Today, I want to review some of the research on fibromyalgia.
For many years, there was great doubt to whither fibromyalgia existed. Fibromyalgia has traditionally been diagnosed by palpating certain trigger points in the muscles. If enough of these trigger points are painful at an abnormally low amount of pressure, then the person was diagnosed with fibromyalgia. This method of using pressure on muscles was and is somewhat subjective, and inconsistent. This subjectivity of diagnosis was one of the main reasons that the condition was doubted.
Also, since muscle pain was the most consistent finding in fibromyalgia, laboratory tests and biopsy of the muscle was often performed. These tests were often inconclusive. More recent studies looking at brain function through specialized scans and laboratory tests have confirmed the presence of this condition. Today, we know that fibromyalgia is primarily a neurologically based issue with pain processing. Our bodies contain tons of pain detecting nerves, that provide constant input to the brain. By this I mean the pain nerve are firing all the time.
However, thankfully we don’t consciously perceive this pain. The reason why is that our brain has a built-in pain blocking system, that allows our unconscious brain to sense dysfunction through pain, but blocks those pain signals from reaching the conscious mind. This pain creating, and pain blocking system is always trying to find a balance. If not enough pain is perceived, the person can do more damage to an already damaged area. If too much pain is perceived, abnormal functions can result and that can cause more damage.
Think about how pain effects on how we move, sleep, and react throughout the day. It’s obvious that a delicate balance must exist in this system in order to function properly. With fibromyalgia, some of the cells that support healthy brain function secrete abnormal chemicals, specifically substance P, that cause pain fibers to be more sensitive. Also, other brain chemical that help block pain, like serotonin, melatonin, cortisol, and norepinephrine are abnormally low. The lack of adequate brain based chemicals reduces fuel that the brain uses to block pain. This shifts the balance of the pain system to allow mare pain to be perceived by the conscious mind.
Sometimes this pain is the result of normal use of the muscles, use that normally would not be perceived as painful. As a result, focusing treatment on both brain and muscle seems to be more effective. Melatonin supplementation of 3mg taken 30 minutes before expected sleep time has been shown to reduce symptoms over a 30-day period. The supplement SAM-e has shown significantly value in enabling the brain to better block pain signals. Research shows treating the muscles with magnesium and malate over 8 weeks significantly decreased pain.
There is also decent evidence in the research that both moderate aerobic exercise and strength training has positive effects.