Running head: FIBROMYALGIA 1

Fibromyalgia

Gina Leymeister

BIO 208/ 02

Dr. Bertoti

Alvernia University

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Fibromyalgia

Etiology

Fibromyalgia is characterized as a widespread chronic pain syndrome without a well-

defined underlying organic disease. This pain is related to the genetics affecting transport or

metabolism of dopamine, epinephrine, norepinephrine, and serotonin. However, the etiology and

pathogenesis of fibromyalgia are not fully understood. There are several factors that seem to be

affected by the process of fibromyalgia. These factors include the dysfunction of the central and

autonomic nervous systems, neurotransmitters, hormones, immune system, external stressors,

and lastly psychiatric aspects (occurs mostly in people who do not express signs of depression).

Gower’s first described fibromyalgia in 1904. He then coined the term “fibrositis”, which was

used until the seventies and eighties, until the etiology of the central nervous system was

discovered by Graham. In 1950, Graham introduced the modern concept of fibromyalgia,

following the coined term by Smythe and Moldofsky in the mid-1970s. Fibromyalgia was then

identified to be " the regions of extreme tenderness or the so-called ‘tender points'"

("Fibromyalgia: MedlinePlus")

Neurologic Signs and Symptoms

Signs and Symptoms

Mood disorders, fatigue, cognitive dysfunction, nonrestorative sleep, insomnia

Consciousness

Difficulty concentrating

Communication and Memory

Impaired: working memory, ability to recall specific events, ability to think quickly

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Sensory, Autonomic & Motor

Widespread pain, stiffness

Inconsistent reports

Normal

(Ludy- Ekman, 152) Neurological Damage

The main region of the nervous system affected by fibromyalgia is the central nervous

system. The central nervous system dysfunction attributes to the atypical sensory processing in

the central nervous system, the dysfunction of skeletal muscle nociception, and the dysfunction

of the hypothalamic pituitary adrenal axis. Research shows that the brain of an individual who

suffers from fibromyalgia has significantly less grey matter density. In addition, the pain

inhibition areas are significantly less active than in healthy individuals. Therefore, those who

have the neurological condition of fibromyalgia have impaired descending pain inhibition. Also,

the neural responses to afferent signals are amplified (“Fibromyalgia”).

Main Goals of Treatment/ Intervention

The main goal of treatment for those who have fibromyalgia is to identify and explain

one's symptoms, along with encouragement to develop and maintain an active exercise program.

In addition, another main goal is to control the pain and to improve pain function. These goals

mentioned prior could be met by using a variety of techniques. Often one will benefit from the

low- dose use of an antidepressant. The antidepressants that are most commonly used to treat

fibromyalgia are 25 mg of amitriptyline (Elavil) or 20 mg of fluoxetine (Prozac). However, the

dosage of the drug has to be individualized (Millea & Holloway).

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On the other hand, if one does not receive well to the use of antidepressants, there are

alternative therapeutic measures. Some of these therapies include exercise, hypnosis, growth

hormone therapy, behavior therapy, acupuncture, or chiropractic treatment. More specifically,

the use of exercise intervention, involving aerobic and strength training, significantly improves

the patient's pain, but the maintenance of the exercise regimes tends to be poor. However, one

must find the appropriate therapy measure for him or her that fits best (Millea & Holloway).

Future Directions

Currently, The Journal of Alternative and Complementary Medicine has conducted a

study that involves tilting whole body vibration. The objective of this study was to analyze the

effect of 12-week tilting Whole Body Vibration therapy (WBV) on the Health Related Quality of

Life (HRQoL) in fibromyalgia. The subjects of the study were thirty-six women with

fibromyalgia, who met the diagnostic criteria of the American College of Rheumatology. The

following exclusion criteria were applied: physical trauma, frequent migraines, peripheral nerve

entrapment, inflammatory rheumatic disease, and severe psychiatric illness (Olivares, Gusi &

Parraca et al).

The tilted WBV was self- administered. The group attended initial thirty -minute

instruction session to familiarize them with equipment and explain the training protocol. The

WBV sessions were performed three times a week for a period of twelve weeks. Each session

included ten-minute warm up which involved slow movements. Following the warm up, was six

repetitions of tilting WBV at the frequency of 12.5 Hz (hertz) with sixty seconds between each

repetition. The duration of each repetition was thirty-seconds during weeks 1-4, forty-five

seconds during weeks 5-8, and sixty seconds during weeks 9-12. The individual would alternate

between two stances at each repetition. One stance would have the left foot positioned slightly

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ahead, the other with the right foot positioned slightly ahead. The stance alteration was done

throughout the twelve weeks (Olivares, Gusi & Parraca et al).

In conclusion, the main finding from the study was that the Whole Body Vibration

therapy was a feasible intervention that prevented the loss of Health Related Qualities of Life in

those who suffer from fibromyalgia.

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References

Fibromyalgia: MedlinePlus. Retrieved from https://www.nlm.nih.gov/medlineplus/fibromyalgia.html

Fibromyalgia. Retrieved from

http://www.mayoclinic.org/diseases-conditions/fibromyalgia/basics/definition/con-

20019243

Result Filters. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23213512

Fibromyalgia. Retrieved from http://www.niams.nih.gov/health_info/fibromyalgia/

Lundy-Ekman,L. (2012). Neuroscience fundamentals for rehabilitation 4th Ed. Philadelphia, PA: Elsevier Saunders Company.

Millea, P., & Holloway, R. Treating Fibromyalgia. Retrieved from http://www.aafp.org/afp/2000/1001/p1575.html

Olivares, P. R., Gusi, N., Parraca, J. A., Adsuar, J. C., & Del Pozo-Cruz, B. (2011). Tilting Whole Body Vibration Improves Quality of Life in Women with Fibromyalgia: A Randomized Controlled Trial. Journal Of Alternative & Complementary Medicine, 17(8), 723-728 6p. doi:10.1089/acm.2010.0296