Fibromyalgia: Pain, Fatigue, and Sleep Issues

The most important information you need to improve your health

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• Publisher: Adams Media
• Year: 2012
• eBook ISBN: 9781440563676
• Topic: Medicine
• Subtopic: Diseases & Allergies

Looking for support with the pain and fatigue associated with fibromyalgia? The Everything® Healthy Living Series is here to help. These concise, thoughtful guides offer the expert advice and the latest medical information you need to manage your pain and lead a healthy life.Inside you'll find expert advice and helpful tips on dealing with the chronic pain, handling the debilitating fatigue, and solving the various sleep issues that arise due to fibromyalgia. As you deal with these fibromyalgia symptoms, the more you know about the disorder, the better you will be able to take charge of your condition.

All about Pain

Long before you learned you had fibromyalgia, you’d already known pain. You felt it when you got a splinter in your finger or twisted your ankle playing sports. You felt pain when you jammed your toe into the dresser or sliced your finger on a piece of paper. But according to people who have fibromyalgia, the intensity of the pain that comes with FMS is unlike anything you might have felt before. Because pain is at the core of fibromyalgia, it helps to understand the concept of pain itself.

What Exactly Is Pain?

As uncomfortable as it is, pain is your body’s built-in alarm system. When your body is injured or afflicted with disease, nerves transmit signals to the brain, which we in turn translate as pain. Pain is undoubtedly unpleasant, but it does warn you that something is awry. The signal may be telling you to pull your hand away from the hot stove or to avoid walking until a leg fracture heals. It’s nature’s way of preserving your body from further damage.

The extent of your pain depends primarily on what occurred that started the sensation. Certainly the prick of a pin is a much milder form of pain than a hammer on your thumb. It also depends on how much pain you can tolerate, which is highly subjective. Other factors that influence your pain threshold include your mood, your temperament, and whether you had a good night’s sleep.

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Question

Is pain the fifth vital sign?
Most doctor visits involve measuring your blood pressure, pulse, respiration, and temperature — what medical experts have for years called the “vital signs.” These indicators help doctors gauge a patient’s health and aid in the diagnosis and treatment of disease. Increasingly, doctors are recognizing that pain is also a way to assess health and well-being, another vital sign.

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The Nervous System

In order to understand why we feel pain, it’s important to know a little about the body’s nervous system, an elaborate network of nerves whose control center is the all-important brain. The nervous system is the body’s most complex system and regulates hundreds of activities — all at the same time.

At the center of the nervous system is the brain, which is the root of your consciousness, the center of your intellect, and the basis of your creativity. The brain also regulates your autonomic processes, all those things your body does that don’t require a moment of conscious thought, such as breathing, blinking, and heart rate.

The nervous system is made up of several distinct parts, each with several unique roles. Think of it as a collection of electrical wires and impulses, all activated and regulated by the brain.

The Central Nervous System (CNS)

The central nervous system (CNS) is made up of the brain and the spinal cord. The brain is the hub of all information processing and bodily functions, while the spinal cord links the peripheral nervous system to the brain. The brain controls reflexes and is the initial pain processing center. The brain, which weighs all of about three pounds, is nestled securely in your skull, where it houses about 100 billion neurons, or nerve cells, that are constantly transmitting information among cells. It is the place where all impulses originate and where all impulses travel. Absolutely everything we do, from casting a nasty glance or laughing at a joke to reading a book or learning a musical instrument, requires our brain.

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Fact

Over time, many luminaries have sounded off on pain. Leonardo da Vinci and his contemporaries came up with the idea that the brain was the main organ responsible for sensation and that the spinal cord was the part that transmitted pain. The poet Emily Dickinson said pain had “no future but itself.” The twentieth-century French missionary Albert Schweitzer described pain as a “more terrible lord of mankind than even death itself.”

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The Peripheral Nervous System (PNS)

The peripheral nervous system (PNS) is an elaborate network of nerve fibers that branch out from the brain and spinal cord to the far reaches of your body, such as your fingertips. This network has the vital task of constantly receiving information from inside and outside the body, then relaying that information to the brain to find out what to do. The PNS is made up of two parts.

The Sensory Somatic Nervous System

Swallowing, chewing, a wiggle of your toes. All these tasks are performed by the sensory somatic nervous system. This system kicks into gear, either voluntarily or involuntarily, when your senses are stimulated by external stimuli such as food, texture, and sound, or by conscious desires, such as when you want to move.

