Diagnosing Fibromyalgia

Diagnosis of FMS is performed mostly in the primary care setting. However, tender point examination rarely is performed in this setting, and when it is performed, it often is done incorrectly - See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.aWEKP0OI.dpuf

Diagnosis of FMS is performed mostly in the primary care setting. However, tender point examination rarely is performed in this setting, and when it is performed, it often is done incorrectly - See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.aWEKP0OI.dpuf

Diagnosis of FMS is performed mostly in the primary care setting. However, tender point examination rarely is performed in this setting, and when it is performed, it often is done incorrectly - See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.aWEKP0OI.dpuf

Diagnosis of FMS is performed mostly in the primary care setting. However, tender point examination rarely is performed in this setting, and when it is performed, it often is done incorrectly - See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.aWEKP0OI.dpuf

Diagnosis of FMS is performed mostly in the primary care setting. However, tender point examination rarely is performed in this setting, and when it is performed, it often is done incorrectly - See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.aWEKP0OI.dpuf

Diagnosing Fibromyalgia is usually done by a family doctor and according to studies, in the past, if the tender point test was done it was often done incorrectly. *

It investigated 19 pain locations and 6 self-reported symptoms: difficulty sleeping, fatigue, poor cognition, headaches, depression, and abdominal pain. It should help a GP get insight into your symptoms and their severity.

Fibromyalgia should be diagnosed by a medical professional. Patients should not diagnose themselves. Patients should always consult their medical professional for advice and treatment. 

*  Fitzcharles MA, Boulos P. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology (Oxford). 2003;42:263-267. 

   Buskila D, Neumann L, Sibirski D, Shvartzman P. Awareness of diagnostic and clinical features of fibromyalgia among family physicians. Fam Pract. 1997;14:238-241.

Fitzcharles MA, Boulos P. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology (Oxford). 2003;42:263-267.
4. Buskila D, Neumann L, Sibirski D, Shvartzman P. Awareness of diagnostic and clinical features of fibromyalgia among family physicians. Fam Pract. 1997;14:238-241.
- See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.T4XiYuC7.dpuf

Fitzcharles MA, Boulos P. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology (Oxford). 2003;42:263-267.
4. Buskila D, Neumann L, Sibirski D, Shvartzman P. Awareness of diagnostic and clinical features of fibromyalgia among family physicians. Fam Pract. 1997;14:238-241.
- See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.T4XiYuC7.dpuf

Behavioral therapy and fibromyalgia

Michael VanElzakker, a Tufts neuroscientist, says "that while behavioral therapies are not curative and may only apply to a subset of patients, they can help moderate symptoms and improve quality of life in some." This is the same man that has proposed a good theory for the cause of Fibromyalgia as explained here by Cort Johnson.

The above statement by Michael VanElzakker explains why some people who have Fibromyalgia do get improvement when trying certain therapies and why some people get no improvement in their symptoms. 

Behavioral therapies include many different techniques and therapies including: 

• Anxiety Management Training
• Behavior management 
• Behavior modification
• Cognitive Emotional Therapy
• Dialectical Behavior Therapy 
• Self talk Identification
• Habit reversal training which includes relaxation training.

In some people with fibro these therapies have helped them reduce pain and improve their mood, amongst other things. The treatment programs usually focus on our thoughts, emotions and behaviors and how they all influence each other. These therapies are taught by psychotherapists, psychologists and other trained practitioners.

Have you tried any of these therapies?

Find out more about Cognitive behavioural Therapy in this calming and informative video by Jessica S.Campbell a psychotherapist.




RESOURCES: 
See more about VanElzakker theories about Fibro/CFS at Simmaron Research 
Cognitive behavioural therapies for fibromyalgia.

Bernardy K1, Klose P, Busch AJ, Choy EH, Häuser W.

Opoids and Fibromyalgia

Opiates are drugs that are derived from the Opium poppy plant.

There is increased concern of adverse effects of opoids on people with Fibromyalgia. “These drugs have never been shown to be effective in fibromyalgia patients, and there is evidence that opioids might even worsen fibromyalgia and other centralized pain states,” Daniel Clauw, M.D., professor of anesthesiology, University of Michigan at the American Pain Society Annual Scientific Meeting in May 2015.

Due to the central nervous system origins of fibromyalgia pain, Clauw said treatments with opioids or other narcotic analgesics usually are not effective because they do not reduce the activity of neurotransmitters in the brain.

