People who live with chronic pain need options beyond prescription opioids, and it’s up to the British Columbia government to provide more services such as physiotherapy, says the head of a group that supports patients and their families.
“There has really been a lack of any appropriate response to chronic pain in our province and in our country,” said Maria Hudspith, executive director of Pain BC, the only non-profit society in Canada to bring together clinical experts and policy-makers to work on chronic pain management initiatives.
Besides painkillers, patients must have access to physical therapy and psychological support but wait for lists stretch from one to three years at the few specialized pain clinics in the province, she said.
“We’ve seen this overreliance on the prescription pad as the only tool in the toolbox,” Hudspith said. “Some people may become dependent on the medication in order to function and some of those people may become addicted.”
One in five people in B.C. lives with pain that can be relentless and crippling but she said some communities have no specialized healthcare providers for patients who need intervention after an injury or surgery, for example.
A lack of dedicated pain services means patients make more doctorsvisits and may require more surgeries, resulting in high healthcare costs and poor quality of life, Hudspith said.
“There’s a growing recognition that this is a huge problem that is really, in any way, at the root of a lot of issues that we’re seeing.”
Hudspith said Pain BC has been in discussions with the provincial government to expand services.
Neither the Ministry of Mental Health and Addictions nor the Health Ministry could provide any information when the provincial government was contacted for comment.
The Food and Drug Administration has just issued what’s called a “Medwatch Alert” warning that Epidural steroid injections or “ESIs” for back and neck pain can be extremely dangerous. The alert says: “Injection of corticosteroids into the epidural space of the spine may result in rare but serious adverse events, including loss of vision, stroke, paralysis, and death.”
Epidural steroid injections – and catastrophic injuries from them – were the subject of my debut investigation for The Dr. Oz Show almost exactly a year ago. The epidural space is an area between the spinal cord and the bony structure of the spine.
Our investigation revealed that the steroids – called corticosteroids – used for epidural injections are not even FDA approved for this purpose and yet ESIs are done nearly 9 million times a year, according to an analysis by Dr. Laxmaiah Manchikanti.
In 2009, the FDA convened a group to study the safety of some types of epidural steroid injections. In its new notice, the FDA said that the group’s recommendations still are not ready and will be released when they are.
Dennis Capolongo of the EDNC, a group that has been campaigning against epidural steroid injections for years, called the FDA’s new warning “bittersweet” because it did not go further. Capolongo wants the FDA to go beyond telling doctors that injecting steroids into the epidural space COULD have severe side effects and instead state that they MUST NOT do it.
In February of this year, Australian and New Zealand health authorities came out with exactly that stronger language, stating that steroids like this, “MUST NOT be used by the intrathecal, epidural, intravenous or any other unspecified routes.” The South African government issued similar warnings, according to Capolongo.
Since the FDA is still actively studying these procedures, it will be interesting to see if the agency takes any further steps. If and when it does, you can bet I’ll pass the information along.
If you aren’t on this medication, chances are you know someone who is. It’s used to treat everything from pain to mood disorders and can be just what the doctor ordered for many.
But now, there is mounting research uncovering misuse of and even a black market for this popular prescription.
We’re talking about gabapentin. It’s approved for some types of seizures and nerve pain.
Doctors also use it off-label to treat everything from insomnia to migraines to anxiety. Sixty-four million prescriptions of it were sold in the U.S. in 2016, up more than 60% from four years earlier.
The thing is, experts, say there is growing evidence it’s being abused, too. It’s even being sold on the streets under the name “Johnnys.”
Dr. Joseph Insler, an addiction psychiatrist, says he’s seeing it all too often.
“Sometimes, I’ve even experienced patients ask me for their “Johnnys” and then they’ll, maybe, catch themselves and say, ‘No, no, no. I mean gabapentin’,” he says.
“I think that some individuals may say that they use it to get high, and others may say they use it and get a drowsy effect. So, we’re talking about the euphoria versus sedation, “ says Rachel Vickers Smith, Ph.D.
Dr. Vickers Smith wrote her dissertation on gabapentin abuse when studying drug abusers in Appalachia.
“We found a nearly 3000 percent increase from 2008 to about 2014 in individuals reporting gabapentin abuse for the purposes of getting high,” she says.
