Negative emotions increase pain responses in women with and without fibromyalgia (FM), while combined treatment with cognitive behavioral therapy and a tailored exercise program can improve outcome in FM, according to two studies published in the October issue of Arthritis Care & Research.
Henriët van Middendorp, Ph.D., of Utrecht University in the Netherlands, and colleagues conducted an experimental study of women with and without FM to examine the effects of emotions on pain response. The researchers found that sadness predicted clinical pain responses, and anger predicted both clinical and electrically-stimulated pain responses. Both women with and without FM reported increased pain in response to both of these emotions; more intense emotion was associated with a greater pain response.
Saskia van Koulil, of the Radboud University Nijmegen Medical Centre in the Netherlands, and colleagues classified patients with FM into two groups based on their clinical pattern — pain-avoidance or pain-persistence — and randomized them to either cognitive behavioral therapy and exercise training or to a wait list for the treatments. They found that use of this combined program at an early stage of FM (soon after diagnosis) was likely to promote improved treatment outcomes for high-risk patients with either pain-avoidance or pain-persistence patterns.
“Building on these findings, we can now report for the first time relatively large physical and psychological improvements in high-risk FMpatients following a treatment specifically addressing pain-avoidance and pain-persistence patterns,” van Koulil and colleagues conclude. “However, as previous meta-analyses and recent studies of non-tailored interventions in chronic physical conditions have overall shown not more than moderate effects, the results of this study [suggest] that a tailored approach is promising for improving treatment effects.”
Each year in the United States, millions of prescriptions are written for opioids to relieve chronic pain. When used appropriately, they can be a viable treatment option for some patients. But, there are health risks associated with the use of opioids. Concerns about opioid addiction have led to increased regulation and changes in opioid prescribing guidelines. With the current opioid epidemic in the United States, healthcare providers and their patients are increasingly seeking non-opioid pain relief options.
For non-opioid pain relief, non-prescription medications such as NSAIDs (e.g. naproxen or ibuprofen) or acetaminophen may be all that some patients need. Other patients may work with their physicians to find that prescription-strength NSAIDs, corticosteroids, or muscle relaxants reduce their pain.
Antiseizure medications (anticonvulsants)can also be used as pain medication. They work by inhibiting certain types of nerve transmissions. This can decrease neuropathic pain sensations, such as those caused by trigeminal neuralgia or diabetic neuropathy. Anticonvulsants commonly used as pain medications include gabapentin and pregabalin.
Topical analgesics can also be beneficial for pain relief. Applied to the skin, these medications are available as creams, lotions, or patches. Several can be purchased over the counter, while others need a doctor’s prescription. They work in a few different ways, depending on their active ingredient. Some deliver pain medication through the skin, such as trolamine salicylate. Other topical analgesics contain ingredients that can interfere with pain perception, such as capsaicin.
If you’re suffering from chronic pain and want to avoid taking opioids or other medications altogether, a pain specialist can work with you to develop a pain management plan. Pain specialists can use interventional pain procedures – minimally invasive, outpatient procedures – to manage chronic pain. Joint injections, nerve blocks, and other minimally invasive procedures such as kyphoplasty and spinal cord stimulators are effective treatment options that can deliver significant pain relief. These procedures are often performed in an ambulatory surgery center, and patients are able to return home the same day. Many patients experience relief from their chronic pain symptoms shortly after their procedure.
Patients may choose to work with their healthcare providers to pursue non-drug remedies such as massage, acupuncture, and exercise to relieve chronic pain. Stretching, strengthening exercises, and low-impact activities such as walking and swimming can help reduce pain symptoms. In fact, exercise is often recommended to alleviate pain due to fibromyalgia, and many arthritis sufferers find that light exercise reduces their joint pain.
Regardless of your chronic pain condition, there are options for the management of your pain symptoms that don’t include the use of opioids. To learn more and discuss treatment options that may be right for you, make an appointment with your physician or a board-certified pain specialist.
Fibromyalgia was once dismissed by many traditional medical practitioners as a phantom illness.
But that view is changing rapidly. Not only is fibromyalgia accepted as a diagnosable illness, it is also a syndrome that researchers are finding more complicated as new information emerges.
As recently as a year ago, many physicians still associated some of fibromyalgia’s symptoms with emotional problems, but that’s no longer the case.
A simple description of fibromyalgia is that it is a chronic syndrome characterized by widespread muscle pain and fatigue.
