Fms Community Newsletter

Fms Community Newsletter #92

With summer in full swing, and heat waves sweeping the U.S., I decided to use this issue of the editor's corner to share the various ways people are beating the heat. These tips are from people that I know in person, and those that I know via online support groups. They all have FM or CMP, CFIDS and over lapping conditions.

Public Library You can go to any public library and sit and read, or use the internet, even if you do not have a current library card. The majority of them allow you to bring in snacks and drinks. Go to the library during the hottest part of the day, read a magazine, surf the net or read a good book. Most of them offer comfy chairs, and most importantly, air conditioning.

Shop without money Even if you don't have money to spend, go to Wal-mart, k-mart or other local stores and wander, or use the electric carts provided at the door. You can browse the books, get decorating ideas or people watch as you cruise around. There is no law that says you have to spend money when you go. Get out of the heat and take advantage of the air conditioning.

Hospitals Some folks go to their local hospital. Each hospital has multiple lobbies with chairs, tv's and magazines. If they are desperate enough they go sit in the lobbies and read, or watch TV.

Mall Get to a mall. By bus, or car pool. Cab or senior transport. They have air and you can sit or walk all day and nobody cares. Many have electric carts you can borrow.

Freecycle Go to freecycle.com and sign up for your city. This is a site where people offer items they don't want, but they don't want them to go into a landfill. You can often find fans or air conditioners that people are giving away. You can post things you want to get rid of and you may ask for items you "want" such as a fan. If someone has one laying around, they will let you know and you can get it for free. *Tip: don't ask and ask for things if you do not offer things. There is a code among freecyclers. You have to give and take.

These are the tips I have gathered so far. If anyone has another great tip to share please send it to turn_ip@cox.net and we will get it to our readers.
Jane Kohler
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In This Issue:

~Fibromyalgia patients show an abnormal dopamine response to pain
~Australian researchers have identified a cluster of genes linked to chronic fatigue syndrome
~Intramuscular and nerve root stimulation vs lidocaine injection to trigger points in myofascial pain syndrome
~Pharmacological treatment of fibromyalgia and other chronic musculoskeletal pain.
~Cranial electrotherapy stimulation and fibromyalgia.

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Fibromyalgia patients show an abnormal dopamine response to pain. Eur J Neurosci. 2007 Jun;25(12):3576-82. Wood PB, Schweinhardt P, Jaeger E, Dagher A, Hakyemez H, Rabiner EA, Bushnell MC, Chizh BA.

McGill University Centre for Research on Pain, Faculty of Dentistry, 3640 University Street, Strathcona Building, Montreal, QC, Canada, H3A 2B2. PMID: 17610577

Fibromyalgia is characterized by chronic widespread pain and bodily tenderness and is often accompanied by affective disturbances. Accumulating evidence indicates that fibromyalgia may involve a dysfunction of modulatory systems in the brain.

While brain dopamine is best known for its role in pleasure, motivation and motor control, recent evidence suggests that it is also involved in pain modulation. Because dopamine is implicated in both pain modulation and affective processing, we hypothesized that Fibromyalgia may involve a disturbance of dopaminergic
neurotransmission.

Fibromyalgia patients and matched healthy control subjects were subjected to deep muscle pain produced by injection of hypertonic saline into the anterior tibialis muscle. In order to determine the endogenous release of dopamine in response to painful stimulation, we
used positron emission tomography to examine binding of [(11)C]-raclopride (D2/D3 ligand) in the brain during injection of painful hypertonic saline and nonpainful normal saline.

Fibromyalgia patients experienced the hypertonic saline as more painful than healthy control subjects. Control subjects released dopamine in the basal ganglia during the painful stimulation, whereas fibromyalgia patients did not. In control subjects, the amount of dopamine release correlated with the amount of perceived pain but in fibromyalgia patients no such correlation was observed.

These findings provide the first direct evidence that fibromyalgia patients have an abnormal dopamine response to pain. The disrupted dopaminergic reactivity in fibromyalgia patients could be a critical factor underlying the widespread.

Australian researchers have identified a cluster of genes linked to chronic fatigue syndrome

This mysterious illness finally be explained. The team from the University of NSW sifted through more than six
million pieces of DNA information in people who had glandular fever, including half who went on to develop chronic fatigue.

Their goal was to identify which genes appeared to be more active in the people who went on to get fatigue, to shed light on what triggers the unexplained condition.

Professor Andrew Lloyd and his colleagues at the Centre for Infection and Inflammation Research were able to find 35 genes linked to the symptoms of the illness. 'These (35) genes might point to the nature
of the disease process that underlies chronic fatigue syndrome, which is currently unknown,' said Prof Lloyd, whose findings are published in the latest Journal of Infectious Diseases.

Chronic fatigue is most commonly triggered by an acute illness, like glandular fever. It is characterised by extreme tiredness but recent studies have left researchers puzzled as to what it actually is.

'We know it's not a psychiatric disorder, and doesn't appear to have anything to do with immune responses or hormones or the severity of the virus,' Prof Lloyd said. 'So that's left us thinking it's some kind of brain disorder.'

