Q: I have been diagnosed with fibromyalgia and chronic fatigue syndrome. Do you have any idea about what causes fibromyalgia? Are there any new treatments available? I do not want to be in this much pain in my muscles and joints for the rest of my life. I am 52 and female.
A: Doctors and researchers are still trying to find out what causes the painful condition known as fibromyalgia.
There is no real consensus but the word syndrome means that it is a collection of symptoms with one or many root causes. In some people, there may be a hereditary link, but it is also possible that several members of the same family could be exposed to the same pathogens or environmental conditions.
Most physicians think it is a result of a several physical and emotional stressors. Depression, anxiety and sleep disturbances are common with this condition.
Because anti-depressants seem to help the pain and the sleep problems, there is speculation that a lowered level of the neurotransmitter substance, serotonin, could be partly to blame.
Women are more likely to be victims of fibromyalgia have about a seventh of the amount of serotonin compared to men. Deficiency in serotonin could also reduce the efficacy of endorphins, which are the body’s natural painkillers.
Exercise may help produce endorphins, which is why gentle exercise such as walking is recommended for fibromyalgia patients.
A relatively new theory is that undiagnosed chronic bacterial, viral or fungal infections may be the underlying conditions that cause inflammation of the muscles, joints and nerves.
People with fibromyalgia often say that they feel much better after taking a course of antibiotics for another reason.
Danish research has also recently discovered that as many as half of all cases of chronic back pain may be the result of bacterial infections.
The problem occurs when a disc becomes herniated. Bacteria can enter and cause an infection leading to swelling of the vertebrae and pressure on the spinal cord and nerve roots. This can be extremely painful.
Researchers conducted a study in which 162 chronic back pain sufferers were given a combination of two common antibiotics for a period of three months.
About 80 percent of them were completely cured or had a significant reduction in their pain levels.
We need to be cautious about the overuse of antibiotics, because this could further increase the rise of drug resistant bacteria such as MRSA or C. difficile.
The Danish studies need to be validated and replicated, using a larger number of participants before we can be certain that treatment with antibiotics is justified.
Clare Rowson is a retired medical doctor in Belleville, Ont. Contact: [email protected]