Fibromyalgia and Sjögren's Syndrome

Well this article from News Medical Life Sciences was definitely of interest to me as I have both Fibromyalgia and Sjögren's Syndrome (SS). I was actually diagnosed with SS first and then when some symptoms did not fit with it the rheumatologist said I also had Fibro. 

You can watch the video or read the transcript below it. 

Studies have explored the possibility of fibromyalgia and Sjögren's syndrome coexisting in a patient. Researchers have found that fibromyalgia is more common in patients with primary Sjögren's syndrome who complain of fatigue as their main symptom.

Fibromyalgia is a common and chronic disorder characterized by widespread muscle pain, fatigue, and multiple tender points.

Sjogren's Syndrome is a systemic autoimmune disorder with the main tissues attacked are the eye's tear glands and the salivary glands of the mouth. 

The resulting inflammation and destruction of these glands leads to the symptoms of dry eyes and a dry mouth that characterize the condition.

These are just the basic points of both of these conditions and believe me they are both very complex conditions that affect the whole body.

Studies have shown that nearly 68% of patients with primary Sjögren's syndrome have fatigue as a major symptom. 

Fatigue is a common symptom in 12% patients who have both fibromyalgia and primary Sjögren's syndrome as diagnosed by set criteria.

In addition patients with primary Sjögren's syndrome also have severe sleep problems that are seen in a large majority of these patients.

Fatigue, as well as dryness of the mucous membranes within the mouth as seen in primary Sjögren's syndrome is commonly seen in patients with fibromyalgia.

Fibromyalgia may present alone or in combination with other diseases like primary Sjögren's syndrome. (This correlates with what I have just found out - people classified as having primary fibromyalgia (PFM) have a defined set of pain, fatigue, cognitive, and psychological symptoms but do not have an inflammatory disorder. People classified as having secondary fibromyalgia (SFM) do have another inflammatory disease such as sjogren's syndrome or rheumatoid arthritis. Read more about this)

In patients with primary Sjögren's syndrome fibromyalgia has been found in 44 to 55% patients according to some studies.

This information is important because the treatment plan in Fibromyalgia and SS is different and because SS can have serious complications such as lung problems and lymphoma. 

SS is usually diagnosed by an ANA test - Antinuclear Antibody test  and 40% to 70% of patients with SS have a positive ANA test result. 

This result supports the diagnosis but is not required for diagnosis. The doctor may want to test for SSA and SSB subsets of ANA. 

Autoantibodies are antibodies created by the immune system that attack the body rather than a foreign object, and they are not found in Fibromyalgia.

The early stages of Sjogren's Syndrome are often picked up by an opthalmologist because of dry eyes, blepharitis, or by a dentist because people with SS have a dry mouth which causes many cavities.

Often, a rheumatologist, a doctor who specializes in diseases of the joints, muscles, and bones,  may diagnose the syndrome.

READ FULL ARTICLE

Find out more about Sjögren's syndrome.

Find out more about Fibromyalgia.

I would love to hear from you in the comments below if you have Fibromyalgia and Sjögren's Syndrome too. 

Primary and Secondary Fibromyalgia Are The Same

Well this is news to me as I didn't even know there was Primary and Secondary Fibromyalgia!

Apparently people classified as having primary fibromyalgia (PFM) have a defined set of pain, fatigue, cognitive, and psychological symptoms but do not have an inflammatory disorder. People classified as having secondary fibromyalgia (SFM) do have another inflammatory disease such as sjogren's syndrome or  rheumatoid arthritis.

Researchers led by Frederick Wolfe, MD, of the National Data Bank for Rheumatic Diseases and the University of Kansas in Wichita, studied patients with primary and secondary diagnoses to see if they “had the same level of outcomes, symptoms, and characteristics” at different points across the polysymptomatic distress (PSD) scale. PSD is a measure to assess the severity in fibromyalgia. I also have never heard of this even though I have Fibromyalgia. As far as I am aware no doctor has ever used this scale on me, and I have seen many specialists. The researchers state that the "PSD can identify criteria-positive FM with > 90% accuracy."

The PSD is calculated by combining two measurements used in fibromyalgia: the widespread pain index (WPI), which counts the number of painful regions in the body, and the somatic symptom scale (SSS), which measures fatigue, sleep, emotional and cognitive problems, and the extent of symptom reporting. 

In their research they studied 1525 patients with a clinical diagnosis of FM and 12,037 patients with rheumatoid arthritis (RA). 

Their Conclusion was that PFM and SFM are equivalent regarding the symptom burden.

But what this new research also shows, Dr Wolfe said, is that while up to now “you couldn’t easily study people with fibromyalgia [in other disorders], it doesn’t matter if you have RA or another disorder in addition to fibromyalgia. You get the full spectrum or severity regardless. The underlying disease wouldn’t affect your identification of the fibromyalgia symptoms.”

This research Primary and Secondary Fibromyalgia Are The Same: The Universality of Polysymptomatic Distress was published online in the Journal of Rheumatology in July 2018.

RESOURCES: Rheumatology News and The Journal of Rheumatology

MY TAKE ON THIS: As I had never heard of these terms PFM and SFM I am wondering if they are terms used a lot in the US and not in Australia where I live. As I have 3 autoimmune diseases as well as Fibromyalgia I was interested to find out that I had SFM but then this report really says they should be treated as the same condition!

