FIBROMYALGIA AND CHRONIC FATIGUE SYNDROME
Chronic Pain
| Chronic Fatigue | Depression
| Anxiety
Sleep Dysfunction | Vitamin and Mineral Deficiency
Chronic Pain
Patients describe their pain as stabbing, throbbing, burning, shooting,
tingling, aching, sharp, dull, or felling bruised all over:
widespread
pain/achiness
Myofascial
Pain Syndrome: regional or local with trigger points
stiffness:
worse upon awakening
non-anatomical
distribution of pain: the pain does not follow any structure or nerve root
distribution. This pain also shifts locations and is often unexpected.
diffuse
arthralgia: pain in joints with swelling or redness
chest
pain and SOB: pain which appears to be cardiac and often is called
"atypical angina"
low
back pain, leg cramps, and chronic H/A
Characteristics of Fibromyalgia Syndrome Pain
Allodynia:
pain resulting from a stimulus that normally would not be painful
Hyperalgesia:
abnormally high sensitivity to pain
Persistent
Pain: pain persists for a longer duration than normal
Tenderness
on Examination: 18 tender points of fibromyalgia syndrome
Physiological Factors Which Determine Pain
Factors which amplify pain:
substance
P (neurotransmitter)
glutamine
(amino acid)
magnesium
and zinc deficiency (mg and zn inhibit NMDA, the receptor which when
stimulated increases pain)
Neurochemicals Which Decrease Pain
serotonin:
low levels of serotonin are due to low levels of 5HTP (a molecule which
converts to serotonin) in platelets
norepinephrine
Nerve Growth Factor
Nerve growth factor is a neurotransmitter in cerebral spinal fluid which increases the number of Substance P neurons and therefore increases painful symptoms of fibromyalgia syndrome
Myofascial Pain Syndrome
The diagnosis of Myofascial Pain Syndrome is based on the detection of objective abnormalities on careful physical examination. Abnormalities include trigger points, taut myofascial bands, and local twitch response of the taut bands. The involvement of the nervous system is very important in the perpetuation and prolongation of pain, thus preventing full recovery. Damage to the nervous system acts as an endogenous perpetuating factor susceptible to augmentation by severe pain, additional trauma, vibration, loud noises, prolonged physical activity, and emotional stress. return to top of page
