Understanding fibromyalgia is easy: listen to the patient!
"Doc! My muscles are painful and tense – it feels like cramps and spasms."
That's exactly what understanding fibromyalgia (fibromyalgia pathophysiology) is about: a muscle cells' disease
Normally, muscle cells are supposed to contract when needed and then to relax.
In fibromyalgia disease they contract non-stop without being able to relax! Instead of a whole muscle getting a cramp (e.g. the calf muscle) it's a patchy number of muscle fibres getting crampy within a given muscle. But it happens in many muscles.
This is why fibromyalgia disease is a diffuse disease with muscle pains on both sides and in many muscles.
How come those muscle cells can't relax?
Let's start with a normal muscle cell.
When a muscle cell needs to contract, it gets a signal from a nerve. This signal is received by a bag (the endoplasmic reticulum) that contains a huge amount of calcium. At rest, the calcium stays in the bag because it is controlled by magnesium. When the signal to contract gets there, the magnesium moves away from the bag (and goes to the mitochondria). Now, the calcium can get out of the bag and reaches a complex of molecules that contract when calcium is present. These complexes of molecules (the actin–myosin complex) will contract as long as there is calcium.
To relax, the calcium must be pumped back inside the bag. All those reactions consume an enormous amount of energy that is provided by the mitochondria.
In fibromyalgia the bag is leaking so the contraction carries on.
Worst, there is also a lack of magnesium! The magnesium not only controls the release of calcium from the bag but it is also necessary to the mitochondria to produce energy.
Not enough magnesium = not enough control of calcium released from the bag and not enough energy available from the mitochondria.
Not only the bag is leaking calcium but the pumps necessary to get the calcium back into the bag cannot work properly because there is no energy available.
So now, you understand what fibromyalgia is:
leaking bag + decreased magnesium = uncontrolled contraction
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Understanding the signs of fibromyalgia is not only understanding the fibromyalgia spasm. It is also understanding:
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