FMS|CFS|MPS (CMP)

fms cfs me mps 2

FMS – Fibromyalgia Syndrome

Fibromyalgia can be described as widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. It is believed by researchers that fibromyalgia acts like an amplifier, boosting pain sensations by changing the way pain signals are processed in your brain.

Symptoms often start after a physical trauma, surgery, infection or major psychological stress. In some other cases, symptoms have gradually crept up over time with no one triggering event.

Women are much more likely to develop fibromyalgia than are men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression.

While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Exercise, relaxation and stress-reduction measures also may help.


Symptoms

Symptoms of fibromyalgia include:
  • Widespread pain. The pain associated with fibromyalgia often is described as a constant dull ache that has lasted for at least three months. To be considered widespread, the pain must occur on both sides of your body and above and below your waist.
  • Fatigue. People with fibromyalgia often awaken tired, even though they report sleeping for long periods of time. Sleep is often disrupted by pain, and many patients with fibromyalgia have other sleep disorders, such as restless legs syndrome and Sleep Apnea.
  • Cognitive difficulties. A symptom commonly referred to as “fibro fog” makes it very difficult to pay attention and concentrate on any tasks that require memory.
  • Other problems. Quite a few people with fibromyalgia can also experience depression, headaches, and pain or cramping in the lower abdomen.

Causes

Doctors don’t know what causes fibromyalgia, but it most likely involves a variety of factors working together. These may include:
  • Genetics. Because fibromyalgia tends to run in families, there may be certain genetic mutations that may make you more susceptible to developing it.
  • Infections. Some illnesses do appear to act as a trigger or aggravate fibro.
  • Physical or emotional trauma. PTSD has also been connected with fibromyalgia.

Why does it hurt?

Researchers have a belief that repeated nerve stimulation causes the brains of fibro warriors to change. This change involves an abnormal increase in levels of certain chemicals in the brain that signal pain (neurotransmitters). In addition, the brain’s pain receptors seem to develop a sort of memory of the pain and become more sensitive, meaning they can overreact to pain signals.


Risk Factors

Risk factors for fibromyalgia include:
  • Your sex. Fibromyalgia is diagnosed more often in women than in men.
  • Family history. You may be more likely to develop fibromyalgia if a relative also has the condition.
  • Rheumatic disease. If you have a rheumatic disease, such as rheumatoid arthritis or lupus, you may be more likely to develop fibromyalgia.

Researchers believe repeated nerve stimulation causes the brains of people with fibromyalgia to change. This change involves an abnormal increase in levels of certain chemicals in the brain that signal pain (neurotransmitters). In addition, the brain’s pain receptors seem to develop a sort of memory of the pain and become more sensitive, meaning they can overreact to pain signals.


Complications

The pain and lack of sleep associated with fibromyalgia can interfere with your ability to function at home or on the job. The frustration of dealing with an often-misunderstood condition also can result in depression and health-related anxiety.


Preparing for your Appointment

Because many of the signs and symptoms of fibromyalgia are similar to various other disorders, you may see several doctors before receiving a diagnosis. Your family physician may refer you to a doctor who specializes in the treatment of arthritis and other inflammatory conditions (rheumatologist).

What you can do

Before your appointment, you may want to write a list that includes:
  • Detailed descriptions of your symptoms
  • Information about medical problems you’ve had in the past
  • Information about the medical problems of your parents or siblings
  • All the medications and dietary supplements you take
  • Questions you want to ask the doctor

What to Expect From Your Doctor

In addition to a physical exam, your doctor will probably ask you if you have problems sleeping and if you’ve been feeling depressed or anxious.


Tests and Diagnosis

In the past, doctors would check 18 specific points on a person’s body to see how many of them were painful when pressed firmly. Newer guidelines don’t require a tender point exam. Instead, a fibromyalgia diagnosis can be made if a person has had widespread pain for more than three months — with no underlying medical condition that could cause the pain.

Blood Test

While there is no lab test to confirm a diagnosis of fibromyalgia, your doctor may want to rule out other conditions that may have similar symptoms.

