Fibromyalgie, diagnose en advies.

Onderzoek naar fibromyalgie

Diagnose voor fibromyalgie volgens de criteria van het American College of Rheumatology.

Fibromyalgia means pain in the connective tissue end muscles.
Fibeomyalgia is a syndrome with common pain and stifness from the locomotor apparatus, it is accompanied by other nonspecific complaints like tiredness, insomnia and and changes in the state of mind. .
For fibromyalgia there is not known a cause.
It is discused if fibromyalgia is an individual disease. There is no consensus about the existence of objective defects that belong to fibromyalgia.
There are indications that with fibromyalgia the processing of pain by the central nervous system is faulty and that there are disorders in the neuroendocrine, the neurovegatative and neuro-immunologic systems.
The lack of clarity about the cause of fibromyalgie is expressed in many different therapies: painkillers, antidepressives, cognitive behavioural therapie, kinesiotherapy, learning to handle stress, acupuncture , etc.
Fibromyalgie is found in 1-2% of the population.
In this program the diagnostic criteria of the American College of Reumatology are used (publishec in may 2010).
Common pain and tiredness can be cause by different diseases. The diagnosis from this program can only be true if there are no other known disease.
Cause of fibromyalgia and what to do.
Here I describe the cause of fibromyalgia and a possible way of treatment. This description is based on known anatomy and fysiology, but is not scientificaly proved. The treatment is based on the different treatments in use. What the best trestment is, is not yet scientificaly proven.
Pain: painstimuluses are send from the skin, the muscles and the organs via the nerves to the controlneurons in the spine. In the controlneurons the stimuluses can be inhibited or reinforced. When there are sufficient stimulusus they are send to the paincentrum in the brain. Here the painstimulusus can again be inhibited or reinforced. If the stimulus is sufficiently strong you feel pain.
Muscletension: a muscle is never tensed or relaxed for 100%. There is always some tension in the muscle, this can be high or low. Each muscle has an antagonist = a reactionmuscle: a muscle for flexion works against a muscle of deflexion. A movement happens if the tension in one of the two is higher. If both muscles have a high tension, no movement is happening. Via the nerves the muscles gives pulses to the controlneurons in the spine to give a signal of the muscletension.
Organs: the organs give stimuluses to the controlneurons in the spine too. If there are many stimuluses this is felt as pain (for instance intestinal spasms). We can not alway say where the pain is coming from. A wellknown example is the pain people feel in the left arm when having a myocardial infarct.

What can we learn from this??
In the controlneurons painstimuluses, the muscletension stimuluses and the stimuluses from the organs are joint together. If there are enough stimuluses a sign is given to the paincentre in the brain. But what is enough? The processes happening in the controlneurons are not yet fully understood. There is problably an influence of the alertness of the central nervous system.
If there is stress, fear, anxiety, nervousness then there is a higher muscle tension, this may cause painstimuluses.
For some people this might cause the controlneurons to fire painstimuluses to the brain at a lower level.
We know that people suffering from a depression have more symptoms, more pain. This is problably caused by the state of mind on the paincentre in the brain. How quick depressed feelings cause a higher sensitivity of the paincentre we do not know. As with all biological processes there will be a wide individuel variability.
In the brain substances are made to suppres pain, endorfines. We are not able yet to measure this in living people. Problably the variability in different people of the production of endorfines causes a part of the differences in pain sensation.

How to get rid of your symtoms
1 stress, fear, anxiety, nervousness must be prevented. Take care of enough rest.
2 try to prevent depressive feelings. Take care of doing nice things.
3 try to prevent high muscletension. You can do this by relaxation exercise or for instance yoga.
4 muscletension and musclerelaxation are happening on different levels over the day. Sport is a good way to stimulate this, work on a better condition. If you doen't do any sport begin than with 15 - 30 minute walking each day, extend this till an hour (walking, cycling or swimming). In the beginning the pain may increase,but after some tme it will help.
5 Painkillers will help, but only in combination with all the other advices..
If you do not succeed in solving the problems, ask your doctor for help.