The Autonomic Nervous System

Anything involuntary that we do is regulated by the autonomic nervous system. Blinking, breathing, and digestion are all processes regulated by this system. It also alerts us to danger, tells our intestines to digest our food, and responds to our emotions.

How Nerves Cause Pain

The nerves, which are located throughout your body, are the sites where you first receive impulses and also the site where you start to process and transmit them. In fact, nerves are the starting point of your pain.

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Essential

It isn’t easy to describe something as subjective as pain. One way to do it is to use a numeric scale of 1 to 10. A verbal scale describes the pain as mild, moderate, or severe. Children might use the Wong-Baker scale, which uses faces to describe degrees of pain. You can also help your doctor’s understanding with words like “radiating,” “excruciating,” or “dull,” or by describing where your body hurts, how the pain affects your activity, and whether anything makes it worse or better.

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At the ends of the nerve fibers are nociceptors, receptors that detect actual or potential tissue damage. Millions of these nociceptors lurk in your skin, bones, joints, muscles, and in the membrane that surround your internal organs. Nociceptors are most prevalent in regions that are prone to injury, such as your fingertips and your toes, or in critical sites such as your eyes.

When these nociceptors sense that something has hurt your body, they immediately transmit a signal to your brain in the form of an electrical impulse. The impulse travels along the nerve to your spinal cord, where it enters a region called the dorsal horn. There, the signal sets off the release of chemicals called neurotransmitters, which then activate other nerve cells that process the information and send it up to your brain.

Making Sense of the Information

Once in the brain, the information arrives in the thalamus, which serves as the brain’s information relay system. All sensory information passes through the thalamus. The information is processed and prioritized and is then sent to multiple parts of the brain:

• The somatosensory cortex, or physical sensation region
• The limbic system, or emotional feeling region
• The frontal cortex, or thinking region
• Deep brain structures that control processes including blood pressure, pulse, and hormone release

These multiple pain messages explain why we respond to pain on several levels. When your finger touches a thorn on a rose bush, your brain might react by saying “Ouch, it hurts,” “I never did like roses,” and “Move that finger!” all at once.

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Fact

A 2004 survey of 1,039 employees at a Fortune 100 company found that 29 percent of respondents had pain problems that affect work performance. The workers with pain scored 45 percent lower on ratings of their physical health and 23 percent lower on measures of mental health. Those in pain were five times more likely to report health-related limitations on their ability to do their job.

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At the end of this split-second transmission, the brain has the task of interpreting the message and deciding what to do with this new information. This decision depends on your age, the circumstances, and your life experience. A child who receives pain signals from a thorn, for instance, may cry and run for her mother. A woman at a party may stifle the urge to cry out and simply inspect and stroke her finger. A gardener may pause and seek relief by placing ice on the injury. How a person chooses to respond depends in large part on the memories stored in the brain, which tell her how effective her previous responses were, as well as what the person has been taught about how to respond to pain.

Normal Pain Versus Fibro Pain

Pain is a normal part of the human experience, but what about pain that seems to serve no purpose, like the widespread musculoskeletal aches that afflict people with fibromyalgia? To better understand the difference between normal pain and the pain in fibromyalgia, we need to distinguish acute pain from chronic pain.

Acute Pain

The bothersome toothache that signals a cavity. Throat pain that alerts you to a strep infection. The agony of a broken leg in a skiing accident. These are examples of acute pain, which usually results from a recent injury or disease. Acute pain grabs your attention and demands you take action. But once it’s properly treated, the pain disappears, and you recover.

Chronic Pain

If acute pain — or its cause — isn’t treated quickly, the nerves “learn” to be in pain. Changes occur within the nerves and their surrounding structures that cause the pain to persist. If these changes become severe enough, the pain will persist even after the cause has disappeared. Acute pain then turns into chronic pain.

People with fibromyalgia suffer chronic pain, often severe enough that it pervades their very existence. In fibro, the pain is not always preceded by a traumatic event — though sometimes it is — and the injured tissue may appear perfectly fine. So while chronic pain may be telling ...

Table of contents

• Cover
• Title Page
• Contents
• Introduction
• Diagnosing Fibromyalgia
• All about Pain
• The Fatigue Factor
• The Sleep Problem
• Also Available
• Copyright Page