Opioid drugs include:

• codeine 
• fentanyl (Actiq, Duragesic, Fentora)
• hydrocodone (Lorcet, Lortab, Norco, Vicodin)
• hydromorphone (Dilaudid, Exalgo)
• meperidine (Demerol)
• methadone (Dolophine, Methadose)
• morphine (Avinza, Kadian, MS Contin, Ora-Morph SR)
• oxycodone (OxyContin, Oxyfast, Percocet, Roxicodone)
• oxycodone and naloxone (Targiniq ER)

Many people with Fibromyalgia report adverse effects to treatment with these drugs and many say they cannot take them at all. 

These drugs seem to temporarily control the pain experienced in fibro and then often significantly complicate other aspects of the syndrome including nonrestorative sleep, fatigue, and irritable bowel symptoms including constipation.  

Other adverse effects such as sedation and mental clouding are also of particular concern in patients with FM because they may also have these problems, ususally called fibro fog, due to the syndrome. Finally, opioid-induced effects on sleep, such as sleep-disordered breathing, may further worsen unrefreshed sleep and fatigue .^[2]

SOURCES: 
 American Pain Society press release
WebMD Opioid (Narcotic) Pain Medications
Ngian GS, Guymer EK, Littlejohn GO. The use of opioids in fibromyalgia. Int J Rheum Dis. 2011;14:6–1
^[2] Wang D, Teichtahl H. Opioids, sleep architecture and sleep-disordered breathing. Sleep Med Rev. 2007;11:35–46.

This post is linked up at Fibro Friday week 63

Fibromyalgia and diet

As a fibro sufferer, and someone who always looks to what we eat as being important, I thought it was time I talked a bit more about diet and fibromyalgia.

Many people have turned to diet to help reduce their symptoms when other methods do not work. I have discovered that Fibromyalgia Syndrome requires a multi pronged attack and food is just one of those prongs. 

 
Please keep in mind that what works for one person very frequently does not work for another. 

This holistic approach may include strategies such as meditation, exercise, massage, acupuncture, pain medications, time in nature, homeopathy, supplements and much more. 

So back to diet... Here is the basis of what I have done to help reduce my own symptoms:

• Remove Aspartame (NutraSweet),  MSG (monosodium glutamate), Yeast and Nitrates from my diet.
• Eat more vegetables
• Eat one fruit at a time
• Eat a more varied diet
• Eat less foods out of packets
• Eat less bread
• Drink lactose free milk and not much of it

These are the things that have helped me and it has been a process of trial and error to work them out. Eating a more varied diet and eating more vegetables can help everyone. The other points may be more specific to me. 

There are a number of co-existing health conditions that have a tendency to occur in people with fibromyalgia. Many of these have overlapping symptoms. These include gluten intolerance, gout (a form of arthritis), and restless leg syndrome. Some doctors believe food sensitivity itself could sometimes be responsible for some of the pain and fatigue of fibromyalgia. MedicineNet

I can go into more detail about these points, if there is any interest over the next few weeks, otherwise here are some other links about the importance of diet in reducing fibro symptoms.

Fibromyalgia: The Diet Connection on MedicineNet.com

Learn about foods to avoid when you have fibromyalgia

Fibromyalgia and Diet: What's the Link? - WebMD

Certain foods might trigger fibromyalgia symptoms. 

WebMD tells you how diet can help you avoid fatigue and boost your energy.

Diet Tips For Fibromyalgia | Prevention

Fibromyalgia, a chronic disease that causes pain and swelling in more than a dozen points all over the body, affects as many as 5 million ...

Fibromyalgia Diet: Eating to Ease Symptoms - Healthline

Eating a healthy diet may ease your symptoms by helping you lose ...

Fibromyalgia: Foods That Help, Foods That Hurt ...

While no magic food will prevent every patient's

fibromyalgia flare-ups, a few dietary improvements 

can make a world of difference and may ...

Food Rules for Pain - Health.com

Although there is little clinical research on fibromyalgia and food, many patients 

say that following a careful diet can help ease aches and discomfort.

Fibromyalgia Diet - Tips & Advice on what to eat - A.Vogel

A fresh look at your diet can help you manage the condition of 

fibromyalgia – a condition giving rise to pain in muscles and 

other tissues in the body.

Diet and Exercise for Fibromyalgia - Fibromyalgia Network

Diet and exercise guidelines to help optimize function for fibromyalgia patients.

