Todays topic: Fibromyalgia

Fibromyalgia is a common syndrome in which a person has long-term, body-wide pain and tenderness in the joints, muscles, tendons, and other soft tissues.
Fibromyalgia has also been linked to fatigue, sleep problems, headaches, depression, and anxiety.

Causes, incidence, and risk factors

The cause is unknown. Possible causes or triggers of fibromyalgia include:

• Physical or emotional trauma
• Abnormal pain response - areas in the brain that are responsible for pain may react differently in fibromyalgia patients
• Sleep disturbances
• Infection, such as a virus, although none has been identified

Fibromyalgia is most common among women aged 20 to 50.
The following conditions may be seen with fibromyalgia or mimic its symptoms:

• Chronic neck or back pain
• Chronic fatigue syndrome
• Depression
• Hypothyroidism (underactive thyroid)
• Lyme disease
• Sleep disorders

Symptoms

Pain in the main symptom of fibromyalgia. It may be mild to severe.

• Painful areas are called tender points. Tender points are found in the soft tissue on the back of the neck, shoulders, chest, lower back, hips, shins, elbows, and knees. The pain then spreads out from these areas.
• The pain may feel like a deep ache, or a shooting, burning pain.
• The joints are not affected, although the pain may feel like it is coming from the joints.

People with fibromyalgia tend to wake up with body aches and stiffness. For some patients, pain improves during the day and gets worse at night. Some patients have pain all day long.
Pain may get worse with activity, cold or damp weather, anxiety, and stress.
Fatigue, depressed mood, and sleep problems are seen in almost all patients with fibromyalgia. Many say that they can't get to sleep or stay asleep, and they feel tired when they wake up.
Other symptoms of fibromyalgia may include:

• Irritable bowel syndrome (IBS)
• Memory and concentration problems
• Numbness and tingling in hands and feet
• Reduced ability to exercise
• Tension or migraine headaches

Signs and tests

To be diagnosed with fibromyalgia, you must have had at least 3 months of widespread pain, and pain and tenderness in at least 11 of 18 areas, including

• Arms (elbows)
• Buttocks
• Chest
• Knees
• Lower back
• Neck
• Rib cage
• Shoulders
• Thighs

Blood and urine tests are usually normal. However, tests may be done to rule out other conditions that may have similar symptoms.

Treatment

The goal of treatment is to help relieve pain and other symptoms, and to help a person cope with the symptoms.
The first type of treatment may involve:

• Physical therapy
• Exercise and fitness program
• Stress-relief methods, including light massage and relaxation techniques

If these treatments do not work, your doctor may prescribe an antidepressant or muscle relaxant. The goal of medication is to improve sleep and pain tolerance. Medicine should be used along with exercise and behavior therapy. Duloxetine (Cymbalta), pregabalin (Lyrica), and milnacipran (Savella) are medications that are approved specifically for treating fibromyalgia.
However, many other drugs are also used to treat the condition, including:

• Anti-seizure drugs
• Other antidepressants
• Muscle relaxants
• Pain relievers
• Sleeping aids

Cognitive-behavioral therapy is an important part of treatment. This therapy helps you learn how to:

• Deal with negative thoughts
• Keep a diary of pain and symptoms
• Recognize what makes your symptoms worse
• Seek out enjoyable activities
• Set limits

Support groups may also be helpful.
Other recommendations include:

• Eat a well-balanced diet
• Avoid caffeine
• Practice good sleep routines to improve quality of sleep
• Acupressure and acunpuncture

Severe cases of fibromyalgia may require a referral to a pain clinic.

Expectations (prognosis)

Fibromyalgia is a long-term disorder. Sometimes, the symptoms improve. Other times, the pain may get worse and continue for months or years.

Calling your health care provider

Call your health-care provider if you have symptoms of fibromyalgia.

Prevention

There is no known prevention.

Do Sweetened Drinks Really Lead to Depression?

In the study, people who drank sweetened beverages -- including regular and diet sodas, fruit punch, and sweetened iced tea -- had a higher risk for depression.

Researchers say the findings suggest that cutting down on sweetened drinks or replacing them entirely with non-sweetened beverages may help lower depression risk.

But an expert who reviewed the findings says it failed to convince him that drinking sweetened beverages raises depression risk.