We wanted to see for ourselves, so we searched online. We easily found people talking about taking “Johnnys”, or gabapentin, to get high. There were also threads of people trying to spread awareness about the abuse.
Experts say gabapentin is typically misused by substance abusers who mix it with other drugs.
But, Dr. Insler says it’s also possible for people with legitimate prescriptions to misuse, too.
He says, “If somebody’s taking excessively high doses or needing early refills” or if their mood changes, family members or clinicians should see these signs as red flags.
A growing body of research shows the problem of abuse, especially among substance abusers is clear. But some experts also worry about the number of prescriptions being handed out.
A recent New England Journal of Medicine letter warned that “clinicians who are desperate for alternatives to opioids” are “increasingly prescribing gabapentin” and that “evidence suggests that some patients misuse, abuse or divert gabapentin.”
Dr. Rachel Vickers Smith says, “ I think that’s why it’s really important to get out the message,” about abuse, in general.
Gabapentin is not a controlled substance or scheduled drug on the Federal level.
We reached out to several government agencies. There was little information on potential abuse although the National Institute on Drug Abuse pointed us to existing research and the DEA says it is beginning to receive calls.
Dr. Vickers Smith says, “ I don’t think that gabapentin abuse is on the CDC, DEA’s, NIDA’s radar, in part because we had this opioid epidemic.”
All experts we talked to stress that this is NOT the next opioid epidemic, but they believe gabapentin abuse is something to watch closely and believe more research is needed.
We contacted two of the manufacturers of gabapentin, including Pfizer, which told us, “Gabapentin is an important treatment option for their approved indications”.
We have received so many complaints about duloxetine side effects that we have lost count. Far more disturbing is the number of people who tell us how hard it is to discontinue this drug.
Decades ago doctors might have told patients taking a drug like Cymbalta that if they experienced anxiety, irritability, or strange sensations after stopping the drug, it was probably their underlying psychological problem returning. Now we know it is withdrawal from the medicine.
Cymbalta was originally approved by the FDA in 2004 for the treatment of major depression. It is officially an SNRI-type antidepressant. In doctorspeak, that means it is a serotonin-norepinephrine reuptake inhibitor and is somewhat similar to other antidepressants such as Effexor(venlafaxine) and Pristiq(desvenlafaxine).
In other words, there was a drug that could relieve your blues and your aches and pains. And the drug company that makes Cymbalta (Lilly) has been aggressively marketing it as a good way to deal with chronic low back pain and osteoarthritis. Perhaps you have seen the commercials on TV promoting the pain-relieving power of the drug with the slogan “Cymbalta can help.” It sounds almost too good to be true.
Ah…and there is the rub. Although there is a long list of serious side effects mentioned during the commercial, the video images seem quite reassuring and trump the scary message the FDA requires for this medication. So, let’s set the record straight. Here, without visual interference, are a list of potential complications associated with this medication.
Depressed mood, suicidal thoughts and behavior, suicide
Such a long list of side effects makes your eyes glaze over after the top 3 or 4. That is why we have included stories from real people so you can better understand what these complications feel like.
Even though such side effects are scary, there is another problem with Cymbalta. When people try to stop taking this drug they frequently report unpleasant withdrawal symptoms. An organization (QuarterWatch) that monitors the FDA’s database of serious adverse drug events has noted that:
“We observed a signal for serious drug withdrawal symptoms associated with duloxetine (CYMBALTA), a widely used antidepressant that is also approved to treat arthritis and back pain, anxiety, and fibromyalgia. In the first quarter of 2012, the FDA received 48 case reports of drug withdrawal identifying duloxetine as the suspect drug. They described a wide spectrum of withdrawal effects that began when the patients stopped the drug, including blackouts, suicidal thoughts, tremors, and nausea. Several cases involved hospitalization.
Probing deeper into the scientific record for duloxetine we found that withdrawal symptoms were reported in 44-50% of patients abruptly discontinuing duloxetine at the end of clinical studies for depression, and more than half of this total did not resolve within a week or two. In addition, we identified a serious breakdown at both the FDA and the manufacturer, Eli Lilly, and Company, in providing adequate warnings and instructions about how to manage this common adverse effect.”
Doctors have taken to calling this “discontinuation syndrome.” These clinical words do not do justice to what it is like to stop antidepressants like Cymbalta, Effexor(venlafaxine), Paxil (paroxetine), Pristiq (desvenlafaxine), or Zoloft(sertraline) suddenly.