Blood tests may include:
  • Complete blood count
  • Erythrocyte sedimentation rate
  • Thyroid function tests

Treatments and Drugs

In general, treatments for fibromyalgia include both medication and self-care. The emphasis is on minimizing symptoms and improving general health. No one treatment works for all symptoms.

Medications

Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices include:
  • Pain relievers. Over-the-counter pain relievers such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others) may be helpful. Your doctor might suggest a prescription pain reliever such as tramadol (Ultram, Conzip). Narcotics are not advised, because they can lead to dependence and may even worsen the pain over time.
  • Antidepressants. Duloxetine (Cymbalta) and milnacipran (Savella) may help ease the pain and fatigue associated with fibromyalgia. Your doctor may prescribe amitriptyline or fluoxetine (Prozac) to help promote sleep.
  • Anti-seizure drugs. Medications designed to treat epilepsy are often useful in reducing certain types of pain. Gabapentin (Neurontin, Gralise) is sometimes helpful in reducing fibromyalgia symptoms, while pregabalin (Lyrica) was the first drug approved by the Food and Drug Administration to treat fibromyalgia.

Therapy

Talking with a counselor can help strengthen your belief in your abilities and teach you strategies for dealing with stressful situations.


Lifestyle and Home Remedies

Self-care is critical in the management of fibromyalgia.
  • Reduce stress. Develop a plan to avoid or limit overexertion and emotional stress. Allow yourself time each day to relax. That may mean learning how to say no without guilt. But try not to change your routine completely. People who quit work or drop all activity tend to do worse than do those who remain active. Try stress management techniques, such as deep-breathing exercises or meditation.
  • Get enough sleep. Because fatigue is one of the main characteristics of fibromyalgia, getting sufficient sleep is essential. In addition to allotting enough time for sleep, practice good sleep habits, such as going to bed and getting up at the same time each day and limiting daytime napping.
  • Exercise regularly. At first, exercise may increase your pain. But doing it gradually and regularly often decreases symptoms. Appropriate exercises may include walking, swimming, biking and water aerobics. A physical therapist can help you develop a home exercise program. Stretching, good posture and relaxation exercises also are helpful.
  • Pace yourself. Keep your activity on an even level. If you do too much on your good days, you may have more bad days. Moderation means not overdoing it on your good days, but likewise it means not self-limiting or doing too little on the days when symptoms flare.
  • Maintain a healthy lifestyle. Eat healthy foods. Limit your caffeine intake. Do something that you find enjoyable and fulfilling every day.

Coping and Support

Besides dealing with the pain and fatigue of fibromyalgia, you also may have to deal with the frustration of having a condition that’s often misunderstood. In addition to educating yourself about fibromyalgia, you may find it helpful to provide your family, friends and co-workers with information.

It’s also helpful to know that you’re not alone. Organizations such as the National Fibromyalgia Association and the American Chronic Pain Association can help put you in touch with others who have had similar experiences and can understand what you’re going through.



photo-1438979315413-de5df30042a1CFS – Chronic Fatigue  Syndrome

Chronic fatigue syndrome is a complicated disorder characterized by extreme fatigue that can’t be explained by any underlying medical condition. The fatigue may worsen with physical or mental activity, but doesn’t improve with rest.

The cause of chronic fatigue syndrome is unknown, although there 4p are many theories — ranging from viral infections to psychological stress. Some experts believe chronic fatigue syndrome might be triggered by a combination of factors.

There’s no single test to confirm a diagnosis of chronic fatigue syndrome. You may need a variety of medical tests to rule out other health problems that have similar symptoms. Treatment for chronic fatigue syndrome focuses on symptom relief.


