(Ivanhoe Newswire) -- The pain is sometimes so unbearable, patients can't get out of bed. For others it's just a constant aching and stiffness in the neck, shoulder, upper back, lower back and hip areas. This pain is often a condition known as fibromyalgia. It is diagnosed by identifying specific tender points on the body. It's a disorder that affects more than 2 percent of the U.S. population, and it is most common in women of childbearing age.

There is no cure or known cause for fibromyalgia, making the quest for an effective treatment very frustrating for many patients. According to Tamara Liller, President of the National Fibromyalgia Partnership, Inc.: "There are currently no FDA-indicated drugs for fibromyalgia at all. Patients currently rely on medications, designed for other illnesses that do not tend to be very effective for pain and other symptoms."

There are however, a number of research studies being conducted trying to find effective treatments for this often disabling disorder.

THE PAIN IS REAL

Patients have been complaining of this pain for years, but a skeptical medical community thought fibromyalgia might be a psychological problem vs. a physical one. But a new study finds fibromyalgia pain is not all in a patients' head.

The results of the study were published in the May 2002 issue of Arthritis & Rheumatism, the journal of the American College of Rheumatology. For the study, researchers used a super fast form of MRI brain imaging on 16 fibromyalgia patients and on 16 people without the disease. The patients had their brains scanned for more than 10 minutes while a small device applied varying amounts of pressure on their thumbnail. The pressures were varied using pain levels that were set before the scan.

Researchers say it only took mild pressure to produce self-reported feelings of pain in the fibromyalgia patients, while the healthy patients tolerated the same pressure with little pain. Lead researcher, Daniel Clauw, M.D., of the University of Michigan, says: "In the patients, that same mild pressure also produced measurable brain responses in areas that process the sensation of pain. But the same kind of brain responses weren't seen in control subjects until the presence on their thumb was more than doubled."

This study offers proof that fibromyalgia patients' pain is real and that some pathologic process is making these patients more sensitive to pain.

MORE THAN ONE TREATMENT

Fibromyalgia pain and symptoms vary from patient to patient and so do treatments. One treatment may work for some patients and not for others. Researchers have found some success with the following treatments:

• MEDITATION: Mindfulness meditation is a technique that encourages self-awareness and living in the present moment. A study done at the University of Louisville finds this type of meditation helps fibromyalgia patients. Associate professor of clinical psychology and lead research Paul Salmon, Ph.D., believes mindfulness meditation can have a profound affect on how a person approaches life. The study found this meditation was effective at reducing stress, pain, sleep difficulties, depression and the impact of fibromyalgia symptoms on the quality of life. Salmon believes meditation can help fibromyalgia patients be calm and accepting of stress and pain, rather than running and trying to hide from them.
• AQUATIC EXERCISE: Water exercises could be the key for some fibromyalgia patients, according to an ongoing program at Hammons Heart Institute at the University of Missouri-Columbia. The class started in 1995 and is tailored specifically for people with fibromyalgia. Instructors say when people are in the water they are using 10 percent to 20 percent of their actual body weight; therefore the amount of stress on the tender points of a person with fibromyalgia is reduced. The water also promotes greater range of motion. Instructors say they have found people with fibromyalgia experience the dual benefit of a rigorous exercise routine followed by a period of relaxation in the water.
• AEROBIC EXERCISE: British researchers report an exercise program may ease the pain suffered by people with fibromyalgia. Researchers studied the use of a community center exercise program among 136 patients with fibromyalgia. Half of the patients did aerobic exercise twice a week and the other half did relaxation and flexibility training. Researcher report those who exercised fared significantly better than those who were assigned to receive relaxation and flexibility training. Researchers also report that at the one-year follow up, fewer participants in the exercise group still had fibromyalgia.
• MASSAGE THERAPY: For some fibromyalgia patients, massage therapy is beneficial. Researchers at the Touch Research Institute in Miami say that may be because massage alters the sleep pattern in patients; which then reduces the amount of pain. Researchers studied 20 fibromyalgia patients who received either massage therapy or relaxation therapy twice weekly. They found both groups of patients showed a decrease in anxiety and depression, but the big difference was found in their sleep. Only the massage therapy group reported an increase in the number of hours they slept and a decrease in sleep movement. Researchers say sleeping better after massage therapy may be why massage is beneficial for some patients with fibromyalgia.
• ACUPUNCTURE: A Swiss study reports an improvement in fibromyalgia patients who received acupuncture. The study included 70 patients who either received acupuncture at the correct points or the incorrect points. Patients kept track of their pain level, medication use, sleep quality and morning stiffness. Researchers say after three weeks, around 75 percent of the correctly treated group saw improvements in seven of the eight reported areas. Researchers at the University of Washington are now conducting a United States study looking at acupuncture for fibromyalgia. The results of this study are expected in 2003.
• BEHAVIORAL THERAPY: Duke University Medical Center researchers are conducting a study to look at how cognitive behavioral therapy affects those with fibromyalgia. The study specifically focuses on those patients with insomnia. Researchers say previous research has shown reducing sleep disturbances has a positive effect on patients with fibromyalgia. Researchers say the current study will be randomized and include 60 patients.
• GROWTH HORMONE INJECTIONS: Some research has indicated that fibromyalgia may be due to low levels of growth hormone. New research done in Spain finds growth hormone injections can relieve pain and stiffness in patients. Researchers say they have found a high number of fibromyalgia patients have low levels of insulin-like growth factor 1 (IGF-1). Growth hormone injections increase IGF-1. In the small study, researchers report the women on the injections reported less pain. Researchers now plan to study treating patients with an oral drug that increases production of growth hormone.