“There is much more evidence that people who are depressed crave sweet things than there is to suggest that sweetened beverages cause depression,” says neurologist Kenneth M. Heilman, MD.

Heilman is a professor of neurology at the University of Florida College of Medicine in Gainesville.

The study included close to 264,000 people over the age of 50 enrolled in an AARP diet and health study.

When they entered the study, the participants were asked about their beverage-drinking habits as part of a detailed dietary survey. About 10 years later they were asked if they had been diagnosed with depression over the previous decade.

The analysis revealed that people who drank more than four cans or cups of diet soda a day had about a 30% higher risk of developing depression over the follow-up period than those who drank none. Those who drank regular soda had a 22% higher risk.

Coffee drinking, however, was associated with a 10% reduction in depression risk.

Drinking diet sweetened-beverages appeared to be associated with a slightly higher depression risk overall than drinking sugar-sweetened beverages.
More Research Needed, Expert Skeptical

The researchers noted that more research is needed to confirm the findings. They warn that people with depression should continue to take all medications prescribed by their doctors.

“While our findings are preliminary, and the underlying biological mechanisms are not known, they are intriguing and consistent with a small but growing body of evidence suggesting that artificially sweetened beverages may be associated with poor health outcomes,” says researcher Honglei Chen, MD, PhD, of the National Institutes of Health in Research Triangle Park, N.C.

Heilman, who is a member of the American Academy of Neurology, says the fact that carbonated and non-carbonated sweetened beverages appeared to increase depression risk, as did drinks sweetened with sugar and non-calorie sweeteners, leads him to question the findings.

He notes that there is evidence to suggest that people who are depressed or have a higher risk for depression seek out sweet foods and drinks as a way of self-soothing.

“The main point is that you can never show cause and effect in a study like this one,” he says. “By telling people to cut down on sugar-sweetened drinks you may be reducing depression risk or having no impact or having the opposite effect and making depression worse.”

4 Inflammation-Fighting Foods for Rheumatoid Arthritis

Rheumatoid arthritis (RA) sufferers know all too well the inflammation and pain that comes with the disease. Although there's no "RA diet" that can treat the condition, some foods may help you lower inflammation in your body. And because they're good for you, these foods -- including fruits and vegetables, whole grains, olive oil, and fish – may help you feel better overall.
An Age-Old RA diet

People with RA have immune systems that attack the lining of their joints. This assault causes chronic inflammation, stiffness, and pain. Research shows the Mediterranean diet's healthful components can help lower inflammation, benefiting people with the disease.

A British study looked at the impact of foods from the Mediterranean diet in women with RA. Researchers split 130 women into two groups. One group took a cooking class on Mediterranean-style eating. The other group received only written information and made no dietary changes.

Women who attended the class ate more foods that were rich in antioxidants and other anti-inflammatory substances, including fruits, vegetables, and monounsaturated fats (the kind found in olive oil). Over the next six months, they had less joint pain and morning stiffness and better overall health compared to the other group.

How can you add these foods to your plate? Here are four foods to try.
Inflammation Fighter: Fish

People with RA have higher levels of substances called cytokines that ramp up inflammation in the body. Polyunsaturated fats – especially omega-3 fatty acids – help suppress cytokines and other inflammatory chemicals.

These good fats also help decrease LDL "bad" cholesterol and triglyceride levels when used to replace saturated and trans fats in the diet. High levels of LDL cholesterol and triglycerides (fats in the blood) promote inflammation, which is thought to play a critical role in heart disease. That's important for people with RA, who have a significantly higher risk of heart disease.

All fish have some omega-3s. But salmon, herring, sardines, and anchovies are chock full of them. Salmon provides the most, with up to 2 grams of omega-3 fatty acids per 3-ounce serving. Go lightly with the heat; overcooking can destroy more than half of the omega-3s. Bake or grill fish instead of frying it to preserve healthful fat.

The American Heart Association recommends eating fish twice a week. Fish high in omega-3s are powerful anti-inflammatory foods that offer a multitude of health benefits.

Don't like fish? Other foods rich in omega-3 fatty acids include walnuts, canola oil, and soybeans. Or ask your doctor about omega-3 supplements derived from plants.