Features

BY PETE DELEA

After more than a decade, Kitty Tucker has chronic pain throughout her body. Every night she is awakened by shooting pain that starts at the backbone and shoots up throughout her arms, neck and head.

"I wake up and I think I'm black and blue," said Tucker. "But when I look in the mirror I'm fine."

Tucker said she went from doctor to doctor and all they could do was eliminate possible causes of the pain. Two years later she was diagnosed with Fibromyalgia, an illness that causes prevalent muscle aches and pain.

"Fibromyalgia is a rheumatologic disorder characterized by widespread pain throughout the muscles and soft tissues," said Dr. Stuart Silverman, medical director of the Cedars-Sinai Fibromyalgia Rehab Program in Los Angeles, Calif. "It can progress to a hypersensitivity response throughout the body that results in associated symptoms such as: headaches, sinus problems, irritable bowel, irritable bladder, thermal dysregulation, sleep disorders, fatigue, impaired memory and cognition.

" Approximately 3 to 6 percent of the U.S. population has the illness, which occurs most often in women age 30 to 50. It often occurs following a physical trauma such as a car accident.

Recent studies have shown that the illness may have genetic component because it frequently strikes families, among siblings, mothers and their children. I

n the past few years, studies have focused on the central nervous system as the root of the cause.

"Current research indicates it is a result of a neurotransmitter imbalance in the central nervous system that results in an imbalance in muscle physiology," said Silverman, who has over 10 years experience including conducting numerous studies on Fibromyalgia.

Additional research has suggested that Fibromyalgia patients have a generalized disturbance in pain processing that results in pain intensification in response to stimuli that would not typically be painful in healthy people.

A group of researchers at the University of Michigan conducted at test where healthy young adults were put into a brain scanner and were temporarily subjected to pain. According to the study, it proved that people who posses two copies of the val-COMT gene withstood a greater amount of pain compared to those who carry the met-COMT gene. The researchers hope to discover what combination of genetics make certain people more susceptible to painful diseases.

Sharon Squiers, director of patient services at the National Fibromyalgia Association, said the research being conducted may be able help physicians diagnose patients early on in their illness.

Squiers said she has the illness and her symptoms started at an early age.

"My legs would just ache and my mother would say it is just growing pains," said Squiers.

She said it wasn't until several years later that she was diagnosed with the illness.

"It gets over looked and confused with other illnesses because there is no objective test," said Squiers.

Silverman said that the problem is that many doctors do not really understand pain and there is no exact cause for Fibromyalgia.

"Fibromyalgia has been around for a long time but people did not understand it well," said Silverman. "There is no X-ray that can be taken or specific test. It's a clinical diagnosis."

He also said that many patients put up with the pain and don't realize what they have. He said the combination of the two probably leaves many undiagnosed.

To be diagnosed with Fibromyalgia, patients must meet the criteria established by the American College of Rheumatology. A patient must have widespread pain in all four quadrants of the body and it must continue for at least three months. Patients also must have pain in at least 11 of the 18 specified tender points when there is applied pressure.

After a patient is diagnosed with the illness physicians begin treatment that focuses on relieving symptoms and improving function since there is no known cure.

"It's treated symptomatically," said Squiers.

Silverman said the first step in the treatment process is to improve sleep and minimize pain. He said numerous medications can be taken such as muscle relaxers including Cyclobenzeprine or Flexeril.

Additional steps in the treatment process include decreasing fatigue, treating anxiety and depression, and addressing symptoms such as cognitive dysfunction and migraine headaches.

Silverman said that treatment can help people live normal lives and suggests that people that have constant pain and have not been diagnosed should contact a rheumatologist for a consultation.