Again, a list of symptoms does not do this problem justice. Below you will read some stories from people who have posted their comments to this website. We would love to hear your story, positive or negative. Share your experience with Cymbalta or any other antidepressant below.
Should you wish to learn more about dealing with depression through some other strategies, we offer our Guide to Dealing with Depression. You will also find a whole chapter on prescribing mistakes doctors make when treating depression and fibromyalgia in our book, Top Screwups Doctors Make and How to Avoid Them.
“My lovely, young daughter-in law, who was about to celebrate her 29th birthday, was prescribed Cymbalta, Klonopin, and Ambien and has committed suicide. “She told her physician and her therapist that she’d had thoughts of suicide but no one took her seriously. She suffered from depression, as well as an eating disorder, and had very low body weight. She also used alcohol. “Please remind your readers of the potentially disastrous effects these chemicals can cause when taken carelessly or in combination with alcohol.”
This from – P.J.: “I have been on Prozac over the last 20 years off and on and it finally stopped working. The last time I took it about 2 years ago I was taking the generic from Barr – the blue and white capsule. I was feeling as if I were in the deepest dark hole there ever was.
“My doctor put me on Cymbalta from which I had a lot of side effects such as palpitations, feeling constant dread, panic attacks, sweats, lightheadedness, and a general feeling of not being well.
“She added Abilify which put me over the edge. I was in the worst depression I have ever been in. Finally, after living like this for several months, I asked to be put back on Prozac. I was taking the generic from Sandoz. When the prescription ran out I ended up on the big blue and white capsules from Barr.
“Over the last couple of weeks, it has been constant crying spells, arguing with everyone, and feeling pretty low. I talked to my doctor and she wrote the prescription for Sandoz only generic. The blue and white capsules are like taking a placebo. My doctor said she had had other patients who complained of the same thing and she had to write prescriptions for a certain generic or name brand.”
Click Here to Visit the Store and find Much More…. – R.P. says: “I took Cymbalta for 3 days and thought I’d go nuts. I’m off it now and refuse to try any other drug like this. My main complaint was extreme hot flashes that estrogen wouldn’t help. I thought I’d be given Prozac but was given Cymbalta instead. It was a rough 3 days and I stopped it last night. I am extremely tired yet cannot sleep at night. I think I was sweating even worse and my legs started feeling like I had Lyme disease again. And to be honest, within those 3 days of taking it, I didn’t contemplate suicide, but I had this crappy attitude of “who would care?” – Nancy relates how hard it was to get off Cymbalta: “It took me 18 months to get off Cymbalta, with no doctor’s help. I can hardly believe that doctors have no exit strategy for this dangerous drug. I had to find this out on my own from reading and as soon as I weaned off that – about a month, the tinnitus that had occurred decreased almost completely. No doctor told me this.” — J.K. shares a parent perspective: “My daughter experienced severe side effects when trying to come off Cymbalta – she had nausea, vomiting, lost peripheral vision for 24-48 hours, had to shake, etc. This was while she was doing a clinical in a hospital for college. Had she known she would have stayed on it until after clinical. I called the manufacturer and they acted like there were no such side effects from withdrawal.
“She too took apart the capsules and it took a while, but finally she is free from that drug. I think it is a crime that the manufacturers don’t publish more detailed information concerning withdrawal. They could even make money selling a one-month or two-month step-down prescription so individuals aren’t taking the capsules apart themselves.” – P.C. Tells what it is like to switch around from one drug to another: “I just turned 52 today. I went on a very low dose of Zoloft about 8 years ago to treat generalized anxiety disorder. It really did help for a long time. I recently have been pretty depressed (however I can cover it up really well) and my psychiatrist switched me to Effexor which was terrible for me. Now I’m trying Cymbalta which has not done anything either except make me feel more anxious and headachy and weird.”
“I am a registered nurse and I do not understand what the long-term effects of these meds are and I am concerned. I really want to get off and see what I can do naturally for myself.” – K.T. tells what it is like to try to stop Cymbalta: “Getting off Cymbalta is challenging but not impossible. I, too, experienced light-headedness, dizziness, and “brain zaps.” I described it as being able to “hear my eyes move.” It sounded like the light sabers on Star Wars. Very strange and disconcerting.