LINKED UP AT FIBRO FRIDAY N0. 26 and NO. 331 (in revised form)

Men with fibromyalgia

Fibro EA

Here I am trying to shed some light on what it is like to be a man with fibromyalgia. I have used comments from guys with the condition and the few studies I could find. 

"Men [with fibromyalgia] often feel broken, even suicidal," says Gavin Levy, an Austin, Texas-based writer who was diagnosed with fibromyalgia four years ago, at age 33. "We've all been there. It feels like your masculinity has been taken away to a degree. You are a provider and protector, then suddenly that role is reversed." 

"As well as being physically difficult, it’s emotionally draining. It feels like you are grieving for a lost life. Over time it takes its toll." says Rob Bimbler a UK blogger diagnosed with fibromyalgia.

"As a man living with Fibromyalgia, it strips me of my masculinity. I want to be the strength, dare I say the hero. But, I’m neither and it hurts me to my core."

"This condition is in no way an attempt to avoid yard work or similar household chores." says Peter, a US blogger living with fibromyalgia. "C’mon, only girls get this, right? Not me, right?"

"People used to respect me, and now, how can anyone respect what I have become? Weak, frail, in pain night and day, tired all of the time, and not enough energy to do anything.  Who could respect anything like that?  Who could love anyone like that?" Male with fibro. 

"I could not believe it. Nice having an answer, but come on… a women’s disease! One with no cure, poor prognosis, multiple medication failures." said Bob about receiving a diagnosis of fibromyalgia. " I was sent into an emotional downward spiral. This was a disease that you did not want to tell others that you had, they would not believe it was a disease anyway. I Looked fine!"

For men, fibromyalgia has an impact on physical health, and also largely on mental well-being, as well as relationships, and careers. We can see from these comments that there is a stigma attached to fibromyalgia for men regarding their feelings of masculinity, their abilities to continue working and the fact that fibro is considered a female condition. Many men feel extra stress due to the stigma of fibromyalgia being perceived as a women’s disease. Nearly 400 men in a Finnish study said that social expectations for men led them to have a different experience than women. 

What does the research about men with fibromyalgia have to say?

Recent studies indicate that the prevalence of fibromyalgia is increasing worldwide even though a 2012 study suggested that fibromyalgia is underdiagnosed in general, and even more underdiagnosed in men. The results suggest that patients, particularly men, who meet the fibromyalgia research survey criteria are unlikely to have been given a diagnosis of fibromyalgia.

Anyone can develop fibromyalgia but it is most common in adults with the highest rate in women. Men do get fibromyalgia and the ratio is reported at 9:1 that is 9 women for every man. Researchers are not clear why women have higher rates of diagnosis but I believe that it could be that men are either not reporting their symptoms or not being diagnosed with fibromyalgia as many people, doctors included, still believe that fibro is universally a syndrome that women get.

Do men and women have the same fibromyalgia symptoms?
Men seem to have some different symptoms than women according to a 2012 study. 
Men with fibro demonstrate a lower pain severity than women but a longer duration of symptoms and disability. Men have a higher pressure pain threshold (PPT) over the 18 tender points and over the second metacarpal and tibialis anterior muscle than women. the metacarpal is in the hand (see diagram) and the tibialis anterior muscle is in the (see diagram)

Palmer view of the left hand (second metacarpal shown in yellow).

 

Tibialis anterior muscle is in red

In men, the intensity of ongoing pain was associated to a more intense painful response over the neck. This study proposes that there may be a different observable type of fibromyalgia in women and men and confirms that women exhibit lower PPT than men.

In a 2018 survey, with more than 800 male participants with fibromyalgia, the top symptom experienced by the men was depression. 

“I have dealt with depression, anger issues, continual pain, inability to walk, think clearly, and unable to do many activities I previously could do. Many people shy away from me, as they don’t understand the concept of nonstop pain.” (41-year-old male)

Some of the participants talked about fibromyalgia leading to the onset or aggravation of mental health issue including depression, anxiety, post traumatic stress disorder and bipolar disorder. 

What men with fibromyalgia should do

Some of the men, included in this article, also expressed that they felt a relief after talking to other guys with fibromyalgia. So besides following the treatment options presented by your medical professionals we strongly suggest finding a fibromyalgia group for men or one that has men included. 

"Contact with others, some of them men, helped me to understand what I was dealing with and that I was not alone in this." said Doc from FibroNews. 

If you have any more information about fibromyalgia in men or some links you would like to be included please comment below. We would love to hear from you as we found the information to be very scarce.



