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An alarm system gone awry: Pain in Fibromyalgia and Chronic Fatigue Syndrome

Sunday 29 April 2012


From's Adrienne Dellwo:


AlarmAn Alarm System Gone Awry: Pain in Fibromyalgia & Chronic Fatigue Syndrome

By Adrienne Dellwo, Guide
April 11, 2012

Pain is necessary. In many cases, it's a good thing - whether it feels like it or not.

However, when your body starts processing pain abnormally, as in fibromyalgia and some cases of chronic fatigue syndrome, it ceases to be helpful and starts doing harm.

The Alarm System

Pain is the body's alarm system. It lets you know when your body is damaged or is about to be. It can alert you to a life-threatening problem such as appendicitis or heart failure while there's still time to do something about it. It can keep you off of a broken leg so you don't damage it further, or makes you stop exercising before you stress your muscles too far.

When the nerves in your cells detect pain, they send signals to your spinal cord which then are relayed to the brain, making you aware of the problem. These cellular signals are transmitted by something called substance P.

When signals reach your brain, certain areas become active as the neurotransmitter serotonin helps to usher signals to the proper places and trigger your body's automatic response to pain.

A Disordered Alarm System

We've all had those neighbors with super-sensitive car alarms that go off every time someone drives by or the neighbor cat hops onto the hood. Not only is it annoying, it makes the alarm ineffective - everyone is so used to it going off that they sit and roll their eyes rather than run to the window to see if something bad is happening.

That's kind of how the pain system works in fibromyalgia and, to a lesser degree, chronic fatigue syndrome.

In fibromyalgia, tests have show high levels of substance P. That means when nerves sense pain, they can send up to 3 times the normal amount of signals. The result is that you feel a lot more pain that you should. The signals are erroneous, but the pain is real.

In both fibromyalgia and chronic fatigue syndrome, we have problems with serotonin. Levels may be too low, or it may be that our brains don't use it properly, but the end result is that pain messages aren't processed like they should be. That "turns up the volume" of pain even more.

As an alarm system, pain demands the attention of your brain. Between the high level of signals coming in and the slugging processing system, it can strain other systems and areas, leading to many of the symptoms we face every day. What is more distracting, aggravating and draining than an alarm going off in your head all the time?

And in the same way we learn to ignore the neighbor's car alarm, we start to discount the urgency of our pain signals because we always hurt. I ignored an infected gallbladder for months, thinking it was fibromyalgia pain. As a result, I was far sicker than I needed to be for a long time. The same thing can happen with injuries, and we can make them worse before we realize something is actually wrong and we should take it easy. (See Dealing With an Injury for more.)

Fixing the System

So far, we don't know how to permanently reset the pain alarm system so that it works properly. However, many of our treatment are aimed at helping the system function more like it should.

  • Antidepressants, such as SSRI/SNRIs, and some anti-epileptic drugs (Lyrica, Neurontin) alter the function of serotonin;
  • Some supplements also alter serotonin function, including SAM-e and rhodiola rosea;
  • Capsaicin topical treatments force your cells to release all of their substance P, resulting in a burning sensation that, for many, fades and results in less pain in the area.

None of these treatments works for all of us, and we generally need to combine several treatments to get substantial relief. It can take a lot of experimentation to find the combination that works for you.

Which of these treatments have you tried? How did they work? Leave your comments here!

Learn more or join the conversation!




The above, with comments, originally appeared here.


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