(WZZM) - It's probably one of the most misunderstood conditions out there, Fibromyalgia.
It's characterized by widespread pain, fatigue, memory problems and even more symptoms.
It's also the topic of this Just Ask segment. Doctor Kristi DeMock with Spectrum Health Medical Group answers your questions about Fibromyalgia.
Click on the video link to watch the segment. Click here to learn more about Fibromyalgia. We could not get to all of the questions on air. Dr. DeMock has answered more of your questions below.
Q: Connie Campbell - People with fibromyalgia often do not get deep REM sleep. What physical impact does this have on the body, and what can be done to help someone with Fibro get better, deeper sleep?
A: First, if you're not taking any medications for fibromyalgia, consider starting. Fibro is thought to occur because of alterations in neurotransmitters (chemicals in the nerves and brain) that lead to increases in pain perception, sleep disturbances, and fatigue. Not getting quality sleep can increase your fibromyalgia symptoms (worse pain, fatigue, mood, etc.). Being on medications to help your condition can help your pain, which can then let you get a better nights sleep. Doctors typically start with Neurontin, Lyrica, or Cymbalta for treatment. The first two try to dampen the pain response, the last helps restore serotonin (which can also improve sleep). Besides this, get into a good sleep hygiene pattern. What I mean is try to do some type of exercise (can be anything from yoga to swimming or walking) about 5 hours before bed. This actually relaxes your body and lets you get better sleep. Also, avoid having a tv or book in your bedroom, avoid nighttime eating/alcohol/caffeine. These all lead to poor sleep. If this all fails, talk with your doctor about a sleep aid. Your doctor may want to make sure you don't also have a sleep disorder (sleep apnea or restless leg syndrome) by ordering a sleep study. Bottom line, sleep can really help fibromyalgia pain, and it's a very important part of treatment.
Q: Megan Dillingham - I was diagnosed with fibro by my family doctor, but never sent to a specialist. I am not on any meds, do not have any dietary restrictions or anything. Is there anything more a specialist can do for me?
A: This depends on how you're doing. If you feel ok, then no need for meds or a specialist. Your doctor should be able to get you started with treatment. You really want an approach that tries to tackle all aspects of the condition. By this I mean, trying to restore function by exercising daily, improving mobility and pain by doing things like yoga, stretching, physical therapy, or massage (to name a few). You may also want a counselor (not for depression as some think) to help you develop coping strategies for stress and relaxation. Stress can really make your fibro worse. If you're interested in medications, ask your doctor. If he or she isn't sure what to do for you, then you should ask to see a specialist who may have more knowledge about the condition.
Q: Lore A. Banks - I have fibro. I am on Lyrica and it doesn't seem to help. Is there anything else I can take? The pain is unbearable.
A: There are a lot of options, actually. Lyrica is a good starting point because it tries to block the pain response that's triggered by your nerves and brain. It definitely can work, you may need to increase your dose. Or, there are other medications (here are a few) to consider (either in addition to lyrica or separately). Lyrica treats only one aspect of fibromyalgia. Again, it tries to dampen the nervous system's pain response (so you don't feel as much pain). The other chemicals we know can affect fibro are serotonin and norepinepherine. These affect sleep (negatively), can increase pain and fatigue, and can affect mood. Your doctor may want to consider adding a medication (like Cymbalta) in addition to the Lyrica. Other options are Savella (similar to Cymbalta), you can also try over the counter medications like capsaisan cream. This can block some of the pain chemicals, making the pain more bearable. Don't forget about diet (low fat, low sugar, low processed foods, etc...healthy), physical therapy, exercise, massage, chiropractic or osteopathic manipulation. These can all help with the pain. Some specialists also do trigger point injections. This is basically injecting anesthetic medication into the painful areas to provide relief. I would talk to your doctor to see what they feel is the next step if you're not improving.
Q: Stephanie Thomason Williams - It is very hard to diagnose fibro, but with everything that is going on with me my doctors say that is what I have. The question I have is I have had numbness in the left side of my face since December. Had a ct scan done it came back neg. Can fibro cause this?
