Fibromyalgia: exercise can offer relief for people who live with this painful malady

Muscle & Fitness/Hers, Dec, 2002 by Frank Claps

RELATED ARTICLE: WHAT IS FIBROMYALGIA?

The scans and X-rays show nothing abnormal, and your blood, urine and stool tests have turned up negative. So why do you have that constant body ache, the headaches, the difficulty sleeping and the bowel problems? Is it really all in your head? One last test could confirm a diagnosis. Your physician, or rheumatologist, may apply pressure to 18 specific points on your body, and if you experience pain on 11 of those sites, you may have fibromyalgia.

Actually, the American College of Rheumatology recognizes two diagnostic tools for fibromyalgia. The first is widespread pain for at least three months, the second is the pressure points. Because fibromyalgia symptoms mimic more serious pathologies, your physician will probably order other tests first. "As doctors, we have to be convinced there is no other reason for the pain." says Don L. Goldenberg, MD, chief of rheumatology at Newton-Wellesley Hospital (Massachusetts) and professor of medicine at Tufts University School of Medicine. "The diagnosis is based on the symptoms and the tender-point examination, and your physician being able to recognize that there's nothing else going on."

As of now, fibromyalgia has no known cause. The symptoms seem to often be initiated by some kind of trauma, physical or emotional. "We also believe strongly that certain viral illnesses can trigger or worsen the condition," Goldenberg relates.

But not everyone who suffers a physical or emotional trauma, or viral illness, gets fibromyalgia. "I don't think it's the nature of the trauma as much as something to do with each person's central nervous system," he adds, referring to the brain and spinal cord. Although the pain is in the muscles, Goldenberg notes, "The muscles are probably more an innocent bystander to some central factor that is very important."

Much of his research centers around an entity called the hypothalamic-pituitary-adrenal axis, also known as the stress axis. These three glands regulate the progressive release of various hormones in response to stress. Alterations in this cascade of events can produce symptoms similar to fibromyalgia. Goldenberg has reported on research that indicated a weaker response of this stress axis among fibromyalgia patients than among healthy controls.

Researchers at the Oregon Health Sciences University (Portland) are focusing their attention on a hormone called somatostatin. "It's usually elevated in this population," says Kim Dupree Jones, RD. PhD, assistant professor in the School of Nursing. "When it's too high, the hypothalamus can't tell the pituitary gland to release growth hormone. People with fibromyalgia have low levels of growth hormone, which is important to help rebuild muscles after exercise."

Goldenberg also points out that people with fibromyalgia often have low levels of serotonin. This hormone is involved in pain perception, enhances sleep, helps regulate intestinal motility (a key factor in irritable bowel syndrome) and depression. Other researchers at the University of Texas Health Science Center in San Antonio observed that Substance P, a neurochemical that signals the brain to register pain, exists at twice the level for fibromyalgia patients than the public at large.