“The key is to do it very very slowly. Take the capsules apart and begin by removing 5 or 10 of the tiny balls inside. Do this for a week or so, then slowly increase the amount you remove each week or two as you can tolerate it.
“Your doctor will probably be no help at all. Mine wasn’t. He instructed me to wean off over a two to three-week period and I almost lost my mind. I did it myself over about a YEAR or more. Be patient. I am completely off now and feeling GOOD.” – Karen’s story: “I was prescribed Cymbalta ‘off-label’ to manage fibromyalgia pain When I stopped taking it because it wasn’t delivering on the promised effect of reducing my pain, I became so horribly depressed that I required hospitalization as I had become SUICIDAL!
“I will NEVER take another anti-depressant for an off-label purpose….such as Elavil/amitriptyline as a “sleep aid” which is very commonly prescribed.
“I believe it should be criminal to prescribe ANY drug for a purpose other than the one it was approved to treat.” – R.H. and Erectile Dysfunction: “I’m a 76-year-old man, my libido was very low. Taking Cymbalta for peripheral neuropathy added ED as a side effect of the drug. I had a testosterone blood test; it was 1/3 what the minimum should be. So I’m taking Androgel to raise testosterone levels and it is magic. I have great libido now and am working on minimizing the Cymbalta pills. In the meantime, I have been prescribed Cialis for the ED. Each pill solves the sex problem for a couple of days.” – M.O. on stopping Cymbalta:
“I have the exact symptoms as everyone else and it’s been a week. I only took Cymbalta for 2 months, but the side effects from stopping it are horrible. My doctor didn’t, nor did anyone else tell me, about any side effects and I did read the insert. Most of the time the listed side effects of meds don’t bother me, so I figured no problem. “From reading other posts on this website and on other sites, the drug seems to affect every person the same way. I would never have taken it for my neck pain if I had known about the likelihood of side effects. The worst part for me is the dizziness, the brain zings and the sudden burst of tears for no reason. I would never take this drug again. I think the FDA needs to do longer studies on all drugs and be honest with their findings and that doctors should be honest and tell their patients what really happens when you take Cymbalta.”
Please add your own experience below in the comment section.
As you age, your cartilage — the spongy material that protects the ends of your bones — begins to dry out and stiffen. Your body also makes less synovial fluid, the stuff that acts like oil to keep your joints moving smoothly. The result: Your joints may not move as freely as they used to. It sounds a little crazy, but the best thing you can do is keep on trucking. Synovial fluid requires movement to keep your joints loose.
When you’re asleep and still for several hours, the fluid that helps your joints move easily can’t do its job. That’s why you wake up with knees or hands that are stiff and swollen. To make it better, try to move around more during the day.
A joint is a place where two bones meet. The end of each bone is covered in a layer of rubbery stuff called cartilage. This keeps them from rubbing together. But cartilage can wear away over time or after an injury. When it’s gone, the bones hit one another, and sometimes, tiny pieces break off. The result is a stiff, swollen, painful joint.
Your first move might be to do fewer things that bother the joint in question. Over-the-counter drugs can help with pain and swelling. If they don’t, your doctor might inject stronger treatments directly into problem areas. You can wrap joints to protect them and stop overuse, but this could weaken your muscles, so don’t overdo it. Some people need surgery, but it’s rare. Your doctor will discuss treatments with you.
Your immune system is supposed to protect you from outside germs. Sometimes, it attacks the lining of your joints instead (your doctor will call this the synovium). RA is most likely to affect your wrist or finger joints, but it can show up anywhere in your body. It often causes constant pain and stiffness. Sometimes, it stays in the background and only flares up now and then.
Doctors treat RA with medications that slow or stop the disease process. You might hear yours call them DMARDs, which stands for disease-modifying anti-rheumatic drugs. The goal is for you to have no signs of inflammation in your body. Your doctor will refer to this as this remission. Along with drugs, you can also take care of yourself — eat well, rest when you need to but keep moving, and take good care of your joints.
OA and RA are the most well known, but other types also affect your immune system and result in stiff joints:
Ankylosing spondylitis: This type mostly affects your spine, but it can make your hips, hands, or feet feel stiff.
Gout: The first sign of this build-up of uric acid in your body is often a searing pain in your big toe.
