FMS vs CFS substance p elevated in FMS but not is CFS. cellular antiviral enzyme RNaseL is elevated in CFS but not in FMS.

Transcription

1 Fibromyalgia widespread pain (right left upper and lower), tender points, cognitive and memory problems, sleep disturbances, unrefreshing sleep, fatigue, morning stiffness, headaches,irritable bowel syndrome, painful periods, numbness or tingling in hands and feet, temperature sensitivity, sensitivity to noise and light. ache all over, flu like symptoms, muscles feel pulled or overworked and can twitch or burn. Pain has no boundaries, deep muscular aching, burning throbbing shooting or stabbing pain. Pain and stiffness are worse in the morning. Pain located in areas like neck, shoulders, sternum, low back, hip, shins, elbows and knees. chronic headaches, fatigue. Alpha EEG anomaly, micro arousal sleep awakenings disturbing stage 4 rem cycle sleep. Reduced exercise tolerance, chronic facial muscle pain or aching. skin sensitivities, allodynia. physiology of FMS and CFS is reduction of midbrain and cortical blood flow, autonomic dysfunction, suppression of the hypothalamic pituitary axis, disturbed stage 4 sleep, reduced serum or csf serotonin levels, suppression of growth hormone, somatomedin C, or IGF1. Chronic Fatigue Syndrome or Exertional Intolerance Disorder main complaint is fatigue, few or no tender points, fever, inflammatory markers (c reactive), unrefreshing sleep, headache of a new type, sore throat, enlarged lymph nodes, muscle and joint pain no swelling, onset after infection, sleep disturbances, impaired memory or concentration, dizziness, bowel disorders, anxiety or depression. Large percentage of fm patients fit criteria for cfs diagnosis. Symptoms worsen after an exertion mental or physical, pacing is important for reserving energy. FMS vs CFS substance p elevated in FMS but not is CFS. cellular antiviral enzyme RNaseL is elevated in CFS but not in FMS. pure CFS is diagnosed when a patient has no complaint of muscle pain. pure FMS is diagnosed when cognitive symptoms are minimal and muscle pain is greatest complaint. 70% diagnosed fit both categories. Myofascial Pain Syndrome no widespread generalized pain, muscles and connective tissues develop hard knots called trigger points. painful when touched or poked. This pain differs from fibromyalgia in that it is localized to specific muscle groups and as opposed to tender points when a trigger point is pressed it causes a twitch in the muscle. headaches, disrupted sleep, unexplained sweating, tinnitus and memory issues. worsen with activity and under stress or weather changes. You can have both mps and fms. Multiple Chemical Sensitivities Syndrome MCSS symptoms exacerbated by exposure to chemicals or smells even at low levels many substances trigger symptoms, involve many organ systems, chronic, perfumes, fabric softeners, air fresheners, sprays, dyes, detergents, organic

2 smells can also trigger symptoms. symptoms improve when chemical is removed. Profound fatigue, headaches, nausea, vomiting, dizziness, hives, rapid heart rate, allodynia. Many fms patients also have MCSS along with sensitivities to light and sound. Adrenal Gland Disorders feeling tired or drained all the time, dizziness and lightheadedness especially standing up, constant infections, increased cravings sugar and salt, digestive issues, sleep schedule shift (feeling more alert later in the evening 10 2am and difficulty waking up), flu like feeling, muscle weakness, decreased appetite or increased need for stimulants, weight loss, dehydration, rapid heart rate, episodes of high or low blood pressure, unexplained sweating, anxiety or panic attacks, moodiness or irritability. Many fms patient have some amount of adrenal insufficiency. Polyglandular Deficiency Syndromes sequential or simultaneous deficiencies in the function of several endocrine glands. candid infections, hypoparathyroidism, adrenal insufficiency (addison disease) or shmidt syndrome (type 2) adrenal insufficiency, hypothyroidism or hyperthyroidism, type 1 diabetes. type3 glandular failure, hypothyroidism and one other disorder (hypogonadism, idiopathis thrombocytopenic purpura, myashtenia gravis, parkinsons, vitiligo, alopecia, seronegative arthritis. (hashimotos) anemia, celiac, biliary cirrhosis. cold intolerance, fatigue, somnolence, poor memory, constipation, menorrhagia, myalgias and hoarseness. (graves) heat intolerance, weight loss, weakness, palpitations, anxiety. (addisons) anorexia, nausea, vomiting, weight loss, weakness, fatigue. Hashimoto s Thyroiditis difficulty getting full breath, slow thinking, mental fog, raynaud's phenomenon, problems concentrating, widespread pain, fatigue, depression, anxiety, irregular menstrual cycle, sleep difficulties, headaches and migraines, muscle cramping and pain, inability to lose weight, ibs. Believed to be a cause of fibromyalgia. Hypothyroidism often misdiagnosed as fibromyalgia but can happen along with fms. Dry skin, hair loss, no energy, weight gain, irregular heartbeat, confusion, anxiety, depression, muscle tension and trigger points, delayed deep tendon reflexes (achilles reflex foot goes down rapidly are raises slowly) as many as 70% of fm patients suffer from hypothyroidism or hormone disruption. Diabetes excessive urination, hunger, thirst, dry mouth, itchy skin, yeast infections, weight gain or loss, nausea, and vomiting, trouble breathing, widespread pain, nerve pain and fatigue. fms and diabetes have a lot of similar symptoms and those with diabetes are at more risk of developing fibromyalgia and because of the limitations on exercise and the tendency for carb cravings lead to diabetes as well. Flare ups and pressure points and thermal sensitivities are more likely fibromyalga, prickling and numbness are more prevalent in diabetes, burning can be caused by both. pain and numbness occurring together might suggest diabetes. Both diabetes and fibromyalgia patients can suffer from drops in blood sugar which can cause confusion, shakiness, dizziness, thirst, sweating, and weakness.