A: First, when were you diagnosed with Fibro? If it began at the same time your other fibromyalgia symptoms started...maybe. If you've had good control of your fibro...maybe not. Numbness and tingling can be associated, but what you're describing is not typical. Your face is not a typical area for fibromyalgia to affect. However, this could be part of something like TMJ (a painful jaw joint condition) and sometimes is seen in association with fibromyalgia. However, you may want to ask your doctor again about this. If a nerve is involved, a CT scan does not usually detect it. CTs of the face typically are better to look for masses, bleeds, sinus problems, and bones.
Q: Meghan Marcusse - Fibro sufferer here also. On tons of meds with very little help. I guess my main question would be something to the effect of how to combat weather changes or stressful situations.
A: Weather is tough. You can try pain medications like ibuprofen or tylenol if it seems to be your joints. If your muscles have more tenderness during certain weather, I'd try some over the counter capsaicin cream to try to help your pain. The other thing is stretching. This can help prevent flares. As far as stress, sometime medications (see above re: medications that can help improve serotonin and norepinephrine) to help deal with stress. Other options include seeing a counselor to teach you relaxation techniques and coping strategies. Massage and biofeedback area also good options.
Q: Sommer Daye Doll DeRoo - My 19 year old boyfriend was diagnosed with fibro at age 14. He complains everyday of pain. He's tried all sorts of prescriptions. Are there any other options? Change in diet? Things to avoid?
A: There are plenty of options. As I've mentioned about exercise can really help. Start slow and build up with exercise. Physical therapy, chiropractic medicine, osteopathic manipulation, counseling (for relaxation techniques and stress reduction), and biofeedback can all help. For diet the general idea is healthy eating. Some things to work on are: eating more raw vegetables. These have higher amounts of nutrients compared to cooked or canned varieties. Avoid high fat foods (chocolate, fried foods, red meat). Also, avoid processed foods, white sugar and flour.
Q: Lauren Sherman - Does the Dr. find that Fibro & Bipolar are somehow linked?
What are the best natural remedies for Fibro?
A: Unfortunately, yet mood disorders like bipolar, depression, and anxiety can be found together. That sometimes makes the diagnosis hard. Luckily, some medications can be used to treat both. About 30% of people diagnosed with fibro also have a mood disorder. This can get at high as 75% as time goes by. In terms of natural treatments, I'm not familiar with too much. Here are some that may work:
Capsaicin cream (from chili peppers)
acetyl L-carnitine can help pain and sleep 5-HT is a serotonin booster. This works to help your body sleep and deal with pain Melatonin - our body makes it to help us get tired. It's available over the counter and can help with sleep and reduce the number of painful areas Black cohost - may help mood and sleep
Q: Joan Cripe - I was diagnosed with fibro. approx 7yrs ago at the U of M. I also have been diagnosed with 3 other autoimmune diseases. They are also diagnosed through Cleveland Clinic. Is it common for several other autoimmune diseases to be going on at the same time? Or is this just part of a bad gene pool?
A: These conditions can all be hereditary, but they are also seen together just like fibro and mood disorders. There's about a 20% crossover rate, meaning that if you have and autoimmune disease you have a higher likelihood of having fibro even though it's not autoimmune.
Q: Char Morse - ?1.) Why do women seem to be diagnosed with fibromyalgia more often than men? Do hormones play a role in this condition?
A: We don't really know why fibromyalgia occurs, so it's hard to say why women are more likely to have it. However, we do know that certain things can trigger fibro, like environmental, physical, or emotional stressors. These include things like physical and emotional abuse, life changes (of any type...even motherhood), and mood disorders. Unfortunately, women do tend to have a higher likelihood of being abused or having a mood disorder, which could make them more likely to have fibromyalgia.
Hormones, like estrogen and progesterone really aren't the cause of the condition to our knowledge. It's actually a nervous system condition where your nerves have increased levels of neurotransmitters (see below for explanation) causing pain, and decreased levels of those that help us cope with pain.
Q: 2.) How much does brain chemistry (neurotransmitters) affect a person's perception of pain? I read an article that suggested low serotonin levels may be part of the reason why patients with fibromyalgia suffer from such intense pain. Is this true?