Infectious arthritis: It often starts with an infection somewhere else in your body that travels to one big joint, like your hip. Your doctor might call it septic arthritis.
Did your grandma say she knew when a storm was coming because her joints ached? She was right. Doctors aren’t sure why, but joint pain seems to get worse when the weather changes. It’s most common when the air pressure (the weather forecaster will call it barometric pressure) falls. That typically happens just before a storm.
There’s no cure, but over-the-counter meds should ease your pain. Your doctor might prescribe other medications. A physical therapist can teach you special exercises to help. You might also try a relaxation technique like deep breathing or a gentle exercise like yoga or tai chi. They’ll help you stretch and strengthen your muscles and tendons.
These conditions are easy to treat. You’ll likely make a full recovery. The first thing to do is give that joint rest and take over-the-counter pain medication. Your doctor will probably give you a splint to wear and tell you to put ice on it. She might show you some exercises to do, too. If that doesn’t help, she could inject a stronger drug straight into the bursa or tendon to manage pain and swelling.
The more you move your joints, the less likely they are to get stiff. A little afternoon gardening or a walk around the block can help. You’ll strengthen the muscles that support your joints, keep your bones strong, improve your balance, and burn calories. Start slow, so you don’t get hurt. Talk to your doctor first if even gentle exercise makes the stiffness worse.
If your joints are extra stiff in the morning, try a hot shower or bath. It’ll get the blood flowing to the area, which loosens things up. You can also buy moist heat pads from the drugstore or make your own. Toss a washcloth into a freezer bag and microwave it for 1 minute. Wrap it in a towel and leave it in the area for 15-20 minutes.
Ice down an achy joint. It narrows blood vessels, which slows blood flow to the area and eases swelling. You can use a store-bought cold pack, or try a bag of frozen veggies instead. Put it on the area, but use a towel to protect your skin. Don’t do it for more than 20 minutes at a time. If you really want to chill a problem joint, try an ice bath.
A research project focused on developing an objective measure of pain-related interference with cognitive performance in people with fibromyalgia is one of three awarded research grants recently by Purdue Pharma.
An independent steering committee oversaw the competition and selection of the three recipients of Purdue’s research grants to study chronic pain and the assessment of pain.
Robert R. Edwards, Ph.D., of the Brigham and Women’s Hospital at the Harvard Medical School in Boston, will lead the project dedicated to pain in fibromyalgia. The project is titled “Development and application of an objective measure of pain-related interference with cognition.”
The goal is to identify a set of cognitive tasks that are affected by variations in pain levels when they are being performed. Once an appropriate set of tasks is developed, they will be used in a randomized, controlled trial to test an intervention designed to improve cognitive performance in this patient population.
Another of the selected projects, led by David A. Seminowicz, Ph.D., at the University of Maryland School of Dentistry, Baltimore, is titled “Development of a reliable neurophysiological pain assessment tool: alpha as a predictive biomarker (APB).”
This study aims to determine if EEG alpha wave activity is an accurate and reliable measure of acute pain and neuropathic pain (chronic pain resulting from injury to the nervous system) in healthy volunteers. Alpha waves are a type of brain wave that allow the assessment of electrical impulses in the brain that reflect the brain’s activity.
The third project, led by Tassilo Baeuerle, president and chief executive officer at CognifiSense, Sunnyvale, California, is titled “Study on the use of virtual reality for pain measurement.”
The goal of this research is to explore the potential for the use of virtual reality technology as a tool in the assessment of chronic pain. Virtual reality is the term used to describe a three-dimensional, computer-generated environment that can be explored interactively by a person.
The study will also evaluate the potential of using movement, among other measures, to assess pain intensity. The association of specific movements with pain will be investigated.
“We are excited to support three investigator–led studies, which we believe will contribute important new information to our body of knowledge about the assessment of chronic pain,” Monica Kwarcinski, PharmD, head of Medical Affairs, Purdue Pharma, said in a press release.
“The assessment of pain levels is important in making a correct diagnosis, determining appropriate therapy, and studying responses to treatment. By addressing these data gaps through research funding, we remain committed to offering innovative solutions to make a meaningful impact on patients’ lives.” Kwarcinski added.
Purdue is a pharmaceutical company founded by physicians, and it is known for its pioneering research on pain.
