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Fibromyalgia Phantom Pain Diagnosis and Treatment

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An unexplained pain disorder is commonly labeled as fibromyalgia. The worse thing about unexplained physical pain is the depression that comes with it and not knowing the cause of it and how to effectively alleviate, or remove the pain. In many fibromyalgia cases, mental health prescription drugs are often the treatment course.

Fibromyalgia is not considered a mental illness disorder… however, it is considered a real disorder once medically substantiated through examination and lab protocol diagnosis. It has been medically determined a depressed and anxious mindset and lack of sleep can cause an autoimmune response leading to inflammatory pain-causing symptoms throughout the body. It has long been a practice for medical professionals to prescribe anti-depressants and sleep aid medications useful in treating acute and chronic phantom pain.

Many who suffer from “medically unsubstantiated and undiagnosed pain cause” are three times more likely to suffer from depression and/or anxiety. In the absence of pain causing illness and disease and physical injury, the central nervous system(s) neuro and hormonal chemicals are often found out-of- balance. Body chemical imbalances are found to trigger an inflammatory autoimmune response in many patients. This chemical imbalance and inflammatory response have a direct connection to mood and bodily pain.

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The populace who tends to be diagnosed with fibromyalgia is women between the ages of 35-55. This condition rarely takes a toll on men, the elderly, or children, although it does occur. Women with fibromyalgia in the U.S. represent over 80% of those diagnosed with this condition. The total populace affected by fibromyalgia in the US represents 2% of our population. Fibromyalgia was formally known as fibrositis (a group of disorders characterized by widespread body aches and pains in muscle, connective tissue, joints and bone). Other triggers that can activate the fibromyalgia condition include exposure to dampness, or cold and certain infections. Pain is usually worse in the morning.

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Understanding Fibromyalgia Basics: Fibromyalgia is a chronic condition that causes pain and stiffness in the muscles, tendons, and ligaments. Although an exact cause of this condition has not been directly identified, it is thought that a major player to this chronic condition resides within the brains serotonin levels which affects mood. Lower levels of serotonin are known to stimulate depression and with depression psychosomatic illness often occurs. If anyone becomes depressed for a long period of time, the body gets sick and real physical pain is experienced. There seems to be a direct correlation between depression, lack of sleep, restlessness, disturbances in bowel function and super sensitivity with touch, whereas key trigger pain receptors are transmitted via the neurochemical highways from the central nervous system (brain). Fatigue combined with depression can trigger autoimmune infection, and related disease and pain anywhere in the body.

When mental and physical pain episodes go undiagnosed too long and without intervention, unhealthy habits and behavior often ensue, i.e., self-medication, sedentary and addictive drinking habits, etc. Unhealthy lifestyle untreated for long duration will lead to more psychosomatic neuro and hormonal chemical imbalances and pain and illness which can lead to other disease manifestation and cancer.

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If you have unexplainable acute/chronic phantom pain in any muscle, joint, tendons and ligaments, seek a medical opinion and request referral to a physiatrist as soon as possible before symptoms worsen.

Recall, “Fibromyalgia is considered a real disorder once medically substantiated.” However, it remains a challenge for many physicians to diagnose an exact cause of pain and treat effectively in some cases. Why? Unlike rheumatoid arthritis or systemic lupus there is no swelling, external-internal tissue damage, or joint-muscle deformity. The patient is healthy otherwise but suffers from chronic muscular pain and stiffness without swelling, deformity or bruising.

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When diagnosing fibromyalgia, the most common symptoms doctors look for: headaches, tender point pain, irritable bowel syndrome, fatigue etc. Psychological symptoms: depression, sleep disturbances and mood changes. Referred lab findings may medically substantiate the disorder via Elevated levels of Substance P (Chemical Nerve Signal) and Nerve Growth Factor (Found in the spinal fluid) and lower levels of serotonin (Brain Nerve Chemical) from laboratory specimen fluid samples.

