Judson Haims: Addressing fibromyalgia remains challenging for medical professionals | AspenTimes.com
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Judson Haims: Addressing fibromyalgia remains challenging for medical professionals

Judson Haims
Special to The Aspen Times

Modern scientific advancements are fabulous. We can split an atom and send a telescope to the farthest regions of the galaxy. However, there is much about our own body that we have yet to fully understand.

Currently, fibromyalgia is a medical conundrum. While it presents itself with widespread pain that often feels like it’s bone deep, it also presents itself with chronic fatigue, sleep disturbances and cognitive dysfunctions. Adding to this is the association of anxiety, concentration/memory, depression and headaches.

With such diverse symptomology, medical providers are often challenged in understanding the cause and diagnosing it.



Symptoms/diagnosing

There is no widely accepted medical test to diagnose fibromyalgia. Instead, diagnostic tests are performed to see if another condition could be causing the symptoms. Blood tests are usually ordered to rule out conditions with similar symptoms.

Fibromyalgia is a diagnosis of exclusion and patients must be thoroughly evaluated for the presence of other disorders that could be the cause of symptoms before a diagnosis of fibromyalgia is made. Some of the conditions that may mimic fibromyalgia are: celiac disease, Lyme disease hypothyroidism, rheumatoid arthritis and osteoarthritis.




Diagnosis is complicated by the fact that fibromyalgia cannot be detected through X-rays, scans or common blood work. Further, as mentioned above, its symptomology is diverse. Often, ailments wax and wane over time, and it affects people physically, mentally and socially in different ways. Unfortunately, as with almost all ailments, stress often worsens the related problems and symptoms.

Until somewhat recently, diagnosing fibromyalgia focused on the symptom of pain and the presence of tender points. Medical providers have used diagnostic guidelines from the American College of Rheumatology to look for various pain point on both sides of the body where pain was identifies when firm pressure was applied to specific areas called tender points. In the past, at least 11 of 18 of the tested tender points had to test positive for tenderness to diagnose fibromyalgia.

Currently, researchers are looking at changes in nerve transmission as the mechanism of cause. It is now believed that fibromyalgia amplifies painful sensations by affecting the way our brain and spinal cord process pain signals. According to a July article in the ScienceDaily, “New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, in collaboration with the University of Liverpool and the Karolinska Institute, has shown that many of the symptoms in fibromyalgia syndrome (FMS) are caused by antibodies that increase the activity of pain-sensing nerves throughout the body.”

A few years ago, a contact at UCLA directed me to a company called EpicGenetics Inc. The company is composed of worldwide experts from Harvard, UCLA, Cornell, University of Illinois at Chicago and other top research institutions. Through great amounts of collaboration and research, a blood test was developed called FM/a, which has a high accuracy in identifying markers produced by immune system blood cells in people with fibromyalgia. The test has a very high degree of accuracy, and insurance companies may pay for it.

Treatment

As the understanding that fibromyalgia may be caused by antibodies as opposed to originating within the brain, some of the methods of treatment have changed. Until recently, treatments involved medication and self-care strategies. Medical providers traditionally treated people with pain relievers, antidepressants and anti-seizer medications. Physical therapy, occupational therapy and counseling have also been used.

Researchers are working on additional modalities, such as retraining the way the brain interprets pain signals in addition to researching therapies such as Therapeutic Plasma Exchange (TPE). TPE is designed to reduce antibody levels by “cleaning” the blood by removing and replacing a patient’s blood plasma. This therapy has recently been used as a supportive treatment for severe cases of COVID-19, fibromyalgia and an autoimmune disorder called myasthenia gravis — a disorder in which antibodies breakdown the communication between nerves and muscle.

Researchers need more time to solve the mystery of fibromyalgia. However, while further research is needed, the prospects of new treatments may be found in the relatively near future.

Judson Haims is the owner of Visiting Angels Home Care in Aspen, Basalt and Carbondale. He is an advocate for our elderly and is available to answer questions. His contact information is VisitingAngels.com/comtns or 970-328-5526.


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