ILLNESSES THAT COEXIST WITH FMS
Arthritis
Arthritis, in all its forms, is inflammatory and can cause the
development of trigger points secondary to the arthritic inflammation.
Arthritis will also worsen FMS. You may not be able to get rid of the
arthritis, but obtaining appropriate therapy for the FMS and for the
trigger points will lessen your pain load considerably.
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome is a condition of wrist pain and soreness and
weakness of the thumb, caused by pressure on the median nerve. It is
often caused by repetitive motion stress. These same symptoms are
frequently the result of subscapularis TrPs. Remember that TrPs can
entrap nerves. Before considering any surgery for carpal tunnel, a
check for shoulder, arm and hand trigger points should be made.
Chronic Fatigue Immune Deficiency Syndrome
Chronic Fatigue Immune Deficiency Syndrome (CFIDS) is characterized by
a history of extreme exhaustion that lasts at least six months, but it
is much more than that. People with this condition often want to sleep
all the time. Exhaustion can be brought on by the slightest effort.
Aches and fever, sore throat, and an inability to concentrate are
usually part of CFIDS, as well as Irritable Bowel Syndrome, frequent
infections, and a dysfunctional HPA axis. CFIDS often begins with
severe flu-like illness. When the fever and aches diminish, they
leave behind disabling fatigue, immune dysfunction, and a disrupted
neuroendocrine system. As with fibromyalgia, there are many subsets
of CFIDS and, in some of these subsets, the two syndromes appear to
overlap. It is wise to remember that research in these two conditions
is in its infancy. More is unknown about them than is known. Many
illnesses are classified together as part of a family of
neurotransmitter disorders. However, not all neurotransmitter
disorders are the same. There is a group of patients that meets
the general requirements for both fibromyalgia and chronic fatigue,
but I have observed that chronic fatigue is often misdiagnosed in
cases of FMS and/or MPS. Either the sleep disruption that results
from the neurotransmitter problems of FMS or the extreme pain of MPS
can cause the fatigue. Even one night of sleep loss will depress the
immune system. In cases of FMS and MPS, however, appropriate therapy
results in the elimination of many of the symptoms classed together
with FMS and CFIDS would be recognized as those of MPS. Then these
symptoms could be properly treated, and patients and doctors would be
better able to deal with the condition(s) that remain.
Depression
Depression can cause overwhelming sadness most of the time, as well
as the inability to enjoy those things that once made life worth living.
Someone suffering from depression might be overwhelmed by lethargy,
confusion, poor memory, sleep problems, and appetite changes. It is
natural to feel grief when you have a chronic pain problem, but that
is not the same as major depression, which can be a life-threatening
condition, especially when coupled with a chronic physical illness.
It should never be taken lightly either by you or by your physician.
Diabetes Mellitus
Diabetes mellitus is a disorder of carbohydrate metabolism, where the
body cannot create enough insulin, or use what insulin is made. It
can occur abruptly in childhood, but the onset of the disease in
adults (type II Diabetes) is gradual. Some of the common symptoms
are extreme thirst, itching, hunger, weakness, and production of a
great deal of urine. I believe that type II Diabetes is often a
result of reactive hypoglycemia, which result from an inherited
tendency as well as from a high carbohydrate diet.
HIV and AIDS
HIV and AIDS have swelled the ranks of people with FMS/MPS. One study
found probable or definite FMS in 41 percent of HIV patients with
musculoskeletal pain and 11 percent of all HIV infected patients.
In all the AIDS patients I've seen with probable FMS, MPS is present,
as well. I have also found trigger points in every other AIDS patient
I have seen. This is vitally important as appropriate treatment of
TrPs can dramatically improve the quality of life for these patients.
Anything that can accomplish this with so little effort must not be
ignored.
Hypoglycemia
Hypoglycemia is generally defined as a deficiency of sugar in the blood.
A type of hypoglycemia occurs in FMS where there is an insufficient
amount of usable sugar in the blood. This is called reactive
hypoglycemia, and it occurs in response to a high carbohydrate intake.
Hypothyroid
Being hypothyroid can cause people to be more susceptible to developing
trigger points. Thyroid hormones influence growth, energy production,
and energy consumption. Low-normal thyroid often escapes detection
because "low normal" is not a worrisome condition, but when it is
coupled with FMS and/or MPS, the added burden is on one you don't need.
Some current research shows that many patients with FMS respond to
T3 (Triiodothyronine) thyroid supplements. Many hypothyroid symptoms
are the same as the symptoms of FMS and /or MPS, and combine to
multiply the effects. Hypothyroid patients are usually cold most of
the time, especially in their hands and feet. Some are intolerant of
heat as well, and don't sweat normally. These patients are stiff and
ache all over, and often experience substantial hair loss.
Hypermobility
Hypermobility is characterized by joint relaxation that allows the
muscles to stretch beyond their normal range of motion. If you have
this problem, stretching techniques should be avoided. Often, TrPs
are found in muscles that cross hypermobile joints. If you suspect
you are double jointed or hypermobile, discuss this with your physician
and your physical therapist. Your physical therapist must be careful
never to stretch through a joint.