Symptoms

Chronic fatigue syndrome has eight official signs and symptoms, plus the central symptom that gives the condition its name:
  • Fatigue
  • Loss of memory or concentration
  • Loss of memory or concentration
  • Sore throat
  • Enlarged lymph nodes in your neck or armpits
  • Unexplained muscle pain
  • Pain that moves from one joint to another without swelling or redness
  • Headache of a new type, pattern or severity
  • Unrefreshing sleep
  • Extreme exhaustion lasting more than 24 hours after physical or mental exercise

When To See a Doctor

Fatigue can be a symptom of many illnesses, such as infections or psychological disorders. In general, see your doctor if you have persistent or excessive fatigue.


Causes

Scientists don’t know exactly what causes chronic fatigue syndrome. It may be a combination of factors that affect people who were born with a predisposition for the disorder.

Some of the factors that have been studied include:
  • Viral infections. Because some people develop chronic fatigue syndrome after having a viral infection, researchers question whether some viruses might trigger the disorder. Suspicious viruses include Epstein-Barr virus, human herpes virus 6 and mouse leukemia viruses. No conclusive link has yet been found.
  • Immune system problems. The immune systems of people who have chronic fatigue syndrome appear to be impaired slightly, but it’s unclear if this impairment is enough to actually cause the disorder.
  • Hormonal imbalances. People who have chronic fatigue syndrome also sometimes experience abnormal blood levels of hormones produced in the hypothalamus, pituitary glands or adrenal glands. But the significance of these abnormalities is still unknown.

Risk Factors

Factors that may increase your risk of chronic fatigue syndrome include:
  • Age. Chronic fatigue syndrome can occur at any age, but it most commonly affects people in their 40s and 50s.
  • Sex. Women are diagnosed with chronic fatigue syndrome much more often than men, but it may be that women are simply more likely to report their symptoms to a doctor.
  • Stress. Difficulty managing stress may contribute to the development of chronic fatigue syndrome.

Complications

Possible complications of chronic fatigue syndrome include:
  • Depression
  • Social isolation
  • Lifestyle restrictions
  • Increased work absences’

Preparing for your Appointment

If you have signs and symptoms of chronic fatigue syndrome, you’re likely to start by seeing your family doctor or a general practitioner. It can be difficult to absorb all the information provided during an appointment, so you might want to arrange for a friend or family member to accompany you. Having someone else hear the information can help you later in case there’s something you missed or forgot.

What You Can Do

Before your appointment, you may want to write a list that includes:
  • Your signs and symptoms. Be thorough. While fatigue may be affecting you most, other symptoms — such as memory problems or headache — are also important to share with your doctor.
  • Key personal information. Recent changes or major stressors in your life can play a very real role in your physical well-being.
  • Health information. List any other conditions for which you’re being treated and the names of any medications, vitamins or supplements you take regularly.
  • Questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.
For chronic fatigue syndrome, some basic questions to ask your doctor include:
  • What are the possible causes of my symptoms or condition?
  • What tests do you recommend?
  •  If these tests don’t pinpoint the cause of my symptoms, what additional tests might I need?
  • On what basis would you make a diagnosis of chronic fatigue syndrome?
  • Are there any treatments or lifestyle changes that could help my symptoms now?
  • Do you have any printed materials I can take with me? What websites do you recommend?
  • What activity level should I aim for while we’re seeking a diagnosis?
  • Do you recommend that I also see a mental health provider?

***Don’t hesitate to ask other questions during your appointment as they occur to you.***

What To Expect From Your Doctor

Your doctor is likely to ask you a number of questions, such as:
  • What are your symptoms and when did they begin?
  • Does anything make your symptoms better or worse?
  • Do you have problems with memory or concentration?
  • Are you having trouble sleeping?
  • How often do you feel depressed or anxious?
  • How much do your symptoms limit your ability to function? For example, have you ever had to miss school or work because of your symptoms?
  • What treatments have you tried so far for this condition? How have they worked?

Tests and Diagnosis

There’s no single test to confirm a diagnosis of chronic fatigue syndrome. Because the symptoms of chronic fatigue syndrome can mimic so many other health problems, you may need patience while waiting for a diagnosis.

