Monday, November 19, 2012

Fibromyalgia Not a big secret, but does your doctor know? by Celeste Cooper

Many of us have been psychologically bruised. We've endured hurtful comments by those in charge of our healthcare, family and friends; I speak for over five million Americans.  But one thing I know for certain, knowledge is our power.

Most agree fibromyalgia is due to a disruption in the Hypothalamus Pituitary-Adrenal (HPA) axis.  Big words that indicate a disruption in a major system of our brain (part of the central nervous system, CNS, which also includes the spinal cord) and its ability to properly receive sort and respond to messages from the peripheral nervous system which is everything outside the CNS. This breakdown in communication between the body and the brain not only leads to amplification (centralization) of pain, it also explains why other conditions co-occur with fibromyalgia, but not in say, low back pain (also thought to be centralized pain.)

The primary symptoms of FM are:

1)      Body-wide pain.
2)      Non-restorative sleep causing fatigue.
3)      Cognitive deficit causing trouble finding words, onset of dyslexic behavior, and memory problems.   

If your healthcare provider tells you other symptoms are from fibromyalgia, they are not, but they could be due to a co-occurring condition, also called comorbid.  For instance, feeling cold could be attributed to Raynaud’s syndrome or hypothyroidism.  The same is true for dry skin and mucous membranes, which might indicate, SICCA, Sjögren’s or hypothyroidism.  Bloating could be due to small bowel intestinal overgrowth, IBS, or leaky gut syndrome. Visual disturbances could be associated with migraine, both silent and classic, or knotted up pieces of muscle fiber (called myofascial trigger points) in the face or neck, etc.  It is important for your doctor to understand the comorbid conditions, because the criterion for diagnosing each of these disorders is specific and having them appropriately treated will minimize aggravating factors to fibromyalgia, your pain and ability to cope effectively.

Conditions to be considered are:

 ·         Chronic fatigue syndrome/myalgic encephalomyelitis·         Hypothyroidism
·         Raynaud’s
·         Adrenal problems
·         Myofascial Pain Syndrome
·         Allergies
·         Bowel  -  irritable bowel syndrome (IBS),  Small intestine bacterial overgrowth (SIBO), Leaky Gut Syndrome (LGS)
·         SICCA or Sjögren’s
·         Bruxism
·         TMJ/TMD
·         Systemic Lupus erythematosus
·         Hypothyroidism  and possible Hashimoto’s
·         Interstitial Cystitis or irritable bladder
·         Restless Leg Syndrome
·         Severe headache/migraine
·         Postural Orthostatic Tachycardia Syndrome
·         Neurally Mediated Hypotension
·         Depression and anxiety
·         Rheumatoid Arthritis
·         Ankylosing Spondylitis
·         Lupus (SLE)
·         Idiopathic edema (unexplained swelling)
·         Piriformis syndrome
·         Pelvic Pain (endometriosis, pelvic floor pain, sexual dysfunction, rectal pain, vulvodynia, and impotence)

The biological aspects of FM have been greatly ignored.  Primary physicians are not always adequately trained in diagnosing fibromyalgia.  They have their own continuing medical education requirements and professional journals that focus on being adept at family and primary medicine.  If you feel you physician does not consider what I have presented here, or he/she is unwilling to look into your symptoms further, should you have them, get a second opinion.

We all need to be diligent about knowing our body, noting any blatant or subtle changes in symptoms, and to track and report them, after all, who else will care as much as we do?  Identifying and treating all aggravating factors, including overlapping conditions can have a profound impact on how we feel. 

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All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  

Celeste Cooper is a retired RN, educator, fibromyalgia patient, and lead author of the Broken Body Wounded Spirit: Balancing the See Saw of Chronic Pain devotional series (coauthor, Jeff Miller PhD), and Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome and Myofascial Pain: The Mind-Body Connection (coauthor, Jeff Miller PhD) She is a fibromyalgia expert for Dr. Oz, et al., at, here, and she advocates for all chronic pain patients as a participant in the Pain Action Alliance to Implement a National Strategy, here. You can read more educational information and about her books on her website,

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