Acupuncture for Chronic Pain: an update

PracticeUpdate  July 2018

The authors of this meta-analysis examined 39 trials including 20,827 participants with nonspecific musculoskeletal pain, osteoarthritis, chronic headaches, or shoulder pain in an attempt to end the controversy regarding appropriateness of acupuncture for chronic pain.

Despite wide use in clinical practice, acupuncture remains a controversial treatment for chronic pain. 

Our objective was to update an individual patient data meta-analysis to determine the effect size of acupuncture for 4 chronic pain conditions. 

We searched MEDLINE and the Cochrane Central Registry of Controlled Trials randomized trials published up until December 31, 2015. We included randomized trials of acupuncture needling versus either sham acupuncture or no acupuncture control for nonspecific musculoskeletal pain, osteoarthritis, chronic headache, or shoulder pain. 

The main outcome measures were pain and function. 

We also found clear evidence that the effects of acupuncture persist over time with only a small decrease, approximately 15%, in treatment effect at 1 year. 

We conclude that acupuncture is effective for the treatment of chronic pain, with treatment effects persisting over time. Although factors in addition to the specific effects of needling at correct acupuncture point locations are important contributors to the treatment effect, decreases in pain after acupuncture cannot be explained solely in terms of placebo effects. 

RESULTS

Acupuncture is effective for the treatment of chronic musculoskeletal, headache, and osteoarthritis pain. Treatment effects of acupuncture persist over time and cannot be explained solely in terms of placebo effects. Referral for a course of acupuncture treatment is a reasonable option for a patient with chronic pain.

My PERSPECTIVE

These findings show that acupuncture has a clinically relevant effect on chronic pain.

This study agrees with previous articles I have written about Acupuncture for Fibromyalgia on Fibro Files.  Many previous scientific studies support the use of acupuncture in reducing symptoms, as do my personal experiences. 

Hydrotherapy Benefits Fibromyalgia Patients Only If They Stick With It, Study Reveals

Hydrotherapy — physical exercise performed in water — can effectively improve clinical symptoms of fibromyalgia only if performed continuously.

That finding was drawn from data collected in a randomized, controlled trial, reported recently in the study “Effects of aquatic training and detraining on women with fibromyalgia: controlled randomized clinical trial.” The study was published in the European Journal of Physical and Rehabilitation Medicine.

Several non-pharmacological strategies have been proposed to manage fibromyalgia symptoms. Among the non-pharmacological possibilities is aquatic physical training, or hydrotherapy, which consists of an aerobic physical training program that is conducted in a heated pool. This alternative treatment option reduced pain and improved the quality of life of fibromyalgia patients.

METHODS

To have a better understanding of the benefits of hydrotherapy, Brazilian researchers conducted a controlled trial. The study enrolled a total of 54 women with clinically diagnosed fibromyalgia who were randomly assigned to undergo hydrotherapy or just perform their normal daily life activities.

The training program consisted of 32 sessions of 45 minutes, twice a week, for a total of 16 weeks. Each session included a 10-minute warm-up phase, 30 minutes of intense exercise, and five minutes of relaxation exercises.

RESULTS

After 16 weeks of hydrotherapy training the participants showed a significant improvement in their aerobic capacity compared to baseline levels, and compared to those in the control group. Also, after the training program the patients said they experienced less fatigue and anxiety, and improved well-being, functional capacity, and vitality.

The patients showed a 7% reduction in pain scores, 192% increase in SF-36 physical function, and a reduction of 19% in FIQ score after completion of the 16 weeks of therapy.

However, these positive effects were lost during the following 16 weeks, in which the participants stopped the training program. 

CLINICAL REHABILITATION IMPACT

The team believes that aquatic physical training “should be continuously performed in order to improve clinical symptomatology and increase the aerobic functional capacity” of those living with fibromyalgia.

READ STUDY REPORT 

MY OWN EXPERIENCES WITH HYDROTHERAPY

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My Wish (Self Love for beginners)

Today's post is by Fibro advocate Sharna Stewart

           

          If I could wish you anything besides good health it would be the ability to love your true authentic self. I wish this for my beautiful niece and all the other readers out there, disabled, abled, chronically ill and everyone else who falls in the majority or minorities of humanity.

          My advice being, not to wait the 34 years and counting, it has taken me to even mutter the phrase ‘self love’. I understand this is no easy wish I’m bestowing on you, but I have to believe that your generation will commence life with a full and healthy dose of self esteem that’s resilient to the bumps and hurdles that happen along the way. A good cup of worthiness, affection, trust and love for yourself, no matter the roads in which you choose to follow. An acceptance that allows you to forgive the multitude of 3am anxiety attacks that see you in tears on the bedroom floor or the number of times you have beaten yourself up for being sick, unreliable, disappointing, boring, a burden and most importantly an overall ‘drain’ on the multidisciplinary healthcare system. 

          In conclusion, try to learn to see yourself through your loved ones eyes and open yours to the incredible real ‘you’, the kind, loving, generous, bubbly, wholesome girl you are and will grow to be. Don’t give in to the deceitful chatter that creeps in when things don’t go as planned, know your self worth and always love you, unconditionally.
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About Sharna Stewart

Sharna is an advocate for Fibromyalgia Awareness. She has had fibromyalgia and CFS for 5 1/2 years.
You can connect with her through her twitter account.

She would like to connect with anyone suffering from fibromyalgia, chronic fatigue syndrome (ME), Gastroparesis, Tachycardia and Irritable Bowel Syndrome. 

She wants to share her knowledge of mental health related issues and the latest treatments for pain management, including but not limited to ketamine, CBT, infrared saunas, float tanks and GET.