“The level of chemical in the cerebrospinal fluid (CSF) called substance P, which transmits pain impulses to the brain, is three times higher in people with the disease than in those who do not have the condition. This likely causes someone with fibromyalgia to experience pain more intensely” [emedicinehealth WebMD 2021]

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If you experience phantom pain and have not been diagnosed with a substantiated fibromyalgia disorder, read the tips and recommendations below and seek a medical opinion and diagnosis to get the help you need and deserve now.

10 Fibromyalgia Tips and Recommendations
1. See your doctor if you experience any combination of the symptoms listed above, or (a.) Experience chronic body pain for more than 3 months above and below the waist. (b.) Feel pain in at least 11-18 possible tender points when light pressure is applied. (c.) Experiencing depression and thoughts of suicide and/or high levels of anxiety.
2. Get help if a family member exhibits: Panic attacks, hostility, restlessness, hyperactivity, sleeplessness, and physical pain.
3. If prescribed anti-depressants, a family member should watch for adverse character changes that lead to self-medication and unhealthy lifestyle habits to control pain. A two- month watch is recommended when prescribed anti-depressants to combat fibromyalgia.
4. Adverse behavioral risk is more prominent within adults under 24 and children.
5. Apply hot showers-spray localized area, use heating pads, whirlpool, hot compresses, gentle message to alleviate phantom pain.
6. Stretching and relaxation will alleviate stress, and biofeedback (doctor advisement on this one) will help ease contracted muscles causing pain.
7. The following prescription may be provided to ease pain. Aspirin, acetaminophen, or ibuprofen. Cortisone and local anesthetic injections at pain trigger points.
8. Antidepressants per doctor recommendations, e.g., Serotonin Reuptake Inhibitors (SSRI).
9. Avoid caffeine and alcohol as these interfere with sleep.
10. Get adequate sleep and general conditioning and exercise, proper nutrition.

Author: Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET. 2009-21 Copyright. All rights reserved, Mirror Athlete Publishing @: www.mirrorathlete.org,  Sign up for your Free eNewsletter.

Cramp Facilitation, The Same as Restless Leg Syndrome?

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The patient Restless Leg Syndrome (RLS) experience is a creepy crawly, twitching, involuntary underlying skin movement sensation and also may be associated with aching mostly in the knee down to the foot.  The symptoms can also occur in the arms with a feeling as if you are in a constant state of a flexing sensation.  This experience also induces insomnia for many that experience restless nights because of involuntary muscle movement.  There are now several potential causes identified with restless leg syndrome.  These causes are mostly to do within diet.  And the other causes could be something of concern that could stay undiagnosed for years until a neurological specialist rules out one thing or the other.

Caffeine and low levels of blood glucose have a known cause-effect associated with RLS.   It is recommended if you have RLS like symptoms, to rule out specific causes possibly through diet and that you seek a referral from your primary care physician to see a neurologist.  Until you get this referral try eliminating coffee, tea, sodas and cocoa from the diet.  This will provide some feedback to your neurologist when you get the consult.  By eliminating these potential causes from diet, either RLS symptoms are relieved, not relieved, or in remission.  If symptoms disappear, don’t cancel your neurology appointment.   The remission of symptoms could simply be due to infrequent muscle facilitation caused by something else.  And when you see your neurologist asks the following questions:  Can I also be evaluated for functional “hypoglycemia (low blood sugar),” and/or deficiencies of folic acid, iron or magnesium.

And if the lab results rule out these diet deficiencies, also ask if consideration of vitamin E and L-tryptophan trials would be worthwhile to assist in determining treatment.  It has been proven in clinical trials that vitamin and mineral deficiencies can and do cause hyper excitable muscle sensations (RLS) and that supplementation in clinical studies have proven to remove, or substantially reduce the symptoms associated with RLS.  But it is important to note while anyone can supplement their diet, using proper dosages under a physicians care is very important for the safety and success of such treatment.