The media can’t look to get its stories about Prince right. As the news feed overflows with stories with the word Princeand drug addiction in them, not many of them feature the word chronic pain. Multiple reports show that Prince had suffered from years with Fibromyalgia pain and Severe Chronic Pain in his hips due to injuries racked up during when his performances started.
His body was wracked with pain, Prince relied on opiate pain medications to provide him some relief. And yet even today the stately New York Times features a long article about Prince looking for help with an addiction.
Prince was not addicted to pain medication. Prince had a medical problem— Severe Chronic Pain — which is criminally under-treated. It is also a medical problem that is more likely to be reacted to with stigma and condescension, even dares about the chronic pain patient’s moral character. Severe Chronic Pain is still the condition that we treat by telling its sufferers to just pull it up or keep a stiff upper lip, or to terminate acting like a wuss.
When anyone dies from complications of the disease, for that is what Severe Chronic Pain is, we react surprisingly, sympathy and anger that the patient died from a drug overdose. Some outlets make money off our doubt about overdose and medications and our interest in drugs.
Reports of 2009 surfaced that Prince was in chronic and debilitating pain. His friends reported that he was taking Severe Chronic Pain medication to try to control the constant, severe pain from damaged hips.
The supposed disagreement between Prince’s conversion to the Jehovah’s Witnesses and his potential to accept a blood transfusion — should the need emerge during hip replacement surgery — was bandied about by the vultures who pose as whispering reporters. The idea that Prince would forego surgery in order to serve his faith granted to the undercurrent that Prince was “strange”. however, some news channels report that Prince did have double hip replacement surgery in 2010.
But it’s not just about how the media doesn’t realize how Severe Chronic Pain works. They are also ignoring the realities of the impact of race upon the carry out of medicine. Into the mix must definitely be added the element of race. Prince was a black man with severe chronic pain. Strong racial disparities in how doctors and other medical staff replied to pain in the emergency room have been documented.
For example, a new study published in one of the most important pediatrics journals studied the treatment of appendicitis, a situation that is often initially suspected after a chandelier test. In medical slang, if a fibromyalgia doctor places her hand on the pain point in the lower abdomen affected by the Severe Chronic Pain of an inflamed appendix, the Chronic pain patient will try to jump up into the metaphoric chandelier on the top limit above their head.
In medical problems in which Severe Chronic Pain has been abiding, scientific evidence recommended that the brain’s pain receptors short out. whereas, regardless of even whether the painful part of the body has been removed — as in amputations — the brain’s pain receptors persist to process signals that the body is under attack.
Phantom limbs can cause severe pain. It does not make the pain fake. It is the brain that can feel pain. And the brain can remain to experience severe chronic pain even after surgery has been performed.
And yet, despite the facts that Prince was being given Percocet for documented pain, the media narrative has shifted to a story in which Prince died of an overdose of drugs. An overdose is a self-inflicted wound. It’s a moral judgment. That is how we react to it.
He was such a brilliant actor. Why overdose of drugs? Or She had such a dominant voice. But she was a demon for drugs.” That story allows us to distance ourselves, to see it as the mistake of a weak personality an addictive personality. It’s part of the mythos we create around brilliant folks.
The idea is that the really gifted are also the ones in the worse psychological pain, and their psychological weaknesses make them mature for drug addiction. Prince is being pressed toward that precipice over which we have pushed Amy Winehouse, Whitney Houston, Philip Seymour Hoffman, Michael Jackson, and every other artist who has died from a drugs overdose in the past century — especially those who succumbed to heroin.
But heroin and Severe Chronic Pain medication are not the same things. certainly, some will gain fame for their discussions of the abuse of chronic pain medication.
Severe Chronic Pain managing requires, in many cases, the taking of power, frequently-opiate-based medicines. any patient who takes these drugs on a daily basis will become “physically needy” in a short time. Physical needy is not addiction. Diabetics physically rely on insulin, and yet we can’t call insulin an addictive drug. Without it, diabetics would die.
Stopping pain medication that has been used for Severe Chronic Pain can kill you if it’s done suddenly. Under a doctor’s care, a change in pain medication is handled on a strict schedule in which the body is weaned off one drug in order to either begin a new medication or to determine whether the body is reacting in an unusual way to the condition causing the pain.