Voices of Fibromyalgia

POSTS BY MEN ABOUT FIBROMYALGIA:

• What Fibromyalgia is Like for Me? by Rob Bimbler
• Fibromyalgia In Men – Effects Beyond the Symptoms by Dan Neuffer
• Fibromyalgia - Peter's journey

OTHER RESOURCES FOR MEN: 

PINTEREST Board Men with Fibromyalgia

Men with Fibromyalgia has a forum
FibroNews by Doc @Fibromen (twitter)
Facebook groups:
Men with Fibromyalgia (over 1000 members)
Fibro For Men (over 5,000 members)
Fibro Support for Men ( over 1,500 members)

FIBRO CONNECT private facebook group has men and women members.

ARTICLES:
Men with Fibromyalgia at National Fibromyalgia & Chronic Pain Association. (NFMCPA)
How Fibromyalgia Affects Men: Men With Fibromyalgia Talk About Their Symptoms, Diagnosis, and Dealing With Other People's Reactions at WebMD

SOURCES FOR THIS ARTICLE:

Understanding the Impact of Fibromyalgia on Men: Findings From a Nationwide Survey.

Daenuka Muraleetharan, MS, Ana Fadich, MPH, CHES, Colin Stephenson, 

Whitney Garney, PhD, MPH

Fibromyalgia, diagnosis and prevalence. Are gender differences explainable? Bartels, E., Jacobsen, S., Jesperson, A., et al. (2009).

Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project.Vincent A, Lahr BD, Wolfe F, Clauw DJ, Whipple MO, Oh TH, Barton DL, St Sauver J.

Gender differences in pain severity, disability, depression, and widespread pressure pain sensitivity in patients with fibromyalgia syndrome without comorbid conditions.

Castro-Sánchez AM, Matarán-Peñarrocha GA, López-Rodríguez MM, Lara-Palomo IC, Arendt-Nielsen L, Fernández-de-las-Peñas C

How Fibromyalgia Affects Men Article at WebMD

PubMed: Fibromyalgia in men and women: comparison of the main clinical symptoms

LINKED UP AT FIBRO FRIDAY

                                                                         

                                

Fibro research in 2014

This is a round-up of all the research into fibromyalgia, that I can find, from 2014. It is very pleasing to see so much research being done on fibro around the world. (It may take me some time to find and add all the studies so please call back if you are interested.)

Nocturnal blood pressure pattern unusual in Fibromyalgia patients
Nocturnal blood pressure is less likely to dip for patients with fibromyalgia when compared to healthy controls, according to research from Gazi University Medical School in Ankara, Turkey.

Specific cytokine lower in fibromyalgia patients
Plasma from female patients with fibromyalgia had lower levels of fractalkine cytokines than healthy control patients, according to results of a recently published study.