The team decided to analyse brain patterns by studying blood samples of 15 people with glandular fever, including some who also developed fatigue. The work was part of a larger project tracking the long-term
health of people infected by three infections - the mosquito borne Ross River virus, Q fever bacterial infection and Epstein-Barr virus, which causes glandular fever - in the central NSW city of Dubbo.

Prof Lloyd said the findings were the tentative beginnings of better understanding the disease. 'It's given us the starting point for some gene expression pattern that might become a diagnostic test for the condition,' he said. 'And it's given some clues of what the disease
process might be that underlies the disorder. 2007 AAP

Intramuscular and nerve root stimulation vs lidocaine injection to trigger points in myofascial pain syndrome

Journal of Rehabilitation Medicine. 2007 May;39(5):374-8. Authors and affiliation: Ga H, Koh HJ, Choi JH, Kim CH. Department of Family Medicine, Inha University College of Medicine, Incheon, Korea. PMID: 17549328

Objectives: To compare the efficacies of an intramuscular stimulation technique and 0.5% lidocaine injection to trigger points in myofascial pain syndrome.

Participants: Forty-three people with myofascial pain syndrome of the upper trapezius muscle.

Interventions: Twenty-two subjects were treated with intramuscular stimulation and another 21 with 0.5% lidocaine injection at all the trigger points on days 0, 7 and 14.

Results: Intramuscular stimulation resulted in a significant reduction in Wong-Baker FACES pain scale scores at all visits and was more effective than trigger point injection. Intramuscular stimulation also resulted in significant improvement on the Geriatric Depression Scale - Short Form. Local twitch responses occurred in 97.7% (42/43) of patients. All the passive cervical ranges of motion were significantly increased. Post-treatment soreness was noted in 54.6% of patients in the intramuscular stimulation group and 38.1% in the trigger point injection group, respectively, and gross subcutaneous haemorrhage (> 4 cm2) was seen in only one patient in the trigger point injection group.

Conclusion: In managing myofascial pain syndrome, after one month intramuscular stimulation resulted in more significant improvements in pain intensity, cervical range of motion and depression scales than did 0.5% lidocaine injection of trigger points.

Intramuscular stimulation is therefore recommended for myofascial pain syndrome.

Pharmacological treatment of fibromyalgia and other chronic musculoskeletal pain.

Best Pract Res Clin Rheumatol. 2007 Jun;21(3):499-511. Goldenberg DL. Newton-Wellesley Hospital, Division of Rheumatology, 2000 Washington Street, Suite 304, Newton, MA 02468, USA. Best Pract Res Clin Rheumatol. 2007 Jun;21(3):499-511. PMID: 17602996

The pharmacologic management of fibromyalgia is based on the emerging evidence that pain in this disorder is primarily related to central pain sensitization.

There is strong evidence that tricyclic antidepressants are effective, and moderate evidence for the effectiveness of serotonin reuptake inhibitors and dual serotonin-norepinephrine reuptake inhibitors.

Recent work suggests that the anti-seizure medications pregabalin and gabepentin are also effective.

The only analgesic demonstrated to be helpful is tramadol.

Cranial electrotherapy stimulation and fibromyalgia.

Expert Rev Med Devices. 2007 Jul;4(4):489-95. Gilula MF. President and Director, Life Energies Research Institute, 2510 Inagua Avenue, Miami, FL 33133, USA. mgilula@mindspring.com. PMID: 17605684

Cranial electrotherapy stimulation (CES) is a well-documented neuroelectrical modality that has been proven effective in some good studies of fibromyalgia (FM) patients. CES is no panacea but, for some FM patients, the modality can be valuable.

This article discusses aspects of both CES and FM and how they relate to the individual with the condition. FM frequently has many comorbidities such as anxiety, depression, insomnia and a great variety of different rheumatologic and neurological symptoms that
often resemble multiple sclerosis, dysautonomias, chronic fatigue syndrome and others. However, despite long-standing criteria from the American College of Rheumatology for FM, some physicians believe there is probably no single homogeneous condition that can be labeled as FM.

Whether it is a disease, a syndrome or something else, sufferers feel like they are living one disaster after another. Active self-involvement in care usually enhances the therapeutic results of various treatments and also improves the patient's sense of being in control of the condition. D-ribose supplementation may prove to
significantly enhance energy, sleep, mental clarity, pain control and well-being in FM patients. A form of evoked potential biofeedback, the EPFX [Electro-Physio-Feedback-Xrroid], is a powerful stress reduction technique which assesses the chief stressors and risk
factors for illness that can impede the FM patient's built-in healing abilities.

Future healthcare will likely expand the diagnostic criteria of FM and/or illuminate a group of related conditions and the ways in which the conditions relate to each other. Future medicine for FM and related conditions may increasingly involve multimodality treatment that features CES as one significant part of the therapeutic regimen.

Future medicine may also include CES as an invaluable, cost-effective add-on to many facets of clinical pharmacology and medical therapeutics.

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