While there is no simple answer when it comes to treatment for fibromyalgia patients, the fact is there are treatments that help some patients. Terry Cronan, Ph.D., from San Diego State University, has done extensive research into fibromyalgia treatments. One of her recent studies focused on evaluating treatments for fibromyalgia patients. The study was published in the Journal of Musculoskeletal Pain.

The research reports a combination treatment program can be effective for fibromyalgia patients. However, researchers say the studies conducted on this disorder need to include longer follow-ups with patients for stronger conclusions. The authors also state, "Studies should be conducted as randomized, controlled trials, so that firmer conclusions about treatment efficacy can be reached."

THE FUTURE

As patients continue to be desperate for answers, researchers continue to search for treatment options. Cypress Bioscience, Inc. focuses on the development of drugs for patients with functional somatic syndromes such as fibromyalgia syndrome. Right now, they are studying the drug milnacipran as a treatment option for fibromyalgia patients with more studies beginning in 2003. Milnacipran is already approved for treatment of depression in 22 countries and is the third best selling antidepressant in Japan. Milnacipran is said to have less side effects than other antidepressant drugs.

Besides drugs, another area of research that is up and coming for fibromyalgia patients is brain stimulation. It's called Flexyx neuropathy and essentially it resets the brain of a fibromyalgia patient. Research has shown that some of the debilitating symptoms of this disorder could be a result of brain injury. The Flexyx Neurotherapy System is being studied by researchers at Neurotherapy Center of Washington in Maryland and Rush-St. Luke's Presbyterian Hospital in Chicago.

Like many diseases, fibromyalgia could also be genetically related. The Fibromyalgia Family Study is currently underway by Jane Olson, Ph.D. from Case Western Reserve University. The research is focusing on the genetic aspects of fibromyalgia.

CONCLUSION

Fibromyalgia is a complex disorder that affects millions of Americans. It is a relatively young disease so research is really just beginning. Public awareness about this disease is increasing, making it easier for patients to understand that their pain is real and not in their heads. Experts say it's important for patients to understand that there is no cure for this disease, but there is help in controlling the symptoms. The trick is finding which treatment will work for each individual patient.

This article was reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the week. To subscribe, go to: http://www.ivanhoe.com/newsalert/.

If you would like more information, please contact:

National Fibromyalgia Partnership, Inc.
140 Zinn Way
Linden, Virginia U.S.A. 22642-5609
Phone: 866-725-4404
Fax: 866-666-2727
http://www.fmpartnership.org

Fibromyalgia Network
P.O. Box 31750
Tucson, AZ 85751
(800) 853-2929
http://www.fmnetnews.com/

American Fibromyalgia Syndrome Association, Inc.
6380 E. Tanque Verde, Suite D
Tucson, AZ 85715
(520) 733-1570
http://www.afsafund.org/

National Fibromyalgia Association
Lynne Matallana, Director
2238 N. Glassell Street, Suite "D"
Orange, CA 92865
Phone: (714) 921-0150
Fax: (714) 921-6920
Email: [email protected]
http://www.fmaware.org

Fibrohugs.com
Ken & Donna Euteneier
167 Scarth St. NORTH
Regina, Saskatchewan
S4R 2Z4 Canada
http://www.fibrohugs.com/

National Institute of Arthritis and Musculoskeletal and Skin Diseases
www.niams.nih.gov