For still unknown reasons, people with fibromyalgia have increased sensitivity to pain that occurs in areas called their “tender points.” Common ones are the front of the knees, the elbows, the hip joints, the neck and spine. People may also experience sleep disturbances, morning stiffness, irritable bowel syndrome, anxiety and other symptoms.
According to the American College of Rheumatology, fibromyalgia affects 3 million to 6 million Americans, 80 percent to 90 percent of whom are women. The condition is most often diagnosed during middle age, but at least one of its symptoms appears earlier in life.
But is there a psychological tie-in strong enough to differentiate fibromyalgia from other similar diseases and conditions? Apparently not.
“Fibromyalgia patients are such a diverse group of patients, they cannot all be the same,” said Dr. Thorsten Giesecke, a University of Michigan research fellow.
Giesecke and his colleagues evaluated 97 fibromyalgia patients, including 85 women and 12 men. The patients underwent a two-day series of tests, answering questions about their coping strategies and personality traits — particularly their emotional well-being. They were also tested for sensitivity to pressure and pain.
“It’s generally been thought that fibromyalgia patients who have higher distress have higher pain sensitivities,” Giesecke said.
In other words, it was believed that those with fibromyalgia who were prone to emotional difficulties such as depression and anxiety were more likely to experience greater physical pain.
But his study didn’t bear that out. In fact, patients in one of the three groups in the study who had the highest pain levels had the lowest anxiety.
The term fibromyalgia comes from the Latin word for fibrous tissue (fibro) and the Greek ones for muscle (myo) and pain (algia). Tender points are specific locations on the body — 18 points on the neck, shoulders, back, hips and upper and lower extremities — where individuals with fibromyalgia feel pain in response to relatively slight pressure.
The U.S. government’s National Institute of Arthritis and Musculoskeletal and Skin Diseases says fibromyalgia patients often experience combinations of many other chronic and frustrating symptoms, including:
cognitive and memory problems, sometimes referred to as “fibro fog.”
Latest research indicates that fibromyalgia is the result of internal biochemical imbalances that cause physical symptoms such as pain, weakness and mental impairment. Because it is a syndrome — a collection of signs and symptoms — rather than a disease, fibromyalgia can’t be diagnosed by an invariable set of specific symptoms or reproducible laboratory findings.
Even with the findings about relatively small psychological influence, practical experience seems to indicate that stress may play a role. Roger H. Murphree, a Birmingham, Ala., chiropractor who specializes in treating patients with fibromyalgia and chronic fatigue syndrome, said he has seen a link between stress and the intensity of fibromyalgia.
“Most of us live in a world of stress,” Murphree said. “Something has to give, and it’s usually sleep. Meanwhile, we subsist on junk food, caffeine, alcohol and prescription medications. Such a lifestyle isn’t good for anyone. But for an unlucky few, the toll is severe.”
Dr. Jacob Teitelbaum, whose practice in Annapolis, Md., led him to do research into fibromyalgia and the closely related chronic fatigue syndrome, concluded that the body’s endocrine system could hold the clue to treatment. It’s a matter of how the body’s energy is marshaled, he said.
“Fibromyalgia is like the body blowing a fuse,” he explained. “The hypothalamus serves as humans’ internal fuse box. When the demands of living build up, stress increases and the hypothalamus shuts down. Because the circuit is overtaxed and the fuse is blown, the body simply can’t generate enough energy.”
“That causes muscles to cease functioning in a shortened position, resulting in pain all over the body and a general feeling of fatigue or weariness,” Teitelbaum said.
Murphree’s experience with hundreds of patients confirms Teitelbaum’s analogy. Most, he said, are either “Type A” perfectionists or “Type B” caregivers.
“Type A fibromyalgia patients work and work and work until they burn out,” said Murphree. “Type B patients give and give and give — nurturing their spouses, children, family and friends — until they break down. Anyone whose lifestyle includes very little downtime is at risk.”
Teitelbaum recommends a four–pronged approach to repair the “blown fuse” and turn the body’s current back on:
Restoration of sleep — at a minimum, eight to nine hours every night, using appropriate medications, as needed;
Restoration of a normal hormone balance, including thyroid, adrenal and reproductive hormones;
Appropriate treatment for infections that may be present as a consequence of the body’s depleted immune function;
Nutritional support, particularly with B complex vitamins, magnesium, zinc and malic acid.