Now let’s take a look at RLS syndrome’s close cousin [Cramp Facilitation Syndrome].  Why do I say cousin?  Because there are many close symptomatic similarities that could confuse the necessity to look further into your condition and unknowingly push off identification and treatment of a more severe and insidious disease.

What is cramp facilitation syndrome and how do you know you have it?  It is a rare condition characterized by muscle pain, twitching, cramps, creepy crawly sensations typically felt within the legs and arms.  These symptoms have also been characterized and confused by patients as restless leg syndrome at the onset.

It is also not common knowledge that there is a whole host of diseases that can cause these symptoms.  Other disease pathology mimics less serious diagnosis than others.  For a piece of mind, if you experience any of these symptoms [RLS, or Cramp Facilitation Syndrome] to seek a referral from your primary care physician to see a neurological to rule out other potential serious disease (Parkinson’s, MS, Cancer, etc.).  I recommend being adamant in pursuing this referral if you have RLS like symptoms.

I’ve become very familiar with RLS through commercialization of this conditional diagnosis as seen on infomercials.  But have never heard of “Cramp Facilitation Syndrome, and in some cases known as Isaac’s syndrome.”  These syndromes also mimic [although typically more pronounced and severe symptoms] very similar conditions, I only knew to be RLS.  Cramp Facilitation Syndrome is also medically transcribed and known as Neuromyotonia (NMT).

NMT or Isaac’s syndrome is a form of peripheral nerve hyperexcitabilty and is very rare.  There are no known cures for Isaac’s syndrome.  And from all I’m reading about it and as discussed with a neurologist, there are a lot of unknowns about the origins of these syndromes.  The 3 causes of spontaneous repetitive muscular activity “throughout” the body triggered by muscle fiber action potential with regard to NMT are: 1) Acquired  2) Paraneoplastic  3) Hereditary.

1)      The Acquired is the most common form of NMT and is thought to be caused by antibodies against the neuromuscular junctions; suspected to be an immune deficiency [80% of all cases).  If the immune system suspects foreign bodies at these neuromuscular junctions, they attempt to neutralize the foreign matter.  These antibodies are produced by our white blood cells and promote various antibodies to deal with perceived invasion of our internal body.  By binding to a perceived internal threat our defense mechanisms cause muscle fasciculation to occur.

2)   What is Paraneoplastic cause of muscle fasciculation – The immune or hormonal response from a tumor sends chemical signal to cause an antibody reaction at neuromuscular junctions within muscle cells.  The cause of this action is the presence of cancer in the body; excreted by tumor cells that trigger the body’s hormones or immune system.  And the muscle hyperexcitability can be triggered before a tumor is diagnosed as malignant!  Tumor cells usually present themselves within the lung, breast, ovaries or lymphatic system.

3)   Hereditary – Genetic predisposition to have NMT symptoms with like biological pathogen source passed down through family genes.

In many cases, cramp facilitation syndrome is treatable.  In rare occasions, those with more severe conditions where antibodies work against voltage-gated potassium channels [a chemical action necessary for muscle movement] impact the central nervous system and could be fatal (e.g., Morvan’s Syndrome).  Rest assured RLS and NMT is not fatal [exception: Paraneoplastic cause appears to have statistical probability associated with fatalities].

NMT does mimic other serious disease that could be fatal.  Most NMT cases are autoimmune and not associated with cancer [80 percent of all cases and is suspected to be autoimmune mediated, which is usually caused by antibodies].  For a piece of mind, having the correct diagnosis allows one to seek appropriate and applicable treatment as soon as possible, which also helps to reduce anxiety and mitigate outcome of insidious disease through early diagnosis and proper treatment.

World Wide Internet References,

http://www.tldp.com/issue/179/restless_legs_syndrome.htm

http://en.wikipedia.org/wiki/Isaac’s_Syndrome

http://www.wrongdiagnosis.com/c/cramp_fasciculations_syndrome/intro.htm

Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET. 2011 Copyright, All rights reserved, Mirror Athlete Publishing @: www.mirrorathlete.org,  Sign up for your Free eNewsletter.