Lupus Myositis
Lupus myositis, also called discoid lupus, is a disorder that is
confined to the skin. There is a scaling, red-ping or brown rash,
often taking the shape of a butterfly on the face, although it is not
limited to that area. This rash is very photosensitive, and these
patients must avoid the sun. Some FMS patients also have this
"butterfly rash", although it may result from the "toxic acid sweat"
that is a symptom of FMS.
Systemic Lupus Erythematosus
Systemic Lupus Erythematosus (SLE) can attack many organ systems.
It is a connective tissue disorder and like rheumatoid arthritis it
is considered an autoimmune disorder. This means that your body
attacks itself. Neither FMS nor MFS is an autoimmune condition.
SLE can also cause a butterfly rash, but all of the connective tissue
can be involved as well, not just the skin. There can be involvement
with any of many organ systems, producing a host of symptoms. It isn't
unusual for people with FMS to test positive for SLE.
Multiple Chemical Sensitivities
Multiple chemical sensitivities may have a tendency to develop with FMS.
The immune system's weakening, which is caused by a lack of sleep, it
probably crucial here, along with what is called
the "leaky gut syndrome." We often take many medications, such
as NSAIDS (nonsteroidal anti-inflammatory drugs), that cause our
gastric lining to become more permeable. This allows larger than
normal foreign proteins to enter the body, which then develops
antigens to combat the foreign proteins. The patient becomes sensitized
to one chemical after an exposure. Then, other foods and environmental
irritants that were previously tolerated begin to provoke allergic or
sensitivity reactions. The signs and symptoms are many and varied.
They include fatigue, headaches, muscle aches, coughing, watery eyes,
and tremors. If this condition advances to the state where nearly
everything is intolerable to the patient, it is considered multiple
chemical sensitivity. At this state, the patient may be unable to
tolerate clothing and many foods, and may need to drink specifically
filtered water. Today, many support groups and resources are forming
as multiple chemical sensitivity becomes more identifiable and
well-known.
Multiple Sclerosis
Multiple sclerosis (MS) is caused by the breakdown of certain central
nervous system (CNS) tissues that occur in multiple, random sites. The
fatty sheath that surrounds some of the nerves is called myelin. In MS,
this sheath becomes damaged and neurotransmitter information is lost or
scrambles. There is cellular overgrowth at the damaged sites, and
hardened or "sclerotic" areas result. Multiple sclerosis is not related
to FMS or MPS, but, as MS causes symptoms, those symptoms may initiate
and perpetuate trigger points. These will aggravate FMS. Using a
wheelchair, or other relative immobility, will perpetuate TrPs.
Post-Polio Syndrome
Post-Polio Syndrome is also call Post-Polio Muscular Atrophy (PPMA).
It occurs many years after recovery from an initial episode of polio.
Post-Polio Muscular Atrophy causes muscle weakness and recurrent
paralysis, which can lead to respiratory paralysis, with slowly
progressing muscle wasting. It is often mistaken for FMS, but
life-threatening respiratory complications of Post-Polio Syndrome
may develop, so, clearly, a proper diagnosis is essential.
Raynaud's Phenomenon
Raynaud's phenomenon is a condition where the fingers and/or toes turn
white, then blue, and then red. This can occur during periods of
cold or emotional stress. Numbness, tingling, and burning may also
be present at these times. Raynaud's phenomenon is common in both
FMS and MPS. The dilation of the blood vessels is governed by
neurotransmitters, and in FMS this dysfunctional. These various
conditions can work together to multiply you misery.
Reflex Sympathetic Dystrophy Syndrome
Reflex Sympathetic Dystrophy Syndrome, also called RSDS or causalgia,
is a disorder of sympathetic nervous system that causes irregular blood
supply to affected area, which can be the hand, foot, knee, hip, or
shoulder. It causes severe pain, often burning in nature. It often
follows an injury, including surgery. In many cases there is no
apparent cause. FMS and/or MPS is often misdiagnosed as RSDS.
Seasonal Affective Disorder
Seasonal Affective Disorder (SAD) is moderated by light. In northern
areas in the winter, people with SAD become sleepy and easily fatigued,
and have little ambition or drive. These feeling disappear in the
summer, or when vacationing in areas of greater sunshine. Light
therapy often works well for this. Seasonal affective disorder may
belong to the family neurotransmitter disorders. About one-quarter
of my local FMS/MPS group has SAD.
Temporomandibular Joint (TMJ) Problems
Temporomandibular joint (TMJ) problems are symptoms, not an illness,
and often occur as a result of TrPs. There is severe pain in the area
of the jaw joint, with a clicking crunching noise of the jaw that
accompanies chewing. This is often accompanied by ringing and /or
itching of the ears. Sometimes there is some hearing loss.
Temporomandibular joint dysfunction starts the trigger point cascade
that eventually can cover your whole body. If the TrPs aren't promptly
treated, the bite will be off balance and the joint of the jaw may
begin to deteriorate.
Yeast Infections
Yeast infections often coexist with FMS and MPS. Any infection can
become a perpetuating factor of TrPs. Fungi are opportunistic organisms.
That means they will take over any area that is made comfortable for
them. A body with an impaired immune system is a prime target for fungi.
It is common medical knowledge that any infection will adversely affect
someone already struggling with other chronic conditions.
Vulvodynia
Vulvodynia, or vulvar pain, is pain that some women experience in
their external sexual parts, although often there are sharp pains in
the vaginal area as well. Some of this may be due to trigger points
and some to causes yet unknown.
