Understanding Fibromyalgia Pain
Posted: Saturday, February 26, 2011
by Angela Carter
Coastal Health Information Services
Fibromyalgia is a complex disorder and if you don't have a medical degree it can be difficult to understand. Even some in the medical field don't understand it because it involves the brain and nervous system and it can impact every part of your body.
People see a collection of unusual symptoms that fluctuate, that don't show up in the usual medical test, and they think that if they don't see any symptoms then there's nothing wrong with you. Their reactions are “They don't look sick.” This is the reaction I got for the first 10 years after I was diagnosed, even my husband started thinking that I was faking it because someone else had told him that's what they thought. There's a lot of scientific evidence that proves that it is a very real physical condition.
Understanding the Pain of Fibromyalgia
Suppose you are having small get together and several people have said that they would help you get ready for it only they don't show up and your guest list doubles or triples. You are so overwhelmed that you don't know what to do. This is what happens with the pain signals in a person with Fibromyalgia. The cells send too many pain messages (the party guest), more then the amount a normal person has. The messages of pain can turn a touch or an itch into pain. When the pain signals reach the brain, they're processed by serotonin. People with fibromyalgia don't have enough serotonin and it leaves the brain to deal with the pain much like those who said they were going to help you with your party and left you to deal with the extra people and preparations. The brain becomes overwhelmed and that's why when you have fibromyalgia you have pain and the tissues where the pain is shows no damage. It isn't imagined pain, it's very real because the brain misinterprets the sensations into very real pain. There are other substances in the brain when you have fibromyalgia that amplifies the signals, like turning up the volume on a radio or television, of everything around you. These can include light, noise and odor, on top of the pain, and it overloads the brain. It can lead to confusion, fear, anxiety and panic attacks.
Types of Fibromyalgia Pain
There are two different types of that are associated with fibromyalgia that are medically defined, and they are:
Hyperalgesia
“Hyper” means excess and “algesia” means pain, this is a medical term for pain that is amplified much like you have with Fibromyalgia. Your brain somehow takes what would be normal pain signals in someone without Fibromyalgia, and amplifies that signal making it more severe than it really is. Most of the drugs prescribed for Fibromyalgia are aimed at reducing hyperalgesia.
Allodynia
This symptom, is what is referred to as the pain that makes your skin hurt when the pressure from clothing or even a light massage, is present. It is believed to be a hypersensitive reaction that may result from a central state of being sensitized, that is associated with Fibromyalgia. This is what I call the ball bat syndrome because my entire body feels like someone has taken a ball bat to it and beat me with it. I have to wear the biggest, baggiest clothes I have in my closet when I get this. Even the wind blowing across my skin will cause me to hurt, and the water from the shower feels like a thousand needles hitting me. Allodynia is fairly rare and it's also associated with a small amount of other conditions, including neuropathy, postherpetic neuralgia and migraine. Pain signals originate from specialized nerves, called nociceptors, that senses information about things like temperature and painful stimuli from the skin. Allodynia comes in three forms:
- Tactile, that is pain from touch or mild pressure.
- Mechanical, that is pain from something moving across the skin like clothes or the wind.
- Thermal, that is pain from heat or cold that isn't severe enough to damage the skin.
Tramadol: (this is a beta-blocker, meaning that it tells your brain that there is no pain). I have used this pain medication for over 10 years with no side effects and it is the only medication I have used this long. I take only 150 mg per day, not at once but one at noon and two at night.
Lidocaine: I have tried this and it didn't work for me. I really don't care for the side effects.
Ketamine
Morphine: I have used this but I still went back to the Tramadol, because the Tramadol has less side effects then the morphine.
There are some who get relief from topical creams like caspaicin, Tiger Balm, Aspercreme or BioFreeze.
Massage therapy may make allodynia worse but there may be other areas of your health that would benefit from it. You will need to talk to your doctor and the massage therapist and keep track of how the treatments impact the symptom.
Keeping a pain diary will help you to identify your triggers, or what it is that is causing your pain to be worse. By writing down the time of day your pain has started, the weather conditions, whether or not you are under any stress, what you had to eat, and what kind of mood you are in will help you to this and then you can either avoid these triggers or find a way to cope with them. For me, my triggers are sugar, stress of any kind (confrontations, heavy traffic, even just driving), and the weather. I avoid these situations if I can, of course it's kind of hard to avoid the weather, so I usually stay inside on the really hot days and on rainy days, I end up having to take a few more Tramadol.
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