More Fibromyalgia News

To understand why you suffer from fibromyalgia, click on the book!

Computer Problems in Fibromyalgia

Problems experienced by people with arthritis when using a computer.Baker NA, Rogers JC, Rubinstein EN, Allaire SH, Wasko MC.Arthritis Rheum. 2009 May 15;61(5):614-22. Here is a new study that shows that amongst people with arthritis, fibromyalgia patients have the most problems in using computers. The usual culprits are:. chair. keyboard. mouse. monitor

More studies are needed.

Great care must be taken to position, height of chair in relation to keyboard and monitor. Remember also to get up and walk a bit around every 15 minutes to avoid stiffness and more pain.

Pregabalin (Lyrica): Really Useful?

Through an unknown mechanism it decreases the central nervous system activity (brain and spinal cord). That’s why it is an anti-epileptic (epilepsy is an abnormal hyperactivity of the brain and anti-epileptics decrease it). That means that any anti-epileptic has a slowing effect on the brain activity.

This is why all anti-epileptics have a positive effect on any pain. And that is by slowing brain activity. They do not cure the pain, they decrease its feeling.

But, the effect on pain depends on the balance between the pain intensity and the effect on brain slowing activity. If the pain does not change and the effect on brain slowing activity decreases: the pain comes back.

Because the cause of the pain is not treated, at best the pain remains the same, at worst it increases. Like any other medication, anti-epileptics tend to loose their effect over time. The end result is a short-lived betterment.

Then starts the increase of dosage in anti-epileptics. And the side effects increase!

This has always been the same with all anti-epileptics. The more powerful the anti-epileptic effect, the more powerful the anti-pain effect and the worst the side effects.

And we are told that anti-epileptics have more effect on specific pains! That's plain rubbish!

Their effect is the same on any pain, from headaches to central pain. In fact, they are now used by some as pre-operative pre-medications to decrease the post-operative pain! It may be advantageous in some situations, but it is unlikely to become a rule given their side effects!

The end effect on pain tends to be incomplete and short lived. The longest study* of pregabalin (Lyrica) effect on fibromyalgia was over 6 months only! When we know that fibromyalgia is a life long painful disease, that's a bit short!

The end result at 6 months was betterment of 13% whilst the betterment from placebo (sugar) was 10%. Only 3% better than sugar! That's a ridiculous difference.

I know, I know! The numbers are not really presented that way because they're playing with the percentage. Let's take an example: if you have 100 patients and 10 of them get better at 2 months, that's 10% of patients better. Now if you take those 10 patients and at 6 months 5 of them are better, that's 50% of the 10 patients better.

In fact, it is only 5% of the original 100! That's the way they show a result in a better light.

So 3% more than with sugar! But in the meantime, some 40% developed side effects and had to stop the medication. Interestingly, they don't tell us if the side effects corrected! I doubt very much that the gains in weight corrected and that's a cause for concern about the quality of life!

Is it really justified to inflict more problems on some 40% of patients for 3% betterment?

This may very well have played a role in the European decision to refuse pregabalin (Lyrica) its status as a fibromyalgia therapy.

Fibromyalgia status as a recognised disease may suffer from that, but the suffering from the indiscriminate use of a debatable therapy is by far a higher threat.

*Fibromyalgia relapse evaluation and efficacy for durability of meaningful relief (FREEDOM): A 6-month, double-blind, placebo-controlled trial with pregabalin. Crofford LJ, Mease PJ, Simpson SL, et al. Pain. 2008;136:419–31.

Fibromyalgia News. Lack of Muscle Relaxation: More Proof

Muscle modifications in fibromyalgic patients revealed by surface electromyography (SEMG) analysis. Bazzichi L, Dini M, Rossi A, Corbianco S, De Feo F, Giacomelli C, Zirafa C., Ferrari C, Rossi B, Bombardieri S.BMC Musculoskelet Disord. 2009 Apr 15;10(1):36

ABSTRACT: BACKGROUND: Several studies have been carried out in order to investigate surface electromyography (SEMG) response on fibromyalgic (FM) patients. Some studies failed to demonstrate differences between FM patients and healthy individuals while others found differences in SEMG parameters. Different muscular region have been analyzed in FM patients and heterogeneity is also produced because of the different ways in which the SEMG technique is used. The aims of this study were to evaluate muscle modifications by SEMG analysis in FM women with respect to a sample of healthy controls and to investigate the relationships between SEMG parameters and the clinical aspects of the disease. METHODS: SEMG was recorded in 100 FM women (48.10+/-11.96 yr) and in 50 healthy women (48.60+/-11.18 yr), from the tibialis anterior and the distal part of vastus medialis muscle during isometric contraction. Initial values and rate of change of median spectral frequency (MDF) and conduction velocity (CV) of the SEMG signal were calculated. The clinical parameters "Fibromyalgia Impact Questionnaire", pain, tender points, tiredness were evaluated and the relationships between these data and the SEMG results were also studied. For the statistical analysis Mann-Whitney test, chi-square test and Spearman correlation were used.

