MUSCLE AND SKELETAL PAIN: HOW FIBROMYALGIA HAPPENS

Researchers have been unable to determine the exact cause of fibromyalgia; however, there are a number of theories as to the possible cause.

Neurochemical Imbalances

It is believed that there is a faulty regulation of two neurochemicals of the central nervous system, namely substance P and serotonin. Substance P is a chemical that is responsible for amplifying pain signals in the body. Research has shown that some people with fibromyalgia have up to three times the normal level of substance P compared to someone who does not have fibromyalgia. This may lead to errors in pain processing. An example is when something that should not be painful, such as a hug or pat on the back, is perceived by your body as being painful. It's not that you cannot tolerate pain, but rather that your body is sensing more pain than it actually should be. Serotonin is a chemical that is important for mood, sleep and pain. Researchers believe that serotonin is either in lower than normal amounts or is not being used properly by the body in people with fibromyalgia. Antidepressant medications such as fluoxetine hydrochloride (Prozac), paroxetine (Paxil), sertraline hydrochloride (Zoloft), and citalopram hydrobromide (Celexa) can help the body use serotonin more efficiently so that it can then help with mood, sleep and pain issues.

Autonomic Nervous System Stress Response (HPA axis)

The autonomic nervous system is that mechanism in the body that helps regulate all the "automatic functions," such as heart rate, breathing, blood pressure and digestion. The autonomic nervous system also is responsible for controlling the stress response, often referred to as our "fight or flight" response. During a time of stress, the body secretes chemicals, such as adrenaline and cortisol, which help you remain alert in a time of stress to be able to deal with the stressor or escape it. Think of a time when you have been faced with a stressor. How did your body respond to that stress? Did you have an increased heart rate, fast and shallow breathing or did you 'forget' to breathe? Were your palms sweaty or did your stomach feel nauseous? These are just a few of the symptoms that can occur under a time of stress. Researchers have found that people with fibromyalgia either tend to run at a slightly higher than normal level of stress or may take a little longer to recover from a stressful event. You may not feel as though you are in a stressful situation. Dealing with chronic pain and fatigue on a daily basis, however, certainly is stressful. This ongoing stress can lead to changes in the brain that alter the way pain signals are processed, leading to increased sensitivity. Symptoms from stress can exaggerate the fibromyalgia symptoms. That is why stress management is a very important key in managing fibromyalgia symptoms.

Sleep Problems

Proper sleep is necessary to provide healing of the body as well as mental clarity and physical endurance. There are two very important types of sleep called NREM and REM. NREM stands for non-rapid eye movement sleep, or non-dream sleep, and is important for physical recovery of the body. There are several stages of NREM sleep with the deeper stages numbered 3 and 4, also known as delta sleep. REM sleep stands for rapid eye movement sleep, which is when dreams occur, and is important for our mental recovery. About 90 percent of people with fibromyalgia do not get into the deep restorative NREM sleep stages 3 and 4. It is during this "delta" sleep that the body secretes a growth hormone called somatomedin C. This chemical is important in adults because it is responsible for directing the repair of muscles. People normally experience micro muscle trauma just from moving around during the day. Muscle is normally restored with the help of somatomedin C secreted in the proper amounts. Your body secretes adequate amounts of growth hormone in two ways: 1) by getting into the deep stages of sleep, possibly with use of a proper medication, 2) by getting aerobic exercise which is directly related to the amount of growth hormone that is secreted.