Fibromyalgia Complications

Fibromyalgia Complications

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    There is often concern on the part of people with fibromyalgia (FM), and sometimes doctors, that FM is the early phase of a more severe disease, such as multiple sclerosis, lupus, etc. Long-term follow-up of people with fibromyalgia has shown that it is very unusual for them to develop another rheumatic disease or neurological condition.

    However, it is quite common for people with "well-established" rheumatic diseases, such as rheumatoid arthritis, systemic lupus and Sjogren's syndrome, to also have fibromyalgia. It is important for these patients' doctors to realize that such a combination of problems exists, since specific therapy for rheumatoid arthritis and lupus, etc. does not have any effect on FM symptoms.
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    ARealAge answered

    Irritable bowel syndrome (IBS) sometimes accompanies fibromyalgia. If patients have frequent gastric upset -- such as constipation, diarrhea, painful gas or abdominal bloating -- they should ask their physician whether they could be suffering from IBS. They should also learn to avoid the foods and habits that trigger their symptoms. High-fat foods, caffeine, and alcohol often are culprits. At the same time, upping their intake of high-fiber foods may help these and other fibro symptoms.

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    ARealAge answered

    Although less common than other coexisting conditions, temporomandibular joint dysfunction (TMJ) develops in about one-quarter of fibromyalgia patients. It's not entirely clear why, although stress may be a culprit. It causes people to clench and grind their teeth and may lead to spasms in the muscles of the jaw.

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    ACeleste Cooper, Rheumatology, answered

    Like fibromyalgia, severe headaches have a central nervous system and myofascial component. This is how fibromyalgia may trigger a headache or vice versa, a severe headache can also trigger other symptoms associated with fibromyalgia. Understanding this connection is important for finding a resolution. 

    Cervicogenic migraine is a severe headache that is perpetuated or preceded by neck pain, which many fibromyalgia patients also have. If you start to feel the marble or golf ball starting to form at the base of your skull, if you can feel a tiny knot in your scalp or on your face, particularly around the eyes or temple, or you have pea size knot or taut neck muscle, you have a myofascial component to your headache. What you are feeling is knotted up pieces of muscle fiber. They can be easily felt unless behind bone or other large muscle, and they radiate muscle and nerve pain, tingling and numbness in a specific pattern.

    Tension has been associated with fibromyalgia and tension type headaches are both the result of muscles that don’t respond correctly.  Find a physician that understands fibromyalgia and myofascial pain syndrome.  Bringing the myofascial component under control will help by blocking the peripheral input to the brain. In fibromyalgia the pain is intensified and other conditions such as teeth grinding, a central mediated disorder that results in development of more myofascial trigger points, and TMJ, which can result from myofascial trigger points pulling the jaw out of alignment can feed off of each other.   

    Alonso-Blanco C, et al. 2012. Muscle trigger point therapy in tension-type headache. Expert Rev Neurother. 12(3):315-322.

    Alonso-Blanco C, et al. 2012. Characteristics of referred muscle pain to the head from active trigger points in women with myofascial temporomandibular pain and fibromyalgia syndrome. J Headache Pain. 

    Ge HY. Prevalence of myofascial trigger points in fibromyalgia: the overlap of two common problems. Curr Pain Headache Rep. 2010 Oct;14(5):339-45
    Fernandez-de-las-Penas C. 2010. New evidence for trigger point involvement in tension-type headaches. J Musculoskel Pain. 18(4):354-360. 

    Küçükşen S, et al. The prevalence of fibromyalgia and its relation with headache characteristics in episodic migraine. Clin Rheumatol. 2013 Feb 27. [Epub ahead of print]

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    ADawn Marcus, Neurology, answered
    Bladder or urinary problems may also occur with fibromyalgia, although these have been studied less extensively than bowel problems. The National Institutes of Health recently formed a Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network to help better understand the causes of chronic conditions such as unexplained bladder or pelvic pain.

    In general, studies show an increased risk for several pelvic or urinary tract problems with fibromyalgia:
    • Three in five women with fibromyalgia report pelvic pain, including vulvodynia -- pain of the external female genital organs that make up the opening to the vagina.
    • One in five have interstitial cystitis, which is unexplained bladder pain and pressure, with a frequent need to urinate and increased pain during urination.
    • People with interstitial cystitis or unexplained bladder pain are more likely to have fibromyalgia, irritable bowel syndrome (IBS), or chronic fatigue syndrome (CFS). Half of the people who have unexplained bladder pain will also have at least one of these other conditions.
    If you are experiencing pain or other symptoms involving your bladder or genital area, ask your doctor to do a pelvic examination. Many easily treatable conditions, such as infection can also cause similar symptoms.
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    ADawn Marcus, Neurology, answered
    Irritable bowel syndrome (IBS) is consistently associated with increased pain hypersensitivity and fibromyalgia. Approximately two in five people with fibromyalgia have IBS. In addition, approximately one in three people with IBS will also be diagnosed with fibromyalgia.
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    ADawn Marcus, Neurology, answered
    Digestive complaints are common in fibromyalgia, including:
    • Irritable bowel syndrome in two of five people with fibromyalgia.
    • Bloating in two of five people with fibromyalgia.
    • Indigestion or heartburn in one of five people with fibromyalgia.
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    ADawn Marcus, Neurology, answered
    A study published in the Clinical Journal of Pain found that women with fibromyalgia are less likely to have a baby. This study compared the number of children born to women with a painful jaw condition called temporomandibular dysfunction (TMD) but no fibromyalgia, women with TMD plus fibromyalgia, and healthy women without pain issues.

    Women with fibromyalgia had 10% fewer pregnancies than either the TMD women without fibromyalgia or the pain-free women. The percentage of women who had never been pregnant was also highest in women with fibromyalgia:
    • 36% of the women with fibromyalgia had never been pregnant.
    • 31% with TMD but no fibromyalgia had never been pregnant.
    • 27% of the healthy women had never been pregnant.
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    ADawn Marcus, Neurology, answered
    Obesity is a global epidemic that affects approximately one-quarter of adults in the United States and Europe and one-fifth of adults in China. Obesity is generally defined as weighing 20% or more over your ideal body weight. Being overweight is even more common among people with fibromyalgia. Seven in every ten people with fibromyalgia are overweight, and half can be classified as obese.
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    ACeleste Cooper, Rheumatology, answered

    As far as we know fibromyalgia does not cause other medical conditions, however, there are certain disorders that cluster with fibromyalgia:

    • Raynaud’s and sensitivity to cold
    • Hypothyroidism
    • Gastrointestinal disorders, such as small intestine bacterial overgrowth (SIBO) and leaky gut syndrome (LGS)
    • Irritable bladder
    • Interstitial cystitis

    Myofascial pain syndrome (MPS) also known as chronic myofascial pain (CMP), which is the presence of myofascial trigger points

    • Insomnia
    • Disordered sleep
    • Cognitive dysfunction
    • Dry mucus membranes (SICCA syndrome)
    • Severe headache
    • Jaw dysfunction and pain (which could be contributed to MPS/CMP)
    • Restless Leg Syndrome
    • Anxiety or depression

    It is felt that most of these comorbid conditions have a common connection in the central nervous system and that is why they cluster together.

    It is important to evaluate each of them if fibromyalgia is suspected, because treatments may overlap, but are specific to each condition.

    All blogs, posts and answers are based on the work in Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-Body Connection by Celeste Cooper, RN, and Jeff Miller, PhD. 2010, Vermont: Healing Arts press and are not meant to replace medical advice.  www.thesethree.com

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