Teitelbaum uses the acronym SHIN to summarize his treatment regimen. “S is for sleep, H for hormone balance, I for infection control, and N for nutrition,” he explained. “The important thing is that all four should be implemented in concert with one another for maximum therapeutic effect.”
November is considered International Nerve Pain Awareness Month, or in simpler terms, NERVEmber. It is a time to bring awareness to complexregional pain syndrome (CRPS) and the more than 150 other conditions with nerve pain as a symptom. Several landmarks across the country were lit up on November 5th to Color the World Orange, and members of the pain community will be wearing orange all month long to show support for those suffering from this debilitating condition.
What is Complex Regional Pain Syndrome?
Complex regional pain syndrome (CRPS) may also be known as reflex sympathetic dystrophy or RSD. A chronic and painful condition, CRPS affects more than 75,000 Americans but has no known or determinable cause. It is a chronic pain condition that affects one limb (arm, leg, hand, or foot), usually after a trauma or injury.
CRPS causes an intense burning or “pins and needles” sensation that radiates to a larger area and will cause a severely painful reaction that is not expected with the type of injury sustained. For example, a small cut on the tip of the finger would be considered minor to someone in good health, but for an individual with CRPS, that small cut would radiate a burning pain that traveled up the arm and could be excruciating.
While there is no known cause for CRPS, it is believed that an injury or trauma that did not heal properly may be a contributor, or nerve damage that spread instead of healing may be a cause. However, known cause or not, those with CRPS suffer many difficult days with their painful condition.
Other common symptoms of CRPS include:
continuous pain in the affected region (may be burning or throbbing in nature)
decreased range of motion in the affected region or body part
extreme sensitivity to non-painful stimuli (clothing against the skin, water pressure from the shower, etc.)
Left untreated, CRPS can eventually spread to the other side or another body part. Regardless of cause or severity, treatment of CRPS has far better results if it is begun early in the onset of the condition. Treatment options for CRPS vary by patient and may include rehabilitation and physical therapy to keep the limb moving, improve blood flow to the affected area, and lessen circulatory symptoms. Medications such as antidepressants, corticosteroids, and anticonvulsants have been beneficial in treating CRPS. Nerve blocks to reduce pain signals have also shown benefits in specific cases, as has spinal cord stimulation and other types of neural stimulation.
Arthritic disease is the most common cause of disability in the United States and now affects 46 million Americans, or more than 21 percent of the adult population, a major new report finds.
That number is expected to rise even higher as baby boomers age, so that by 2030, 40 percent of American adults will suffer from some form of arthritic disease, the researchers said.
Today, almost two-thirds of people with arthritis are under 65, and more than 60 percent are women. The disease hits whites and blacks equally, but the rate is lower among Hispanics, according to the report.
“Arthritis remains a large and growing problem,” said lead researcher Dr. Charles G. Helmick, an epidemiologist with the U.S. Centers for Disease Control and Prevention. “Cases of osteoarthritis has risen, while rheumatoid arthritis has gone down since our last estimate,” he added.
Rheumatoid arthritis is a painful autoimmune disorder of uncertain origin leading to chronic inflammation at the joints. Osteoarthritis is a more common illness caused by a gradual breakdown of cartilage in the joints.
The reasons why there are now fewer cases of rheumatoid arthritis is unclear, Helmick said. One reason may be that experts have changed the way they estimate the number of cases. Today, they use a more specific and restrictive definition of the condition, he said. But there has been a real decreases in cases of rheumatoid arthritis worldwide, and no one is sure why, Helmick added.
The main reason that osteoarthritis is increasing is an aging population, Helmick said. “As more people age, there will be more people with osteoarthritis. That’s what’s driving the numbers upward,” he said.
Also, the obesity epidemic in the Unites States is taking its toll, Helmick noted. “Obesity is a risk factor for knee osteoarthritis, one of the most common types of arthritis,” Helmick said. “We don’t have any cures, we treat the symptoms and, when it gets bad enough, we do knee replacements, which are very expensive,” he said.
As more people suffer from arthritis, the costs associated with the disease will also keep going up. Currently, the costs to the country from arthritis top more than $128 billion a year in lost earnings and medical care, Helmick said.
The researchers, from the National Arthritis Data Workgroup, used data from the U.S. Census Bureau, national surveys, and findings from community-based studies across the United States to determine the prevalence of arthritis in 2005 and beyond. The results were published in two papers in the January issue of Arthritis & Rheumatism.
