CHRONIC FATIGUE & FIBROMYALGIA

Pain - People describe the pain as deep muscular aching, throbbing, shooting, and stabbing. Intense burning may also be present. Quite often, the pain and stiffness are worse in the morning and you may hurt more in muscle groups that are used repetitively.

Fatigue - This symptom can be mild in some patients and yet incapacitating in others. The fatigue has been described as "brain fatigue" in which patients feel totally drained of energy. Many patients depict this situation by saying that they feel as though their arms and legs are tied to concrete blocks, and they have difficulty concentrating, e.g., brain fog.

Sleep disorder - Most FMS patients have an associated sleep disorder called the alpha-EEG anomaly. Researchers found that most FMS patients could fall asleep without much trouble, but their deep level (or stage 4) sleep was constantly interrupted by bursts of awake-like brain activity. Patients appeared to spend the night with one foot in sleep and the other one out of it.

Many FMS patients have been found to have other sleep disorders in addition to the alpha-EEG, such as sleep apnea (as well as the newly discovered form of interrupted breathing called upper airway resistance syndrome, or UARS), bruxism (teeth grinding), periodic limb movement during sleep (jerking of arms and legs), and restless legs syndrome (difficulty sitting still in the evenings).

Irritable Bowel Syndrome - Constipation, diarrhea, frequent abdominal pain, abdominal gas, and nausea represent symptoms frequently found in roughly 40 to 70% of FMS patients. Acid reflux or gastroesophogeal reflux disease (GERD) also occurs with the same high frequency.

Chronic headaches - Recurrent migraine or tension-type headaches are seen in about 70% of FMS patients.

Temporomandibular Joint Dysfunction Syndrome or TMJ causes tremendous jaw-related face and head pain in fibromyalgia patients. Typically, the problems are related to the muscles and ligaments surrounding the jaw joint and not necessarily the joint itself.

Other common symptoms - Premenstrual syndrome and painful periods, chest pain, morning stiffness, cognitive or memory impairment, numbness and tingling sensations, muscle twitching, irritable bladder, the feeling of swollen extremities, skin sensitivities, dry eyes and mouth, dizziness, and impaired coordination can occur. Patients are often sensitive to odors, loud noises, bright lights, and sometimes even the medications that they are prescribed.

Aggravating factors - Changes in weather, cold or drafty environments, infections, allergies, hormonal fluctuations (premenstrual and menopausal states), stress, depression, anxiety and over-exertion may all contribute to symptom flare-ups.

POSSIBLE CAUSES

The cause for both remains unknown, however various infectious agents such as Epstein Barr virus, Herpes v-6, Candida, Mycoplasma, Enteroviruses and Influenza have been implicated. Many triggering events thought to precipitate the onset such as infections (viral or bacterial), gut dysbiosis, an automobile accident or the development of another disorder, such as rheumatoid arthritis, lupus, or hypothyroidism.

These triggering events probably don't cause the condition, but rather, they may awaken or cause alterations in pain-related chemical transmitters (particularly substance P, nerve growth factor, serotonin, and other neurotransmitters), immune system function (e.g. abnormally elevated levels of cytokines that form the communications link between your immunologic and neurologic systems), sleep physiology, and hormonal irregularities. Substance P and nerve growth factor are increased threefold and fourfold (respectively) in the spinal fluid of people with FMS.

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