Fibromyalgia is looking for its cause

Dear Dr. Donohue: Please say something about fibromyalgia and what causes it. I have a friend who lives far from me, but we keep in touch by phone almost daily. She's a wreck because of fibromyalgia. She's having a very tough time running her house. She has five children. What can be done for it? — R.V. Dr. Paul Donohue–HEALTH
Sept 6,2006
Dear R.V.: Fibromyalgia is an illness in search of a cause. No one knows what the cause is. It’s a state of muscle pain, exhaustion and disturbed sleep. Affected people complain most about pain in the neck, shoulder, hip and extremity muscles. Their constant tiredness is partly the result of nonrefreshing sleep. They also have trouble concentrating and remembering.

The pain might be due to abnormal processing of pain signals in the brain. That’s one conjecture.

A special feature of fibromyalgia is tender points. They’re 18 body sites where slight finger pressure produces pain far in excess of the applied pressure. That’s one reason why some believe the brain amplifies incoming pain sensations.

Exercise is an important aspect of treatment. It has to be started at a low level and gradually increased. Water aerobics is a good way for fibromyalgia patients to get their muscles working again and keep them functioning even though they’re painful. Any kind of low-intensity exercise will fit the bill.

Small doses of the antidepressant medicine amitriptyline can often restore normal sleep and restore some energy to these people. Seizure medicines such as Lyrica, Topamax and Neurontin, again in low doses, can bring pain relief. Muscle relaxants, an obvious choice, don’t work by themselves. But when they’re used in combination with Celexa or Effexor, they’ve benefited some patients.


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