A: This is true. What current research is showing us is that our bodies produce excess pain neurotransmitters (substance P and glutamate) in fibromyalgia. This causes amplified pain responses, which is why a person's muscles can feel so tight, sore, and inflamed. Serotonin and norepinepherine are present in the brain (among other areas) and act to keep our mood even/happy, help us sleep and feel energized, and help us deal with pain. If these are low, like they can be in fibromyalgia, more pain, poor sleep, and fatigue can occur. This is why we are currently trying to target these neurotransmitters with medication. Lyrica, gabapentin(neurontin), cymbalta, and savella are some common medications you may have heard of.
Q: Laura Wahr Steenhagen - I was "diagnosed" about a year and a half ago. I was nursing at the time and now pregnant and have been told there isn't anything I can take for the pain that's safe for the baby. I am in Muskegon and told the only rheumatologist around doesn't even believe in FM. So I still only see my family Dr. Is there a pregnancy safe medicine? Are there any Dr.'s in the Muskegon area who believe in and treat FM patients like it's a real problem and not just in their head?
A: Unfortunately, I don't have too much good news for you in terms of medication. It's true, most meds are unsafe in pregnancy. We really try to use as little as possible when someone is pregnant, and fibro meds are typically unsafe. This might be a great time to try other things like massage, PT, or trigger point injections though.
Also, I'm unfamiliar with Muskegon so I can't help there. But, Grand Rapids isn't too far away, so if you're looking for someone to treat you long term for this condition, there are plenty of rheumatologists here who could help. It's well worth the drive if your symptoms can improve.
Q: Sarah Shaw - What's a safe way to work out without being down in bed for 2 days after? I'm 26, diagnosed at 13, trying to believe I don't have it, but there's just that nagging pain everyday which magnifies if I work out. I have a hectic and stressful job and life- will a massage or chiropractor help? Aquatic aerobics? Yoga?
A: First, try to accept the diagnosis. I understand why you don't want to, but in order to really improve, you have to try. Next, all the things you mentioned can be great! Whatever you do, start slowly. You may only be able to do a few minutes a couple days a week to start. Don't get discouraged, this is a lifelong work in progress and you have to build up your conditioning. You may want a trainer or physical therapist to start you off right. Water aerobics are wonderful. It makes the weight of our bodies much less, so our muscles can have much less pain while increasing mobility. It's also great because it's a total body workout. Yoga, too, is great since it improves mobility and really stretches those muscles. Besides this, massage, chiropractor, biofeedback can all help. The other thing you mentioned was stress. Consider therapy. I can't stress this enough: I'm not saying you're depressed. People naturally think if they're seeing a therapist we consider them to be "crazy" or depressed. No. It can help you deal with day to day stress that's otherwise unavoidable. Stress really does affect fibro in a negative way.
Q: Shelley Devries- Esquivel - I too have fibro along with other neuro and autoimmune diseases. I am in a lot of pain and miserable everyday. I have tried countless meds with no positive results. I am tired of feeling like a guinea pig with docs. I'm not looking for a magic pill, meds have too many side effects and my system doesn't deal well with meds. I always end up sick because of the meds. I would love a more natural approach to just feeling a little better. It's hard to keep a positive outlook when docs seem to know so little about it. To many so called docs think its all in your head. It's not in my head, I have no mental issues just a PAIN issue. Its hard to get your spouse to understand how you feel when you can't get a doc to understand. My primary care doc is great but he has tried all he knows to help. Can you help me help him to make me feel better?
A: Sadly, there is no treatment that is 100%, which is probably why you feel like you're a guinea pig. There are other options out there (see above for non-medication treatments), which may be helpful. In terms of natural, remember that everything you put into your body can cause side effects, whether it's natural or synthetic. I'm not saying natural won't work, but you should let your doctor know if you try any supplements. This condition certainly is not in your head. The more research that comes out, the more we understand. New treatments are still being developed, so try to hang in there. If your doctor is having difficulty treating your condition, perhaps it's time to see a specialist? Bottom line, keep trying and don't give up!