RESULTS: MDF absolute values and the so-called Fatigue Index (FI) were significantly lower (p<0.001) in both muscles studied in FM patients (MDF: 93.2 microV; FI: 1.10, 0.89) with respect to healthy controls (MDF: 138.2 microV; FI: 2.41, 1.66) and a smaller reduction in the percentage values of MDF was observed in FM patients vs controls (22% vs 38%). A significant correlation was found between the SEMG parameter decrement of normalized median frequency (MNF) (%) and seriousness of FM (evaluated by means of tender points).

CONCLUSIONS: We have found some interesting muscle modifications in FM patients with respect to healthy controls, regarding MDF, CV and FI values which resulted significantly lower in FM. Patients might have a different fiber recruitment or a possible atrophy of type II fibers suggesting that they are not able to reach muscle relaxation.

Elevated CRP in Fibromyalgia

Comment: Study showing that CRP, an inflammatory marker, is elevated in fibromyalgia. Strangely, the study of diverse diseases in elderly men includes osteoporosis and fibromyalgia. Those 2 diseases are not very prevalent in men. The study finds also an increase in other diseases such as diabetes or myocardial infaction that are not only so common in elderly men but also as an association with fibromyalgia. What was the association of other diseases in the fibromyalgia sufferers? It is so common as to wonder what is the real cause of the elevated CRP in fibromyalgia!

C-reactive protein variations for different chronic somatic disorders. Haheim LL, Nafstad P, Olsen I, Schwarze PE, Ronningen K. Scand J Public Health. 2009 Apr 16.

AIMS: To compare the levels of C-reactive protein (CRP) in a range of chronic disorders such as osteoporosis, asthma, diabetes, chronic bronchitis/emphysema, myocardial infarction, current oral infections, stroke, angina pectoris, hay fever, and fibromyalgia/chronic pain syndrome. METHODS: In all, 5,323 men took part in the first and second health screening of the Oslo Study in 1972/73 and 2000. Questionnaire information on medical history recorded at the second screening was used to identify men with relevant diseases. Serum samples collected in 2000 were stored for later analyses of CRP. In 2000 the men were aged 48-77 years. RESULTS: Men with self-reported myocardial infarction, asthma, diabetes, chronic bronchitis/emphysema, osteoporosis or fibromyalgia/chronic pain syndrome had significantly elevated mean levels of CRP versus non-cases. Men with osteoporosis had the highest mean values of 6.53 versus 3.55 mg/l in participants without this disease. Cases of asthma also had an increased mean CRP level of 5.01 versus 3.47 mg/l in non-cases and in chronic bronchitis/emphysema the corresponding levels were 4.42 versus 3.59 mg/l. Men with diabetes had 4.53 versus 3.53 mg/l and men with myocardial infarction had 4.27 versus 3.59 mg/l. In fibromyalgia/chronic pain syndrome the values were 4.79 mg/l and 3.60 mg/l respectively. Conclusions: Elevated CRP levels were observed in elderly men in a number of chronic diseases, indicating a persistent inflammatory response. Mean levels varied according to the disease and indicated a baseline level in the individuals with a particular disorder. This is useful knowledge when CRP is used in the clinic for infection and inflammation status.

The Central Pain Theory: Another Study Against It!

Comment:The central pain theory to explain fibromyalgia is based on the fact that there are changes in brain function in fibromyalgia patients. However those changes are present in any chronic pain condition. Moreover, Central Pain is a very specific condition that always exists with a lesion of the central nervous system. No lesion of the central nervous system has ever been recorded in fibromyalgia. Here is another study that cannot find any. The changes in the brain are secondary to the chronic pain condition and not the explanation! Fibromyalgia is a muscle disease!

Hsu MC, Harris RE, Sundgren PC, Welsh RC, Fernandes CR, Clauw DJ, Williams DA. No consistent difference in gray matter volume between individuals with fibromyalgia and age-matched healthy subjects when controlling for affective disorder. Pain. 2009 Apr 15.

Fibromyalgia (FM) is thought to involve abnormalities in central pain processing. Recent studies involving small samples have suggested alterations in gray matter volume (GMV) in brains of FM patients. Our objective was to verify these findings in a somewhat larger sample using voxel-based morphometry (VBM), while controlling for the presence of affective disorders (AD). T1-weighted magnetic resonance image (MRI) brain scans were obtained on 29 FM patients with AD, 29 FM patients without AD, and 29 age-matched healthy controls (HCs) using a 3T scanner. Segmentation, spatial normalization, and volumetric modulation were performed using an automated protocol within SPM5. Smoothed gray matter segments were entered into a voxel-wise one-way ANOVA, and a search for significant clusters was performed using thresholding methods published in previous studies (whole-brain threshold of p<.05 correcting for multiple comparisons; region-of-interest (ROI) threshold of p.001 uncorrected, or p<.05 small-volume corrected). The whole-brain analysis did not reveal any significant clusters. ROI-based analysis revealed a significant difference in left anterior insula GMV among the three groups (xyz={-28, 21, 9}; p=.026, corrected). However, on post-hoc testing, FM patients without AD did not differ significantly from HC with respect to mean GMV extracted from this cluster. A significant negative correlation was found between mean cluster GMV and scores of trait anxiety (State-Trait Personality Inventory, Trait Anxiety scale; rho=-.470, p<.001). No other significant clusters were found on ROI-based analysis. Our results emphasize the importance of correcting for AD when carrying out VBM studies in chronic pain.

Fibromyalgia News: Do you really have fibromyalgia? Fibromyalgia Test is free