By 2030, almost 67 million people will have arthritis — an increase of 40 percent. Osteoarthritis, the most common type of arthritis, affects almost 27 million Americans. That’s a big increase from 1990, when 21 million suffered from the condition.
The prevalence of rheumatoid arthritis has declined to 1.3 million Americans, from 2.1 million in 1990.
The prevalence of gout, a form of inflammatory arthritis, has risen in 2005 to about 3 million up, from 2.1 million in 1990.
Currently, juvenile arthritis affects some 294,000 children between infancy and age 17.
An estimated 59 million Americans have suffered an episode of low back pain over the past three months, the researchers said, while 30 million have suffered neck pain over the same time period.
In addition, the report includes estimates for related conditions such as fibromyalgia, spondylarthritides, systemic lupus erythematosus (lupus), systemic sclerosis, Sjögren’s syndrome, carpal tunnel syndrome, polymyalgia, and rheumatic/giant cell arteritis.
One expert advised staying active and keeping your weight under control to help prevent or treat arthritis.
“We know that cases of osteoarthritis are likely to grow, because it’s age-related,” said Dr. Patience White, chief public health officer at the Arthritis Foundation. “In addition, weight plays a big role in risk, as well as lack of physical activity, in keeping your muscles strong,” she said.
Losing weight and keeping physically active can help to reduce pain and keep the disease at bay, White said. “If you lose as little as 10 pounds, you can decrease pain in the knees and hips by 50 percent,” she said. “With exercise, you can decrease progression.”
With fall comes cooler temperatures, and if you suffer from arthritis, you know arthritis pain often increases in cold weather. Whether you have osteoarthritis or rheumatoid arthritis (RA), this pain can limit your ability to enjoy any normal activities requiring movement. However, fall weather doesn’t have to keep you from doing the things you love. Here are five ways you can help manage arthritis pain in cold weather:
Keep head, hands, and feet covered to manage arthritis
In cold weather conditions, some blood flow is diverted from our extremities to the critical organs of our core, such as our heart and lungs. This results in reduced blood flow to our joints, which can cause stiffness and pain. Wearing the right clothing when going outdoors can help you ease the chill. Dress in layers to stay warm, and wear socks and waterproof boots to avoid getting your feet wet or damp. Since internal body heat is lost most quickly through the head, hands, and feet, covering these body parts can help maintain the body’s internal warmth.
Eat a healthy diet
Eating a balanced diet can help you keep off the extra pounds that can add more stress to your joints. Consider adding foods that can help fight inflammation that can cause joint pain, such as omega-3-rich fish (salmon, tuna, and mackerel), soybeans, green tea, and walnuts.
Proper nutrition also ensures you get the vitamins and minerals you need. Recent studies suggest that low levels of vitamin D may be linked to the severity and progression of arthritis. You naturally get less vitamin D in the fall and winter, and being deficient might make your joints hurt more. The National Institutes of Health (NIH) recommends the following daily amounts of vitamin D:
Adolescents aged 14-18 years: 600 International Units (IU)
Adults aged 19-70 years: 600 IU
Adults aged 71 and older: 800 IU
Pregnant and/or breastfeeding women: 600 IU
Vitamin D is only absorbed by the body in the presence of calcium, so you also need to consume this mineral on a daily basis in food or by taking a supplement. Without needed Vitamin D and calcium, cartilage cell growth is adversely impacted.
Staying hydrated is vital for flushing toxins out of your body and keeping your joints lubricated, which reduces joint pain and inflammation. It can also help you to maintain flexibility and reduce the risk of injury. The typical recommendation is eight glasses a day, however, ask your doctor for a recommendation based on your activity level and health history. If plain water isn’t your thing, try adding berries or freshly cut cucumbers. You could also try green or black tea, which is both rich in polyphenols – plant compounds that have strong anti-inflammatory effects.
Exercise eases arthritis pain, and staying active during cold weather can help prevent joints from becoming stiff. There are many physical activities that can be done indoors, and are easy to do:
Talk with your doctor about over-the-counter remedies
Topical pain medications – which often come in cream or gel form – can be rubbed on the skin over joints to relieve pain. Counterirritants, salicylates, or capsaicin are common ingredients in these products, and each works differently. Counterirritants, such as menthol, eucalyptus, and camphor, create a temporary hot and/or cold sensation, which can interrupt pain signals to the brain. Salicylates are chemically similar to aspirin and have a mild anti-inflammatory effect. Capsaicin is derived from chili peppers and is also believed to interfere with pain signals in the brain.
