years of age (seven percent

of this population suffers from fibromyalgia). But because they are more

likely to seek out medical help for the problem, women between the ages of

30 and 50 are most often diagnosed as having this illness. These numbers

may grossly underestimate the number of people who actually suffer from

fibromyalgia because many do not see a doctor about it.

Fibromyalgia is one of those disorders that is not well understood

and because of its array of symptoms and no specific test that can

diagnose it, it has long been considered a questionable syndrome. Many

practitioners have treated it as a psychosomatic illness and the patient

as a hypochondriac.

Many researchers now believe that there is in fact a very real

physical basis for this ailment and that it involves nervous system

chemicals called neurotransmitters that regulate sleep, mood and pain

perception. However, despite this evidence, there is still a huge debate

within the medical community about how much psychology plays a part in

this disorder.

Sufferers typically experience chronic, widespread musculoskelatel

pain, fatigue and sleep disturbances. Irritable Bowel Syndrome, depression

and anxiety are also prevalent among many of those with the disorder. The

severity of the symptoms can range from moderate to very severe.

The appearance of the disorder often follows the occurrence of a viral

illness ã like the flu ã or a physical injury or emotional trauma.

The criteria for diagnosing fibromyalgia is that the patient must

have generalized body pain that is not caused by the presence of another

disease and have multiple tender points (when pressed, at least 11 out of

18 specified points on the body must produce pain).

There is no known cure for fibromyalgia but there are some

effective treatments. Low dosages of anti-depressants, even for those

patients not experiencing depression, can be extremely helpful. The

anti-depressants treat both the sleep disturbances ã helping them get

needed slow-wave (deep) sleep, which they are often deprived of ã and also

seems to ease some of the pain.

One of the most important treatment methods is exercise. Both

cardiovascular exercise and stretching are advised. The former because it

helps increase blood flow throughout the body, and the later because it

helps prevent muscle spasms.

GETTING DOCTORS TO LISTEN

The biggest challenge for sufferers of fibromyalgia is getting

doctors to believe that you are suffering from very real symptoms and that

a proper diagnosis gets made. There is a lot of controversy over this

illness, but growing numbers of doctors, specifically rheumatologists,

like myself, believe that this absolutely is a legitimate syndrome and

although not curable at this point, it is treatable.

The human being is a single organism and the physical and

psychological parts of us cannot be separated. The medical community has a

very difficult time with illnesses that cannot be objectively diagnosed by

one test or another or when we don¼t have clear physical abnormalities. So

there are many physicians who will label fybromalgia as purely psychiatric

or psychosomatic. But there is also a very large group of us who have been

researching and treating this illness for quite some time who see it as

very similar to other syndromes like migraines, irritable bowel syndrome

and even depression where a chemical basis has been clearly demonstrated.

The chemical serotonin is a central player in fibromyalgia. Although

fibromyalgia involves pain experienced in the muscles, we believe it¼s

generated from the central nervous system so it is not a disease of the

muscles, it¼s an illness that involves pain perception.

For patients, the first and most important thing to do is to get

the proper diagnosis. The best way to do this is to see a rheumotologist

or a physical medicine specialist since they tend to be more experienced

in dealing with fibromyalgia and also are willling to make the diagnosis

if they think it is fibromyalgia. What¼s so important about getting that

diagnosis is that it stops patients from continuing to doctor shop and

allows them to begin a process of treatment that can help their physical

problems.

Fighting fibromyalgia

Treating the symptoms of fibromyalgia can include prescribing low

doses of anti-depressants, which helps to improve sleep and reduce some of

the pain. There are also various pain medicines that can be used when pain

is severe. The most important aspect of treatment though is exercise. It¼s

sometimes very tough to get people who are in physical pain to do

exercise, but it can make a significant difference in how they feel. It¼s

recommended that patients do at least 30 minutes of cardiovascular

exercise of moderate intensity, 3-4 times a week and also 15 minutes of

stretching daily.

Some fibromyalgia sufferers have also found various alternative

approaches helpful including massage, acupuncture and chiropractic. But

the effectiveness of these methods really varies from patient to patient.

Education is one of the most important things for people who think

that they suffer from this disorder. There¼s a lot of misinformation they

get fed from the media, books, the Internet and even from doctors about

this illness. So see a physician experienced in treating this problem and

talk to other people who suffer from it.

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Ý Ý Ý ÝDr. Don Goldenberg, is chief of rheumatology at Newton-Wellesley

Hospital and Professor of Medicine at Tufts University School of Medicine.