Patients with Fibromyalgia Disease may have reduced volume of the olfactory bulb, a key structure in how we perceive and distinguish smell, a study found. That finding may help explain why some patients report impairments in olfactory perception.
The study, “Decreased olfactory bulb volumes in patients with Fibromyalgia Disease,” was published in the journal Clinical Rheumatology. Olfactory perception, including being able to identify and distinguish different types of odors, is a feature often reported to be impaired in Fibromyalgia Disease patients.
The olfactory bulb is the first structure involved in our perception of a smell. It is composed of two types of nerve cells that receive input from cells in the nasal cavity. But, while “self-reported olfactory functions have been studied with olfactory tests, olfactory bulb volumes have not been studied” in Fibromyalgia Disease patients, the research team wrote.
To determine the volume of the olfactory bulb in a group of Fibromyalgia Disease patients, researchers used magnetic resonance imaging (MRI). In total, the study enrolled 62 female participants — 30 with FM and 32 healthy controls — with mean ages of 44.2 and 41.7, respectively.
MRI analyses showed that the olfactory bulbs of patients with Fibromyalgia Disease had a reduced volume compared to healthy controls. Specifically, the mean volumes of the right olfactory bulbs were 74.9 mm3 in the Fibromyalgia Disease group and 92.6 mm3 in the control group. The mean volumes of the left olfactory bulbs were 74.3 mm3 and 92.8 mm3, respectively.
The mean of total olfactory bulb volume (the volume of both right and left) was 146.6 mm3 in the Fibromyalgia Disease group and 186.5 mm3 in the healthy control group, a 1.2 ratio difference.
Overall, the team concluded that patients with Fibromyalgia Disease are at risk of having decreased olfactory bulb volumes.“Outcomes of the present study should be kept in mind for proper and reasonable management of this tough syndrome and for future studies,” the team wrote.
You are going to find that this new diagnosis could mean that you have to change the way in which you live your life.
Everything that you do, even the most mundane of activities, can make a difference in how you feel later.
Even a shower could be something that causes more pain or even makes the symptoms of fibromyalgia flare up more than they already are.
Fibromyalgia is something that affects numerous people. The key to having this illness is learning what you can do to lessen the symptoms while still maintaining the life that you have always dreamed of having.
There are numerous people in the world who are functioning with fibromyalgia easily and they are still doing what they always want to do. How can you be one of these people?
One of the first things that the person needs to realize is that there are going to be obstacles that you must learn to deal with.
Whether you attack these obstacles head-on or you learn what you can do and what you need to pace yourself with, you will find that your life is going to be better for learning this control.
There are several obstacles that you may have to come to realize in order to gain more control over your life. Some of these obstacles may include:
What was your regular workout routine like? It could be you have to change this.
Did you work in a physically demanding job? If so, it may be time to look for something else.
You may have to start getting more sleep–in order to give your body the rest that it needs
When you step into the shower, most often you are not thinking about how much exertion this is going to require, but it does.
We often link a shower with relaxation, but if you look at all that you do in the shower, it does take some exertion.
For example, you are standing the entire time, you are going to be doing a fair amount of bending stretching, and reaching while you are lathering and washing your body.
Those who have fibromyalgia often find that these repetitive movements are almost as if they have run a marathon.
While it should not make a person tired, this is just one of the issues that fibromyalgia patients have to deal with.
Is too much relaxation something that a person should worry about? If you have fibromyalgia, then yes this is something that you need to worry about.
This is especially true if you are taking a shower in the morning before your day gets going. Why is this?
Those who have fibromyalgia often find that they are tired constantly. This tired feeling is normal when dealing with fibromyalgia, but a shower can make this tired feeling even more pronounced due to the way it makes a person relax.
If you are taking a shower first thing in the morning, you want to be woken up, not relaxed, and falling to sleep all day long.
It is a chronic condition that renders sufferers so sensitive that even the lightest touch triggers waves of excruciating pain. Fibromyalgia is thought to affect up to a million Britons, commonly women over 40, and experts have likened the debilitating sensations to ‘death by a thousand needles’.
Other symptoms include lack of concentration, memory loss, headaches, and muscle stiffness. And for a long time, there were little doctors could do to help quell the agony.
Yet today, with the help of sophisticated scanning techniques, pain specialists have been able to pinpoint the parts of the brain responsible for the condition.