Over-the-counter pain medications, such as acetaminophen, ibuprofen, or naproxen sodium can help relieve arthritis pain. However, each pain medication comes with its own risks. Talk with your doctor to find out which, if any, of these medications may be right for you.
New research shows that the Chinese treatment known as acupuncture may help control lower back pain without the added side effects of many pain control medications.
An ancient Eastern science that has been steadily gaining popularity in the West, acupuncture uses the relatively painless placement of tiny needles into various nerve pathways on the body to help stimulate the production of natural pain relievers called endorphins.
“Essentially, the acupuncture works somewhat like a pain-relieving drug in the sense that it provides temporary relief,” says study author Dr. Charis Meng, a licensed acupuncturist and rheumatologist at the Integrated and Complementary Care Center of Hospital for Special Surgery in New York City.
Unlike traditional painkillers, which often require increasing amounts to get the same relief, acupuncture has somewhat of a cumulative effect, Meng says. “After a period of time, the number of treatments can be dramatically reduced while still maintaining the same levels of pain control,” she says.
According to rehabilitation medicine expert and licensed acupuncturist Dr. James Dillard, for those who can’t or don’t want to use traditional pain medicines, acupuncture is becoming an accepted way to control chronic pain.
“The study is small but well done and is another entry in the growing body of evidence that shows acupuncture can be an accepted and very effective form of therapy for some people,” says Dillard, clinical advisor to Columbia University’s Richard and Hinda Rosenthal Center for Complementary and Alternative Medicine and assistant clinical professor at Columbia University College of Physicians and Surgeons.
In particular, he says, the benefits for the elderly can be extremely important.
“Most elderly people are already taking a number of medications for various health problems, so anytime you can cut down on the number of pills they have to take and still offer pain relief, that’s a good thing,” says Dillard.
Indeed, the six-week study did concentrate on elderly patients, with 40 participants all over the age of 60. Each complained of chronic low back pain for at least 12 weeks, and all had undergone various types of medical imaging to rule out spinal tumor, infection, fracture, as well as certain neurological symptoms. Patients who had previously undergone either acupuncture or lumbar surgery were also excluded.
“The study did include patients who suffered with sciatica or disk problems,” says Meng.
At the start of the study, patients answered questions and took a test that measured the degree of their pain.
The patients were then divided into two groups. One group of 21 patients continued taking standard pain therapy prescribed by their doctors, including non-steroidal anti–inflammatory drugs, muscle relaxants and acetaminophen (Tylenol), as well as back exercises.
The second group of 19 patients also continued taking their traditional therapy, but added twice-weekly acupuncture treatments for five weeks.
Pain scores were repeated two weeks into treatment, again one week later, and three weeks after the treatments ended.
The result, says Meng, was that “patients who underwent acupuncture had significantly less pain and disability in their lower back than patients who took standard traditional therapies alone.”
In addition, she says, results were so impressive that 17 of the 21 patients in the group that were allowed only standard therapy elected to begin a six-week acupuncture regimen when the study ended. They, too, experienced similar pain reduction.
The results were presented at the annual meeting of the American College of Rheumatology, which met earlier this month in San Francisco.
In addition to the lower back pain study, research also presented at the conference found acupuncture provided relief for patients with fibromyalgia, a chronic and painful muscle-related disorder affecting mostly women.
During this 16-week study, conducted by a group of Brazilian researchers, 60 patients received nightly doses of 25 milligrams of amitryptiline, an antidepressant found to offer some pain relief. Additionally, 20 of the 60 patients received a once-weekly acupuncture treatment, while 20 more received a weekly sham acupuncture treatment.
Using various pain diagnostic methods before and after the study began, the doctors concluded that, over the study period, only those patients who completed the acupuncture treatments had a measurable decrease in their pain.
“Fibromyalgia is a devastating problem that is frustrating for both doctor and patient because there are so few treatments that offer significant improvement in symptoms,” says Dillard.
“As with chronic back pain, anything that you can do to help these patients, particularly if it doesn’t require the use of more drugs, becomes an important contribution to their treatment and care,” says Dillard. This study, he says, is an important step in expanding the boundaries of treatment for patients with fibromyalgia.