Guided imagery relaxation can reduce pain and depression in Fibromyalgia patients Guided imagery as a nursing intervention can alleviate pain and depression in patients diagnosed with fibromyalgia. Study: Walking more improves fibromyalgia symptoms Patients with fibromyalgia who gradually increased the number of steps walked daily had improved self-reported physical function, level of impairment and depressive symptoms with no negative impact on pain intensity. Whole-body vibration may reduce pain associated with fibromyalgia Whole-body vibration exercise effectively reduced the severity of pain in patients with fibromyalgia, according to study findings. Cryotherapy treatment used by Fibromyalgia sufferers A study from Italy reveals that fibromyalgia patients reported positive results after 15 cryotherapy sessions. Research finds nerve damage in patients with Fibromyalgia New findings reveal that patients with fibromyalgia may also have a diagnosable small fiber neuropathy. Fibromyalgia connected to problems with sense of smell Acupuncture Soothes Fibromyalgia And Helps Sleep Researchers determined that “acupuncture is an effective form of treatment for individuals with fibromyalgia” in a meta-analysis of eleven studies. Aspartame connections to fibromyalgia continue to be questioned A study from the Department of Rheumatology at Dijon University Hospital and the Faculty of Medicine at Burgundy University in France found aspartame-induced fibromyalgia was causing chronic pain in patients. Can a vegan diet help fibromyalgia patients? A study from the United States found that a vegan diet can help some fibromyalgia patients. The participants agreed to follow a raw vegetarian diet that consisted of fruits, vegetables, juices, nuts, seeds and tubers. After two months, they reported a significant reduction in their chronic pain and improved mobility. Fibromyalgia correlated with decreased brain connectivity Women with fibromyalgia also reported higher sensitivity to pain, suggesting that decreased brain connectivity can affect pain perception. Cognitive dysfunction of Fibromyalgia does not impair driving ability Fibromyalgia Mystery Finally Solved! Researchers Find Main Source of Pain in Blood Vessels Fibromyalgia sufferers have trouble processing sight, sound, touch A paper published in Arthritis & Rheumatology, Marina Lopez-Sola of the University of Colorado, Boulder, showed that people with fibromyalgia are hypersensitive to everyday sensory stimulation including sight and sound cues as well as touch. Gastrointestinal problems in Fibromyalgia Several studies have demonstrated an elevated comorbidity of irritable bowel syndrome (IBS) among patients with fibromyalgia. Celiac symptoms in Fibromyalgia patients Research shows a subgroup of patients with fibromyalgia could experience subclinical celiac disease or nonceliac gluten intolerance. Analgesic and anti-hyperalgesic effects of muscle injections with lidocaine or saline in patients with fibromyalgia syndrome. These results suggest that muscle injections can reliably reduce clinical FM pain Melatonin analgesia is associated with improvement of the descending endogenous pain-modulating system in fibromyalgia Melatonin alone or associated with amitriptyline was better than amitriptyline alone in improving pain Suffering from Fibromyalgia? Blame Your Herpes Virus (HSV) A recent study found a link between the herpes simplex virus (HSV) and Fibromyalgia (FM). Low-level laser therapy to treat Fibromyalgia Low-level laser therapy was found to provide relief from fibromyalgia symptoms in patients and should be the subject of additional investigation as a therapeutic tool for management in fibromyalgia. Abnormal epidermal nerve fiber density in Fibromyalgia Evidence of abnormal epidermal nerve fiber density in fibromyalgia Marked improvement of pain from long-term Fibromyalgia Fibromyalgia can be effectively treated with an innocuous dose of dextroamphetamine sulphate. Electrical Brain Stimulation for Fibromyalgia French study saw improvement in people's mood, quality of life Cluster system helps categorize Fibromyalgia severity Researchers have proposed a system of categorizing patients with fibromyalgia into clusters subsets, described in a new study. Music decreases pain and increases functional mobility in Fibromyalgia Cognitive and emotional mechanisms seem to be central to music-induced analgesia. Findings encourage the use of music as a treatment adjuvant to reduce chronic pain in FM and increase functional mobility thereby reducing the risk of disability. Believing and valuing the patient must be central part of Fibromyalgia therapy Primary qualitative research focusing on reconciling acceptance with moving forward with pain might help us to further understand the experience of pain. Metal allergy can trigger Fibromyalgia Metal-induced inflammation triggers fibromyalgia in metal-allergic patients. Interdisciplinary Fibromyalgia treatment benefits sustained Centralized pain may warn of poor opioid response Patients with centralized pain syndromes, such as fibromyalgia, may have a poor response to opioids, research suggests.   Circadian rhythm of cortisol in Fibromyalgia Concludes that there is an abnormality in circadian secretion of cortisol in female FMS patients. Vitamin D supplements can reduce chronic pain Vitamin D supplements can improve the symptoms of the debilitating chronic pain disorder Fibromyalgia Cough suppressant may ease Fibromyalgia pain Researchers found that the cough suppressant, dextromethorphan, temporarily diminished pain perception in both fibromyalgia patients and healthy adults. Fibromyalgia patients found to have low melatonin levels The involvement of melatonin in the clinical status of patients with fibromyalgia syndrome. Effects of exercise on serotonin in Fibromyalgia Effects of physical exercise on serum levels of serotonin and its metabolite in fibromyalgia: a randomized pilot study. Central sensitization in Fibromyalgia: A Systematic Review on Structural and Functional Brain MRI Imbalance between oxidants and antioxidants found in Fibromyalgia patients Reveals an imbalance in FM patients. The lower antioxidant enzyme activities may lead to oxidative stress through the oxidation of DNA and proteins, which may affect the health status of FM patients. Men with Fibromyalgia experienced greater sleep respiratory disorders than women Long-term evaluation of opioid treatment in Fibromyalgia Overall, the findings show little support for the long-term use of opioid medications in patients with FM given the poorer outcomes across multiple assessment domains. Skin-related symptoms in Fibromyalgia Patients with fibromyalgia may have skin-related symptoms associated with their fibromyalgia LINKED UP AT FIBRO FRIDAY No 12  and Read with Me