Your doctor must rule out a number of other illnesses before diagnosing chronic fatigue syndrome. These may include:
  • Sleep disorders. Chronic fatigue can be caused by sleep disorders. A sleep study can determine if your rest is being disturbed by disorders such as obstructive sleep apnea, restless legs syndrome or insomnia.
  • Medical problems. Fatigue is a common symptom in several medical conditions, such as anemia, diabetes and underactive thyroid (hypothyroidism). Lab tests can check your blood for evidence of some of the top suspects.
  • Mental health issues. Fatigue is also a symptom of a variety of mental health problems, such as depression, anxiety, bipolar disorder and schizophrenia. A counselor can help determine if one of these problems is causing your fatigue.

Diagnostic Criteria

To meet the diagnostic criteria of chronic fatigue syndrome, you must have unexplained, persistent fatigue for six months or more, along with at least four of the following signs and symptoms:
  • Loss of memory or concentration
  • Sore throat
  • Enlarged lymph nodes in your neck or armpits
  • Unexplained muscle pain
  • Pain that moves from one joint to another without swelling or redness
  • Headache of a new type, pattern or severity
  • Unrefreshing sleep
  • Extreme exhaustion lasting more than 24 hours after physical or mental exercise.

Treatments and Drugs

Treatment for chronic fatigue syndrome focuses on symptom relief.

Medications

Because chronic fatigue syndrome affects people in many different ways, your treatment will be tailored to your specific set of symptoms.

Symptom relief may include certain medications:
  • Antidepressants. Many people who have chronic fatigue syndrome are also depressed. Treating your depression can make it easier for you to cope with the problems associated with chronic fatigue syndrome. Low doses of some antidepressants also can help improve sleep and relieve pain.
  • Sleeping pills. If home measures, such as avoiding caffeine, don’t help you get better rest at night, your doctor might suggest trying prescription sleep aids.

Therapy

The most effective treatment for chronic fatigue syndrome appears to be a two-pronged approach that combines psychological counseling with a gentle exercise program.

  • Graded exercise. A physical therapist can help determine what types of exercise are best for you. Inactive people often begin with range-of-motion and stretching exercises for just a few minutes a day. If you’re exhausted the next day, you’re doing too much. Your strength and endurance will improve as you gradually increase the intensity of your exercise over time.
  • Psychological counseling. Talking with a counselor can help you figure out options to work around some of the limitations that chronic fatigue syndrome imposes on you. Feeling more in control of your life can improve your outlook dramatically.

Lifestyle and Home

For chronic fatigue syndrome, certain self-care measures may help:
  • Reduce stress. Develop a plan to avoid or limit overexertion and emotional stress. Allow yourself time each day to relax. That may mean learning how to say no without guilt.
  • Improve sleep habits. Go to bed and get up at the same time each day. Limit daytime napping and avoid caffeine, alcohol and nicotine.
  • Pace yourself. Keep your activity on an even level. If you do too much on your good days, you may have more bad days.

Alternative Treatment

Many alternative therapies have been promoted for chronic fatigue syndrome. It’s difficult to determine whether these therapies actually work, partly because the symptoms of chronic fatigue syndrome often are linked to mood and can vary from day to day.

Pain associated with chronic fatigue syndrome may be helped by:
  • Acupuncture
  • Massage
  • Yoga or tai chi

Coping and Support

The experience of chronic fatigue syndrome varies from person to person. For many people, however, the symptoms are more bothersome early in the course of the illness and then gradually decrease. Emotional support and counseling may help you and your loved ones deal with the uncertainties and restrictions of chronic fatigue syndrome.

You may find it therapeutic to join a support group and meet other people with chronic fatigue syndrome. Support groups aren’t for everyone, and you may find that a support group adds to your stress rather than relieves it. Experiment and use your own judgment to determine what’s best for you.



woman hide scarf

ME – Myalgic Encephalomyelitis

Myalgic encephalomyelitis (ME) is a condition with unknown origin and unclear treatment options. Widespread inflammation and multisystemic neuropathology seem to be at the core of its pathophysiology.