Back pain affects 80 percent of us at some point in our lives. The good news is that for many people suffering from low back pain, exercises to stretch the hip flexor muscles can help.
The hip flexors are a group of muscles than run from your thighs all the way up to your low back. They include muscles with strange-sounding names such as the ilacus, the psoas, and the rectus femoris. As a group, these muscles let you bend at the waist and bring your knee to your chest.
The problem is that many of us spend our days sitting. When we do that, these muscles are always in a state of contraction. This causes them to shorten and become weaker.
One of the hip flexor muscles, the psoas is attached to your lumbar vertebrae—the five bones that form the spine in your lower back. So you can see why tightness or weakness in this muscle could affect your back.
Stretching the hip flexor muscles can help prevent and treat some causes of lower back pain. If you’re having low back pain and you think it might be a result of tight or weak hip flexors, spending a few minutes a day on some simple stretches could help.
Before you start any exercise program, of course, check with your doctor to make sure you’re in good enough health to perform the exercises without hurting yourself and that there aren’t underlying conditions that need to be treated.
Kneel with your knees and hands on the ground, facing the floor, and your back straight.
Move your right foot forward so that it’s on the outside of your right hand. Make sure the right ankle is slightly in front of the right knee.
Extend your left foot back behind you so that your knee, shin, and foot are touching the floor.
Press your hips forward until you feel a stretch. Hold the stretch for 30 seconds.
Repeat the stretch on the other side of your body.
For more ideas on stretching your hip flexor muscles, check out this Self magazine article or this GuerillaZen Fitness video. You also might find this article on yoga-based stretches helpful.
To be sure you’re doing the exercises correctly, we encourage you to make an appointment with a physical therapist.
Fibromyalgia patients have more “connectivity” between brain networks and regions of the brain involved in pain processing, which may help explain why sufferers feel pain even when there is no obvious cause, a new study suggests.
Researchers had 18 women with fibromyalgia undergo six-minute fMRI brain scans, and compared their results to women without the condition.
Participants were asked to rate the intensity of the pain they were feeling at the time of the test. Some people reported feeling little pain, while others reported feeling more intense pain.
Brain scans showed the connectivity, or neural activity, between certain brain networks and the insular cortex, a region of the brain involved in pain processing, was heightened in women with fibromyalgia compared to those without the condition.
The connectivity to the insular cortex was even stronger in participants who reported feeling more intense pain compared to milder pain, said study author Vitaly Napadow, a neuroscientist at Massachusetts General Hospital.
“We took advantage of the fact that there is a large discrepancy in the amount of pain patients happen to be in at the time they come in. Unfortunately some patients come in, and they are in a lot of pain. Other patients come in and they are not in pain,” Napadow said.
The study, by researchers from Massachusetts General Hospital and the University of Michigan, is published in the August issue of Arthritis & Rheumatism.
Fibromyalgia is a chronic pain syndrome that’s characterized by widespread pain, fatigue, insomnia, and the presence of multiple tender points. The syndrome can also cause psychological issues, including anxiety, depression and memory and concentration problems, sometimes called the “fibromyalgia fog.”
Prior research has shown that people with fibromyalgia feel a given amount of pain more intensely than others, Napadow explained. In other words, studies have shown a typical person might rate a painful stimuli a “one” on a scale or one to 10, while a person with fibromyalgia might rate the pain a 5 or higher.
The new study is different in that fibromyalgia patients’ pain responses were measured while they were at rest and not being exposed to anything painful, Napadow said.
The brain networks involved were the default mode network (DMN) and the right executive attention network (EAN). The DMN is involved in “self–referential thinking,” when you think about yourself or what’s happening to you, Napadow explained.
The EAN is involved in working memory and attention. When that brain network is occupied, or distracted, by pain, it may explain some of the cognitive issues that fibromyalgia patients experience, Napadow said.
Dr. Philip Mease, director of rheumatology research at Swedish Medical Center in Seattle and a member of the National Fibromyalgia Association medical advisory board, said the study provides insight into what may be going on in the brains of people with fibromyalgia.
“This work shows there is increased connectivity between different brain centers that connect the purely sensory pain processing centers of the brain with some of the emotional and evaluative parts of the brain, or areas of the brain that take a sensory stimulus and say, “How do I interpret this? How do I feel about this’?” Mease said.