Using a combination of psychotherapy and medicines more commonly used to treat depression and epilepsy, many sufferers are able to find relief.
‘Patients with fibromyalgia typically have what we call tender points,’ says Dr. Ernest Choy, consultant rheumatologist at King’s College Hospital in London.
‘There are 18 sites throughout the body – in the neck, back, arms, and legs – where, with light pressure, they experience pain, when a normal individual wouldn’t.
‘As well as pain, patients usually complain of a degree of fatigue and poor sleep quality. Depression and chronic pain often go hand-in-hand – it’s so hard to cope with such grinding discomfort every single day.’
The patient will have suffered widespread pain for three months on both sides of the body, above and below the waist, as well as pain in at least 11 of the 18 known tender points when pressed.
‘Unfortunately, fibromyalgia isn’t well understood by many clinicians because pain is often a very subjective symptom,’ says Dr. Choy.
‘According to a European survey, it takes approximately 18 months to two years to get a diagnosis of fibromyalgia. There are still a lot of clinicians who don’t even know about it.’
The exact cause of the condition isn’t known but, according to Dr. Choy, research has highlighted that it is likely to be due to a problem with how the nervous system handles pain.
‘When a normal individual experiences pain, there is what we call a coping process in the brain that manages it,’ he explains.‘In some patients with fibromyalgia, that process isn’t working properly so their threshold for experiencing pain is much lower.
‘Recent advances in assessing the way the brain works, using functional magnetic resonance imaging [fMRI], have really changed our understanding of the disease.
‘It’s clear that the way the brains of people with fibromyalgia process pain is very different from normal individuals.’
There are certain risk factors for developing the condition. ‘My symptoms started almost six years ago, with my joints suddenly swelling and feeling very painful’ ‘There is evidence to show that people who have physical or psychological stress are more prone to developing fibromyalgia,’ says Dr. Choy.
‘In some individuals, it may be that they sleep very poorly, while in others it may be that they have other illnesses, such as depression.’
There is no cure, but treatments can help ease symptoms. Dr. Choy explains: ‘The aim of treatment is to help patients cope with their condition.
In most patients, we use a combination of non-drug-based treatments, as well as medications.
‘Exercise can be helpful. Although many patients get worsening of their pain when they start, if they build up exercise gradually, they’ll get long-term benefits.
‘Taking warm baths or exercising in warm water will also help alleviate the pain and tiredness. Cognitive-behavioral therapy, a kind of psychotherapy, can help improve patients’ ability to handle pain.
‘Aside from that, some simple painkillers can help, and we often prescribe antidepressants mainly because the chemical substances in the brain that control the processing of pain are also the same as those that cause depression.
‘These are given at much lower doses than are used to treat depression, though. Anti-epilepsy drugs have also been shown to be effective. These work on readjusting the nervous system and reducing sensitivity to light pressure.’
One sufferer, Nicki Southwell, 53, runs a fibromyalgia support group. Nicki, who lives in Carlisle with her husband Merlin, 51, a teacher, says: ‘My symptoms started almost six years ago, with my joints suddenly swelling and feeling very painful.
‘It got so bad I couldn’t climb the stairs. I was eventually diagnosed early last year, though no one knows what caused it. In the meantime, I had to stop work as a carer.
‘And although I’m usually very organized, suddenly I couldn’t find my diary or manage the housework. I felt totally out of control and I hated that. Along the way, I’ve suffered from depression too, but I don’t know if that’s because of the fibromyalgia.’
More than a year on from her diagnosis, Nicki sleeps normally but wakes with aching, stabbing pains – mainly in her back and legs. Her short-term memory is also still poor so she makes lists.
‘I take painkillers and I use a Transcutaneous Electrical Nerve Stimulation [TENS] machine for pain relief, which delivers electrical impulses to the body,’ she says. ‘I also did an NHS hydrotherapy course, which involved exercising in warm water and was brilliant.
‘I know lifestyle changes are key, so I’m going to try swimming, t’ai chi – anything. I still have bad days but things are getting better.
‘My message to other sufferers would be to persevere for diagnosis and treatment. Don’t give up hope.’
Dr. Choy says: ‘What works for one patient might not for another. It is important to remember there are treatments already available that can help ease symptoms. I think the future is looking bright for patients with fibromyalgia.
