About 10 million Americans have fibromyalgia , which is characterized by painful, tender points along the body; fatigue; sleeplessness; and cognitive issues known as fibro fog.
Unfortunately, people with fibromyalgia are more likely than people in the general population to have certain other conditions too. If you have fibromyalgia, here are seven other health concerns. Credit: Corbis. Tension headache may also respond to biofeedback. Replay gallery. Pinterest Facebook. Up Next Cancel. By Denise Mann. Share the Gallery Pinterest Facebook. Skip slide summaries Everything in This Slideshow.
The progression of fibromyalgia may be dependent on increased ROS. Treatment with antioxidants and vitamins, in addition to antidepressants and structural analogs of gamma-aminobutyric acid, was able to change the florid symptoms of FM patients [ ]. Certain groups of bioactive compounds derived from medicinal plants have also demonstrated analgesic activity and antioxidant properties with respect to FM: these include essential oils [ ], extracts [ ], monoterpenes [ ], sesquiterpenes [ ] and alkaloids [ ] Table 3.
FM is a complicated syndrome characterized by chronic pain, joint rigidity, fatigue, sleep interruption, cerebral dysfunction and depression. Research on FM is becoming progressively more significant because of the compromised quality of life of patients and the economic weight on the medical care system. The pathogenesis of fibromyalgia is not well known, and the diagnosis is only clinical at present. Oxidative stress, mitochondrial dysfunction, multivitamin deficiencies and a disproportion between oxidants and antioxidants are interesting and clinically attractive topics that require further study to clarify the state and development of FM.
To date, no objective tests or biomarkers with sufficient diagnostic accuracy have been identified, and current analyses can only indicate a predisposition to fibromyalgia. Numerous studies, however, provide insights into the pathophysiology of fibromyalgia. Proteomic research as well as gene expression profiling may have potential applications as novel methods for the diagnosis of FM. Pharmacological treatment alone is inadequate for the majority of patients who suffer from FM syndrome.
Given the different mechanisms of pain sensitivity, treatments will continue to involve multidisciplinary programs that target the peripheral, central, cognitive-emotional and interpersonal causes of the chronic pain that characterizes FM pathophysiology.
Writing—original draft preparation, D. All authors have read and agreed to the published version of the manuscript. National Center for Biotechnology Information , U. Int J Mol Sci. Published online Apr 9. Find articles by Rosalba Siracusa. Find articles by Rosanna Di Paola. Find articles by Daniela Impellizzeri. Emanuele Marzetti, Academic Editor. Author information Article notes Copyright and License information Disclaimer. Received Jan 27; Accepted Apr 7.
See letter " Comment on Siracusa et al. This article has been cited by other articles in PMC. Abstract Fibromyalgia is a syndrome characterized by chronic and widespread musculoskeletal pain, often accompanied by other symptoms, such as fatigue, intestinal disorders and alterations in sleep and mood. Keywords: central sensitization, cognitive-emotional sensitization, biomarkers, genetic aspects, therapy.
Fibromyalgia Fibromyalgia FM is a syndrome characterized by chronic musculoskeletal pain. Open in a separate window. Figure 1. The dots indicate the 18 tenderness points important for the diagnosis of FM. Pathophysiology The pathophysiological factors of FM are not yet well known and continue to be the focus of much research. Figure 2. Ascending and descending pathways that influence pain sensitivity.
Inflammation and Immunity Increasing evidence indicates that neurogenic-derived inflammatory processes occurring in the peripheral tissues, spinal cord and brain are also responsible for the pathophysiology of FM [ , , ]. Genetic Aspects Over the years, studies have shown the potential involvement of genetic factors in the onset of FM [ , ].
Endocrine Factors The role of stress in the exacerbation of fibromyalgia symptoms has been widely described from an epidemiological point of view through both self-reports and clinical questionnaires. Psychopathological Factors and Poor Sleep As previously highlighted, psychiatric comorbidities in fibromyalgia constitute a relevant aspect of the disease, and a close correlation between stress and fibromyalgia symptoms has been described several times.
Table 1 Candidate genes in the pathogenesis of FM [ ]. Genetic Approach The prevalence of fibromyalgia in family clusters and several studies supports the theory that genetic factors, in conjunction with environmental causes such as trauma, illnesses or emotional stress, could predispose individuals to FM. Epigenetic Modifications Previous studies have shown that early life experience and environmental factors in general may modulate genome function and the phenotype through epigenetic mechanisms without changing the DNA sequence [ ].
Gene Expression Since gene expression is modulated by epigenetic pathways, studies have compared transcriptional changes between FM patients and controls. Mu-Opioid Receptor on B Lymphocytes as a Biomarker It is important to note that the endogenous opioid system is similar to the immune system due to the presence of opioid receptors on the lymphocyte membrane.
Serological Markers There is considerable interest in using a simple blood test to diagnose fibromyalgia. Table 2 Blood markers for FM diagnosis. Autoantibodies The association between antipolymer antibody APA and fibromyalgia was assessed because APAs were present in the serum of women with fibromyalgia-like signs [ ].
Neuropeptides Neuropeptide Y has been shown to both decrease and induce pain. Glutamate Compared to healthy controls, fibromyalgia patients displayed higher levels of glutamate compounds in the right amygdala, and pain was associated with elevated levels of glutamate in the left thalamus [ ].
Inflammatory Cytokines Cytokines have been suggested to be involved in fibromyalgia syndrome, but the findings tend to be controversial, particularly because there have been reports of increases, decreases and no substantial changes.
