Fibromyalgia Was Once A Unrecognized Syndrome
Fibromyalgia was mostly unrecognized, as recently as thirty years ago. The symptoms of fibromyalgia syndrome which include muscle pain and chronic fatigue led people on a quest for help. Clinical examinations often revealed no concrete physiological findings. X-rays, blood tests, and muscle biopsies appeared normal, and therefore the symptoms seemed unexplainable. The patient was frequently told the symptoms were “all in their head.” Psychological stresses have long been regarded as contributory to fibromyalgia syndrome, but now much new research is ongoing. Better physiological and biological evidence is being gathered.
Sleep Abnormalities And Fibromyalgia
In 1975, two researchers were asked by colleagues to interview patients complaining of chronic muscle pain for which no physiological cause could be found. Following the interviews the two researchers suspected sleep abnormality and it was found that the patients had a deficiency in the deepest stage of sleep, known as stage 4. One of their studies involved awakening healthy people and disrupting their sleep pattern as they entered stage 4 of sleep. Interestingly, it was found that the healthy subjects developed fibromyalgia symptoms when their sleep was disturbed, but the symptoms subsided when they were permitted to sleep undisturbed. As the two researchers analyzed the study results, they concluded that the patients not only had sleep abnormalities but also had disregulation of normal body circadian rhythms affecting periods of wakefulness too.
Muscle Abnormalities and Fibromyalgia
Until about thirty years ago, fibrositis was the term used rather than fibromyalgia. Fibrositis was an incorrect term because it means muscle inflammation, and it is now known that inflammation does not exist in the muscles of fibromyalgia patients. In the late 1980’s a study was done which revealed that there were no more muscle abnormalities in fibromyalgia patients than in pain-free control subjects. Other researchers have analyzed the connection between sleep disorders and muscle damage. Growth hormone, which is important in muscle maintenance and repair, is secreted during sleep stage 4. Research indicates that about one-third of fibromyalgia patients have a growth hormone deficiency.
Substance P and Serotonin
There has been some research which has focused on the chemicals of the nervous system which help regulate pain messages sent out to brains. Two such chemicals are:
Substance P: Substance P is a neurotransmitter associated with increased pain perception. Normally, substance P begins the pain signal process which follows painful tissue injury. Serotonin normally reduces the intensity of pain signals.
Serotonin: Serotonin has also been found to play an important role in sleep regulation.
There are studies which show abnormal levels of both of these hormones in people with fibromyalgia. Research also has described some people with fibromyalgia as having decreased blood flow to certain areas of the brain which help regulate pain signals sent from the spinal cord to the brain. The theory that some people with fibromyalgia have exceptionally high intensity pain messages sent to the brain, along with a deficiency in pain inhibition, is supported by the research indicating abnormal levels of substance P and serotonin, and decreased brain blood flow.
Hormones and Fibromyalgia
Researchers also have taken the fact that fibromyalgia is more common in women than men and suggested that the sex hormone estrogen is involved. However, little correlation has been discovered. It also has been suggested that the lower levels of testosterone in women than in men is more likely involved since testosterone is involved in building muscle strength. Researchers found that cortisol levels are low in people with fibromyalgia. When the body is deficient in cortisol, the symptoms of fibromyalgia are mirrored, such as:
- muscle pain
- abdominal distress
- thinking problems
- mood swings
- sleep disturbances
Researcheres found that fibromyalgia patients produce less cortisol in response to stress than do healthy people. It is not clear how important cortisol deficiency is in the onset or course of fibromyalgia. Giving patients corticohormone medications does not improve the condition.
The Bottom Line – The Cause of Fibromyalgia Syndrome?
Fibromyalgia is most likely the result of different causes, only time will tell. In terms of treating fibromyalgia syndrome, it can be compared to conditions such as hypertension – a condition not completely understood, yet treatable.