ME is also commonly referred to as chronic fatigue syndrome but advocates for the condition prefer the ME nomenclature. Chronic fatigue syndrome has been often misused and/or over-diagnosed in the past so it is currently unclear if ME is a rare condition. A recent prevalence study (Vincent et al 2012)  had the estimated number of patients in the U.S. at around the 200,000 mark but more studies are needed to ascertain its true prevalence.

In this interview with Rare Disease Report, patient – and patient advocate – Charlotte von Salis describes ME and the need for more awareness and funding for this condition.



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MPS (CMP)
Myofascial Pain Syndrome aka Chronic Myofascial Pain

Myofascial pain syndrome is a chronic pain disorder. In myofascial pain syndrome, pressure on sensitive points in your muscles (trigger points) causes pain in seemingly unrelated parts of your body. This is called referred pain.

Myofascial pain syndrome typically occurs after a muscle has been contracted repetitively. This can be caused by repetitive motions used in jobs or hobbies or by stress-related muscle tension.

While nearly everyone has experienced muscle tension pain, the discomfort associated with myofascial pain syndrome persists or worsens. Treatment options for myofascial pain syndrome include physical therapy and trigger point injections. Pain medications and relaxation techniques also can help.


Symptoms

Signs and symptoms of myofascial pain syndrome may include:
  • Deep, aching pain in a muscle
  • Pain that persists or worsens
  • A tender knot in a muscle
  • Difficulty sleeping due to pain

When to see a doctor

Make an appointment with your doctor if you experience muscle pain that doesn’t go away. Nearly everyone experiences muscle pain from time to time. But if your muscle pain persists despite rest, massage and similar self-care measures, make an appointment with your doctor.


Causes

Sensitive areas of tight muscle fibers can form in your muscles after injuries or overuse. These sensitive areas are called trigger points. A trigger point in a muscle can cause strain and pain throughout the muscle. When this pain persists and worsens, doctors call it myofascial pain syndrome.


Risk Factors

Myofascial pain syndrome is caused by a stimulus, such as pressure, that sets off trigger points in your muscles.

Factors that may increase your risk of muscle trigger points include:
  • Muscle injury. An acute muscle injury or continual muscle stress may lead to the development of trigger points. For example, a spot within or near a strained muscle may become a trigger point. Repetitive motions and poor posture also may increase your risk.
  • Stress and anxiety. People who frequently experience stress and anxiety may be more likely to develop trigger points in their muscles. One theory holds that these people may be more likely to clench their muscles, a form of repeated strain that leaves muscles susceptible to trigger points.

Complications

Complications associated with myofascial pain syndrome may include:
  • Sleep problems. Signs and symptoms of myofascial pain syndrome may make it difficult to sleep at night. You may have trouble finding a comfortable sleep position. And if you move at night, you might hit a trigger point and awaken.
  • Fibromyalgia. Some research suggests that myofascial pain syndrome may develop into fibromyalgia in some people. Fibromyalgia is a chronic condition that features widespread pain. It’s believed that the brains of people with fibromyalgia become more sensitive to pain signals over time. Some doctors believe myofascial pain syndrome may play a role in starting this process.

Preparing for your Appointment

Because many of the signs and symptoms of myofascial pain syndrome are similar to various other disorders, you may see several doctors before receiving a diagnosis.

What You Can Do

You’re likely to start with a visit to your primary care doctor, who may refer you to a doctor who specializes in diagnosing and treating muscle and joint conditions (rheumatologist).

You may get more from your appointment if you do these things beforehand:
  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there’s anything you need to do in advance to prepare for your evaluation.
  • Write down any symptoms you’re experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Make a list of your key medical information, including any other conditions for which you’re being treated, and the names of any medications, vitamins or supplements you’re taking.
  • Consider questions to ask your doctor and write them down. Bring along notepaper and a pen to jot down information as your doctor addresses your questions.
For myofascial pain syndrome, some basic questions to ask your doctor include:
  • What are the possible causes of my symptoms?
  • Is my condition temporary?
  • Will I need treatment?
  • What treatments are available?
  • Do you have any brochures or other printed material that I can take home with me?

