Fibromyalgia and Chronic Fatigue Syndrome; Are they the same thing

Many people get these two diseases confused and interchange the terms. Fibromyalgia and Chronic Fatigue Syndrome (CFS) are different diseases with similar symptoms. Some people unfortunately even have both conditions. Fibromyalgia is a disorder that causes muscle pain and fatigue. Chronic fatigue syndrome (CFS) is a complex disorder with profound fatigue that is not improved with rest and may worsen with physical or mental activity. Both conditions have similar symptoms but have some unique qualities. Fibromyalgia is characterized with trouble sleeping, morning stiffness, headaches, painful menstrual periods, tingling or numbness in hands and feet and problems with thinking and memory (“fibro fog‚Äù). CFS patients will also suffer from short-term memory or concentration problems, muscle pain, and headaches; additionally they will only achieve unrefreshing sleep, exhibit tender lymph nodes, and experience joint pain without swelling or redness.

 

Both conditions are difficult to diagnose and define. As a result many patients feel stigmatized as suffering from a mental condition rather than a physical one. There are no specific diagnostic tests available for concrete diagnosis of either condition. In many cases the diagnosis is made by excluding other known conditions before a diagnosis of CFS or Fibromyalgia is made. Elimination of other conditions such as hypothyroidism, sleep apnea, narcolepsy, chronic mononucleosis, bipolar affective disorder, alcohol or substance abuse must be ruled out before diagnosing CFS or Fibromyalgia. There is no effective treatment other than treating the symptoms of either condition.

 

The cause or causes of these conditions is unknown. Genetic and environmental factors may play a role in causing and prolonging these illnesses. Fibromyalgia has been linked to stressful or traumatic events, repetitive injuries, other illness and diseases. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) some scientists think that a gene or genes might be a factor in developing fibromyalgia.

 

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Recent research is linking a virus as the cause of Chronic Fatigue Syndrome. This research is being done at Whittemore Peterson Institute in Reno under the guidance of Dr. Judy Mikovits. In her recently released study Dr. Mikovits has identified a virus called xenotropic murine leukemia virus (XMRV) in patients who have CFS. The National Cancer Institute is taking XMRV seriously and is conducting its own studies.

 

Chronic conditions such as Fibromyalgia and CFS wreck havoc with peoples lives. Inability to concentrate on tasks, move without pain or achieve any meaningful rest disturbs normal family and work patterns. According to the Centers for Disease Control and Prevention (CDC) somewhere between 1 and 4 million Americans suffer from Chronic Fatigue Syndrome (CFS). About 25% of these patients are seriously impaired and can not work and are on disability. 40% of people in the general population who report CFS symptoms have a serious, treatable, undetected medical or psychiatric condition such as diabetes, thyroid disease or substance abuse. CFS strikes more women than men between the ages of 30-50.

 

Fibromyalgia affects 5 million Americans according to the NIAMS. 80-90% of patients are women. Most are diagnosed in middle age. Women with a family member with fibromyalgia may be more likely to have this disease. Additionally people with rheumatoid arthritis, systemic lupus erythematosus or spinal arthritis might be predisposed to develop fibromyalgia.

 

Both conditions are difficult to diagnosis, have no cure and generally are long term chronic conditions which can seriously disrupt an individual’s normal life. It is important to seek medical treatment to rule out other medical or psychiatric conditions and to learn to manage the underlying symptoms of these conditions.

ABCNews quotes Andrea Goldstein, a study author at the University of California at Berkeley as saying, "Our results suggest that just one night of sleep loss significantly alters the optimal functioning of this essential brain process, especially among anxious individuals.”

This impacts an individual’s personal and professional relationships and ability to function in either setting.

Sleep deprivation often starts early on in life but it is important to manage it as much as possible.

Creating a sleep schedule with a set bedtime can help increase the amount of hours a person sleeps.

The most important thing to remember is that if you are having sleep issues, or have concerns about your sleep habits, seek the help of a professional who can assist you further.

Fibromyalgia Advocacy Sheet

A person affected with fibromyalgia could visit several doctors before being diagnosed with the condition, and a lot is still not known about the disorder. Fibromyalgia is considered a syndrome, not a disease, that is associated with and can overlap arthritis.

A person with symptoms of fibromyalgia may experience widespread pain, body tenderness and sensitivity, headaches, painful menstrual periods, sleep disturbances and fatigue, morning stiffness, sensitivity to loud noises and temperature in addition to other, often overlapping symptoms.

While it is still uncertain what causes fibromyalgia, research has shown that acute stress such as that occurring with a car accident or some other traumatic incident could contribute. Researchers also agree that fibromyalgia is a disorder of abnormal sensory processing in the central nervous system causing pain amplification. There are ongoing studies working toward further understanding of the disorder.

■How is fibromyalgia diagnosed? There are no laboratory tests for diagnosing fibromyalgia, so doctors have to rely on patient history, reported symptoms, physical examination, and accurate manual tender point examination (based on American College of Rheumatology standards). It is important to work with a doctor familiar with fibromyalgia if you suspect you may have this condition.

■How do I know if what I’m feeling could be fibromyalgia? If you are experiencing multiple symptoms, contact your doctor. According to The National Institute of Arthritis and Musculoskeletal and Skin Diseases, women and people with family members who have had fibromyalgia are most likely to develop fibromyalgia.

■How is fibromyalgia treated? Your doctor may suggest you see a specialist (rheumatologist) for proper diagnosis and treatment, unless your doctor is skilled in dealing with fibromyalgia. When treating the disorder, doctors will form a program of pain and sleep management, psychological support, and possibly other treatments like physical and/or massage therapy to help relieve symptoms.