Proteomic Approach It has become generally accepted in the last few years that the genome represents only the first layer of complexity. Metabolomic Approach In an untargeted 1 H NMR metabolomics examination of urine samples, a group of clinically well-defined female FM patients with no psychiatric co-morbidities could be completely distinguished from a group of young healthy women [ ]. Antioxidants and Diet for Fibromyalgia Management Fibromyalgia patients produce higher levels of harmful free radicals than healthy people and have a decreased antioxidant ability, contributing to oxidative stress.
Table 3 Compounds with antioxidant and analgesic properties for FM management. Compound Effects References Melatonin In an animal study, melatonin was able to improve behavioral defects, oxidative and nitrosative stress, mast cell infiltration and activation of microglia in a reserpine-induced FM model.
The combination of amitriptyline and melatonin provided better results than amitriptyline alone, as calculated by the visual analog pain scale, in subjects with FM. In particular, an association has been found between vitamin D deficiency and FM. However, its role in FM pathophysiology and the clinical relevance of its identification and treatment requires further clarification. Only vitamin E appears to be related to quality of life and pain sensation. Preclinical and clinical studies support the idea that PEA merits further consideration as a therapeutic approach for controlling inflammatory responses, pain, related peripheral neuropathic pain and symptoms of FM.
Conclusions FM is a complicated syndrome characterized by chronic pain, joint rigidity, fatigue, sleep interruption, cerebral dysfunction and depression. Author Contributions Writing—original draft preparation, D. Funding This research received no external funding.
Institutional Review Board Statement Not applicable. Informed Consent Statement Not applicable. Data Availability Statement Not applicable. Conflicts of Interest The authors declare no conflict of interest. References 1. Gerdle B. Prevalence of widespread pain and associations with work status: A population study. BMC Musculoskelet. Bennett R. An internet survey of people with fibromyalgia. Bellato E. Fibromyalgia syndrome: Etiology, pathogenesis, diagnosis, and treatment.
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Koca T. Epstein S. Psychiatric disorders in patients with fibromyalgia. A multicenter investigation. Leino P. Depressive and distress symptoms as predictors of low back pain, neck-shoulder pain, and other musculoskeletal morbidity: A year follow-up of metal industry employees. Mindfulness Meditation. Mindfulness meditation is a type of meditation that involves completely focusing on experiences on a moment-to-moment basis.
In several studies, mindfulness meditation training has led to short-term improvements in pain and quality of life in people with fibromyalgia. However, the number of studies is small, and the quality of the evidence is relatively low, so no definite conclusions can be reached. Frequent practice of mindfulness techniques may be important for good results. In a study of mindfulness for fibromyalgia, those participants who practiced mindfulness more frequently had a greater reduction in symptoms.
Mindfulness and other forms of meditation are generally considered to be safe for healthy people. However, they may need to be modified to make them safe and comfortable for people with some health conditions. More information about meditation. Other Mind and Body Practices. Natural Products. It has been suggested that deficiencies in vitamin D might worsen fibromyalgia symptoms. In one study of women with fibromyalgia who had low vitamin D levels, 20 weeks of vitamin D supplementation led to a reduction in pain.
Researchers are investigating whether low magnesium levels contribute to fibromyalgia and if magnesium supplements might help to reduce symptoms. Other natural products that have been studied for fibromyalgia include dietary supplements such as soy, S-adenosyl-L-methionine SAMe , and creatine, and topical products containing capsaicin the substance that gives chili peppers their heat.
Even vitamins and minerals including vitamin D and magnesium can be harmful if taken in excessive amounts. Other Complementary Approaches.
Balneotherapy is the technique of bathing in tap or mineral water for health purposes; it also includes related practices such as mud packs. Balneotherapy has a good safety record. Homeopathy is a medical system based on the unconventional idea that a disease can be cured by highly diluted solutions of a substance that causes similar symptoms in healthy people. Studies of homeopathy have not demonstrated that it is beneficial for fibromyalgia.
Highly diluted homeopathic remedies are generally safe. However, not all products labeled as homeopathic are highly dilute; some may contain substantial amounts of ingredients and therefore could cause side effects. More information about homeopathy. Magnetic Therapies. Static permanent magnets are found in magnetic mattress pads, shoe inserts, bracelets, and other products.
Electromagnets are used in a type of treatment called transcranial magnetic stimulation TMS , which influences brain activity. Food and Drug Administration has approved certain TMS devices for treating migraine and treatment-resistant depression. A small number of preliminary studies have evaluated TMS for fibromyalgia symptoms, and some have had promising results. Magnets and magnetic devices may not be safe for people who have metal implants or medical devices such as pacemakers in their bodies.
Headaches have been reported as a side effect in several studies of TMS for fibromyalgia. More information about magnets. The study showed no effect of Reiki on pain or any of the other outcomes measured in the study physical and mental functioning, medication use, and visits to health care providers.
Reiki appears to be generally safe. More information about Reiki. Recent NCCIH-sponsored studies have been investigating various aspects of complementary and integrative interventions for fibromyalgia, including: The effectiveness of traditional Chinese medicine for treating fibromyalgia How tai chi compares to aerobic exercise as an adjunctive treatment for fibromyalgia symptoms Whether brain responses to placebos differ between people with fibromyalgia and healthy people.
More To Consider. Be aware that some complementary health approaches—particularly dietary supplements—may interact with conventional medical treatments. Tell all your health care providers about any complementary or integrative health approaches you use.
Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care. For More Information. Toll-free in the U. National Institute of Arthritis and Musculoskeletal and Skin Diseases NIAMS The mission of NIAMS is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases.
MedlinePlus To provide resources that help answer health questions, MedlinePlus a service of the National Library of Medicine brings together authoritative information from the National Institutes of Health as well as other Government agencies and health-related organizations. Key References. Reiki for the treatment of fibromyalgia: a randomized controlled trial.
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