What To Expect From Your Doctor

Your doctor or health care provider is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on.

Questions your doctor might ask include:
  • What symptoms are you experiencing?
  • Where do you feel the most intense area of pain?
  • How long have you been experiencing these symptoms?
  • Do your symptoms seem to come and go, or are they persistent?
  • Does anything seem to make your symptoms better?
  • Does anything seem to make your symptoms worse?
  • Are your symptoms worse in the morning or at any particular time of the day?
  • Do you perform repetitive tasks on the job or for hobbies?
  • Have you had any recent injuries?
  • Does your pain cause you to limit your activities?

Tests and Diagnosis

During the physical exam, your doctor may apply gentle finger pressure to the painful area, feeling for tense areas. Certain ways of pressing on the trigger point can elicit specific responses. For instance, you may experience a muscle twitch.

Muscle pain has many possible causes. Your doctor may recommend other tests and procedures to rule out other causes of muscle pain.


Treatments and Drugs

Treatment for myofascial pain syndrome typically includes medications, trigger point injections or physical therapy. No conclusive evidence supports using one therapy over another. Discuss your options and treatment preferences with your doctor. You may need to try more than one approach to find pain relief.

Medications

Medications used for myofascial pain syndrome include:
  • Pain relievers. Over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) may help some people. Or your doctor may prescribe stronger pain relievers. Some are available in patches that you place on your skin.
  • Antidepressants. Many types of antidepressants can help relieve pain. For some people with myofascial pain syndrome, amitriptyline appears to reduce pain and improve sleep.
  • Sedatives. Clonazepam (Klonopin) helps relax muscles affected by myofascial pain syndrome. It must be used carefully because it can cause sleepiness and can be habit-forming.

Therapy

A physical therapist can devise a plan to help relieve your pain based on your signs and symptoms. Physical therapy to relieve myofascial pain syndrome may involve:
  • Stretching. A physical therapist may lead you through gentle stretching exercises to help ease the pain in your affected muscle. If you feel trigger point pain when stretching, the physical therapist may spray a numbing solution on your skin.
  • Posture training. Improving your posture can help relieve myofascial pain, particularly in your neck. Exercises that strengthen the muscles surrounding your trigger point will help you avoid overworking any one muscle.
  • Massage. A physical therapist may massage your affected muscle to help relieve your pain. The physical therapist may use long hand strokes along your muscle or place pressure on specific areas of your muscle to release tension.
  • Heat. Applying heat, via a hot pack or a hot shower, can help relieve muscle tension and reduce pain.
  • Ultrasound. This type of therapy uses sound waves to increase blood circulation and warmth, which may promote healing in muscles affected by myofascial pain syndrome.

Needle procedures

Injecting a numbing agent or a steroid into a trigger point can help relieve pain. In some people, just the act of inserting the needle into the trigger point helps break up the muscle tension. Called dry needling, this technique involves inserting a needle into several places in and around the trigger point. Acupuncture also appears to be helpful for some people who have myofascial pain syndrome.


Lifestyle and Home Remedies

Take care of yourself if you have myofascial pain syndrome. Self-care measures to keep your body healthy may make it easier for you to concentrate on coping with your pain.

Try to:
  • Exercise. Gentle exercise can help you cope better with pain. When your pain allows, get moving. Ask your doctor or physical therapist about appropriate exercises.
  • Relax. If you’re stressed and tense, you may experience more pain. Find ways to relax. Meditating, writing in a journal or talking with friends can all be helpful.
  • Take care of your body. Eat a healthy diet full of fruits and vegetables. Get enough sleep so that you wake rested. Take care of your body so that you can put your energy toward coping with your pain.

Coping and Support

Having a chronic pain condition such as myofascial pain syndrome can be frustrating. Treatment may be only moderately successful for you. It may help to talk to a counselor about the challenges you’re facing. Online or in-person support groups also can be helpful by connecting you with people who understand what you’re going through.


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