■What is the long-term risk? As new information about fibromyalgia is developed, patients can find ways to improve their quality of life despite the lack of a cure. While there is prescription medication available, it is only a step in improving patient treatment.

■What information should I share with my doctor if I suspect fibromyalgia? It is important to keep track of symptoms, medications and supplements, what seems to help or worsen your condition, personal and family medical history, and share it with your doctor.

■Is there any research I can do on my own and what sources would you recommend? Your doctors can suggest their favorite web sites for obtaining more information and helping you cope with fibromyalgia.

How Many Medications Do You Take? Do You Need Them All?

Imagine this story. A woman has high cholesterol, requiring her to take a pill to lower her numbers. This causes her muscles to feel sore, inducing her to take routine pain medications.

The pain starts to wear on her affecting her mood, so she swallows an antidepressant that causes nausea, therefore she uses an anti-nausea medication to help her get through the day.

One of these medications causes mild to moderate heartburn at night therefore she cannot sleep and requires a heartburn medication on days she remembers, and if not she pops something for sleep.

Some days she does both for good measure.

This may sound like a joke, however the journal ACS Chemical Neuroscience published a report that 4.02 billion drug prescriptions were doled out last year. That is a whole lot of medications.

Leading the list in sales is Lipitor (for cholesterol) followed by Plavix (blood clots), Nexium (heartburn), Abilify (depression and bi-polar), Advair (asthma), Seroquel (depression and bi-polar), Singulair (asthma), Crestor (cholesterol), Cymbalta (depression), and Humira (autoimmune arthritis and Crohn’s disease).


In terms of actual prescriptions versus sales, the 2010 numbers show that the pain medication hydrocodone/APAP (commonly known as Vicodin) tops the list followed by Amoxicillin (antibiotic), Lipitor (cholesterol), Levothyroxine (thyroid), Lisinopril (blood pressure), Simvastatin (cholesterol), Plavix (blood clots), Nexium (heartburn), and Singulair (asthma).

Interestingly, the top psychiatric medicine routinely prescribed is Xanax which is commonly used for anxiety, however it is addictive and should be used sparingly.

This goes to show you the extremely high amount of stress and anxiety in our society in the last year (or two) given the numbers.

Looking at the sales numbers and actual numbers sheds a lot of light onto the health issues of Americans. Clearly pain, cholesterol, and psychiatric issues are a huge issue requiring a lot of medication.

One in 8 with fibromyalgia uses cannabis as medicine

One in eight people with the painful condition fibromyalgia self-medicate with pot and other cannabis products, according to a new Canadian study.

"That is not unusual behavior, in general, for people with chronic medical illnesses for which we don't have great treatments," said Dr. Igor Grant, who heads the Center for Medicinal Cannabis Research at the University of California and was not involved in the study.

"People start looking around, they look for other types of remedies, because they need the help," he told Reuters Health.

The question is if self-medicating with cannabis is really helpful for people with fibromyalgia, researchers say.

Marijuana has been shown to ease certain types of pain in patients with HIV and other conditions. But Grant said he doesn't know of any research showing the drug can relieve the pain associated with fibromyalgia.

And the question of whether it helps fibromyalgia sufferers regain some of their daily functions, such as housekeeping or working, remains up in the air, too.

"We don't want to just see pain reduction, but an improvement in function," said Peter Ste-Marie, a pain researcher at McGill University in Montreal, who worked on the new study. "If it's not helping them get back into a daily life pattern, is it helping them?"

People with fibromyalgia typically experience pain in their joints and muscles and may also suffer from frequent headaches and fatigue.

According to the Centers for Disease Control and Prevention, about two percent of adults have fibromyalgia, which remains a mystery to scientists.

About Fibromyalgia Pain

In the United States, about 5 million people have fibromyalgia, with 80 to 90 percent of patients being women, according to the U.S. Department of Health and Human Services Office on Women’s Health.

Patients with fibromyalgia have pains that occur all over their body — above and below the waist and on both sides of the body. The MayoClinic.com noted that the pain that fibromyalgia patients experience is described often as “a constant dull ache, typically arising from the muscles.”


In addition to the widespread pain, patients with fibromyalgia have additional pain at certain parts of the body when pressure is applied. These areas are called “tender points.”

There are 18 tender points, or nine pairs of tender points. These include:


• Inside of the knee

• Back of the neck behind the patient’s ear

• The midway point between the tip of the shoulder and the base of the neck

• Behind the bony part of the hip

• Above and toward the outside of the buttocks

• The area in which the back muscles meet the shoulder blade

• Above the collarbone

• Below and to the outside of the elbow crease

• Either right or left of the sternum


Finding the right treatment to manage the pain of fibromyalgia can be difficult and patients may need to try different treatments until they find the one that works best for them. Medications are one option. The U.S. Department of Health and Human Services Office on Women’s Health noted that several medications are approved by the U.S. Food and Drug Administration for fibromyalgia, including milnacipran, pregabalin and duloxetine.

The MayoClinic.com recommended that patients with fibromyalgia pain come up with a list of coping strategies when their pain becomes severe. Options include avoiding negative talk (instead of saying “I cannot do anything because of this pain,” say instead “I can do many things, but I just need to take breaks throughout the day"), telling other people about the symptoms, asking for help when it is needed, and using relaxation techniques.

Another option is cognitive behavioral therapy, a type of psychotherapy