For years, fibromyalgia has been a highly misunderstood syndrome, with some doctors doubting it even existed, and others attributing the pain to depression or other psychological issues.
That began to change early this decade, when brain scans showed pain-processing abnormalities in fibromyalgia patients, Mease said.
“That first neuroimaging study really demonstrated fibromyalgia patients were different than normal individuals, and at a neurobiological level, were truly experiencing more pain at lower intensities,” Mease said.
The new research moves understanding of the condition a step further, by exploring what’s happening in the brain during a resting state.
“Regardless of poking or prodding them, this study is trying to get at an understanding of what is crackling in the brain, intrinsically, such that they have this higher sensitivity,” Mease said.
About 10 million Americans are believed to have fibromyalgia, almost 90 percent of whom are women, according to the National Fibromyalgia Association. Sufferers report a history of widespread pain in all four quadrants of the body for at least three months, and pain in at least 11 of 18 “tender points.”
There’s no question about it, as we get older, our chances of suffering a painful medical condition go up. Some studies indicate that 50 percent of older adults live with chronic pain. The rate is even higher for those living in nursing homes.
But we don’t have to just accept pain as part of our lives. In fact, we shouldn’t. Pain comes with its own damaging side effects. It makes it harder to stay active and get a good night’s sleep and increases the risk of depression. So it’s important to take pain seriously and treat it.
Older residents of the Phoenix metro area are fortunate that there are more options than ever today for treating pain—and they’re available right here in the Valley.
When you think of pain treatment, your first thought is probably medication. And it’s true, medication is an important component of pain treatment for most people.
But all medications—even over-the-counter ones—can have side effects, and those become even more problematic as we age. The kidneys, liver, and gastrointestinal tract don’t work as efficiently as we get older, so drugs may be absorbed and processed more slowly. On top of that, we’re more likely to suffer from several medical problems as we age, and be taking multiple medications. All of those medications can have side effects and interact with one another.
In this blog, we will look at some minimally invasive procedures that may be able to relieve your pain and lessen the need for medication. Next month, we’ll look at other alternatives, like acupuncture and physical therapy, that can help with your pain. For the best results in both controlling pain and controlling side effects, your doctor may recommend a combination of treatments.
Here is a look at just a few of the numerous minimally invasive procedures offered by Chronicillness.co Site physicians that may help relieve your pain.
Joint Injection. This treatment can bring relief to patients with osteoarthritis and rheumatoid arthritis pain. A joint injection contains cortisone, a steroid that helps reduce muscle pain and joint inflammation.
Vertebroplasty/Kyphoplasty. This procedure can bring relief to patients suffering debilitating back pain caused by compression fractures in their vertebrae. Both use x-ray guidance to place cement into the patient’s damaged vertebrae to stabilize the fracture and restore the spine’s height.
Endoscopic Discectomy. If you’re suffering from herniated discs, an endoscopic discectomy—which removes portions of the herniated disc so that compressed nerves can move back to their normal position—may help. This minimally invasive spine surgery can usually be done on an outpatient basis, so you can go home the same day of the surgery.
Botox. Believe it or not, botulinum toxin, or Botox, is not just for hiding wrinkles. A Botox injection can help with pain caused by neuromuscular disorders, myofascial pain, and chronic migraines. It does this by preventing painful muscle contractions in the face, neck, or low back.
Peripheral Nerve Block. In this therapy, a combination of local anesthetic agents is injected around the peripheral nerve branches. It can reduce the pain of different neuropathies, including peripheral neuropathy and diabetic peripheral neuropathy. The pain relief may last from a few weeks to a few months.
Spinal CordStimulation. In this FDA-approved, minimally invasive procedure, a nerve stimulation device is implanted that delivers low-voltage electrical currents to areas of the spine. This interferes with the ability of pain signals to reach the brain. It’s an option for patients with chronic back or leg pain who have not responded to more conservative treatments for at least six months.
IDET/Nucleoplasty. Intradiscal electrothermoplasty (IDET) and nucleoplasty are minimally invasive procedures that use heat or plasma to destroy damaged nerve fibers in the spine. Both procedures destroy damaged nerves while sparing healthy tissue.
At Chronicillness.co Site we provide more than a dozen minimally invasive procedures that can help with many different types of pain, from cancer pain and pancreatitis to complex regional pain syndrome.