3 Lyme Disease bacterial infection transmitted by ticks. Blood tests can determine this disease most of the time, but can become chronic if not treated early. Mimics chronic fatigue and fibromyalgia, but depending on infection can cause many other symptoms. Long term treatment with antibiotics can cause severe problems so must be done with caution and considerable guidance. Research. Dysautonomia dysfunctions of the autonomic nervous system. heart rate, digestion, respiratory rate, salivation, perspiration, pupillary dilation, urination, and sexual arousal. Can cause symptoms including fatigue, sleep disturbances (waking often), altered cognitive function, cold or heat intolerance, headaches, and bladder or bowel dysfunction. POTS post orthostatic tachycardia syndrome causes a heart rate to drop and patient passes out. Orthostatic intolerance (the inability to remain upright). Dysautonomia is a common comorbidity of fibromyalgia and possibly many of the neurologic disorders like CFS, MS, and ALS. Multiple Sclerosis presents very similarly to fibromyalgia and is only defined as the disease progresses and shows further symptoms. Depression, anxiety, ibs, chronic fatigue, headaches, pain, spasms, numbness and tingling, muscle weakness and stiffness. Can cause lesions on the brain detectable by mri. Osteoarthritis causes joint pain not widespread pain occurs commonly in older fm patients. Rheumatoid Arthritis autoimmune disorder causes inflammation and swelling, muscle and joint pain, damage to joints, extreme fatigue, digestive disorders, sleep disturbances, memory loss and anxiety. Positive ana and inflammation markers (pain in ends of fingers would more likely be fibromyalgia, raynauds, or osteoarthritis) can also have fm. Major Depression depressed mood everyday, feeling worthless or guilty, inability to concentrate or make decisions, insomnia or excessive sleeping, low energy, restless or feeling slowed down, significant weight gain or loss 10%, suicidal thoughts, no tender points present. This depression is primary and not related to pain from fibromyalgia. Polymyalgia Rheumatica autoimmune disorder causing inflammation, pain and stiffness. Generally in women over 50. tender points are present and almost always in hip and shoulders. fever, weight loss, fatigue. ESR and inflammation markers are high. Low dose steroid and anti inflammatories prescribed. Can cause serious vision problems if untreated, can also remit. Lupus autoimmune disease causing joint pain, muscle pain, fatigue, skin rashes, sensitivity to the sun, joint swelling, sores in mouth, fever, hair loss, blood and protein in urine, positive ANA, often specific biomarkers for types of lupus. A diagnosis of lupus will not be made without at least 4 lupus features: mylar rash, discoid rash, photosensitivity, oral ulcers, arthritis, serositis, renal disorder, neurologic disorder, hematologic disorder, ana, immunologic disorder. Lupus is treated with corticosteroids and immunosuppressants. It is common for lupus patients to

4 develop fibromyalgia but is less common for a fm patient to develop lupus, however it can take years to develop enough symptoms for a correct diagnosis. Ehlers Danlos Syndrome mixed connective tissue disease causing overly flexible joints, stretchy, fragile skin. Can cause chronic pain, inflammation, joint dislocations and subluxations, scarring, poor wound healing, poor muscle tone, early onset of osteoarthritis, bruising and tearing of skin. Mild cases of this disorder can be misdiagnosed as fibromyalgia. Can be diagnosed with genetic testing. Many fm patients have hyper mobile joints that cause pain but are not severe (taping and physical therapy can help stabilize painful joints). Sjogren's or Sicca Complex mixed connective tissue disease causing dry eyes and mouth, extreme fatigue, joint pain, digestive problems and nerve disorders. Lip biopsy can diagnose but is invasive. Complex Regional Pain Disorder or Reflex Sympathetic Dystrophy extremely painful disorder (considered one of the most painful) characterized by constant, extremely intense, and out of proportion pain to original injury. Usually originating in same location as an injury but can show up years after initial injury. This pain is accompanied by swelling, skin changes, extreme sensitivity and can spread to other parts of your body. Constant chronic burning pain, affected area may feel cold to the touch. Inflammation causing bruising, mottling, tiny red spots, shiny or purplish skin, excessive sweating, spasms, memory problems, concentration difficulties, sleep disturbances. Myasthenia Gravis autoimmune disorder causing weakness of muscles that increases during periods of activity and improves with rest. Muscles of the eyes and face are often affected as well as muscles that control breathing, neck and limb movements. Nerve Trunk Compression and other nerve compression syndromes can cause pins and needles as well as burning, sensations of coldness or bluish white skin around affected area. these are common in joints like wrist, elbow, shoulder, spine, hips and can happen any place a nerve can be compressed. These compressions are typically easier to diagnose. Degenerative Disk Disease back and leg pain, weakness, tingling or numbness in legs or buttocks, difficulty walking and poor posture. seen on MRI Spinal Stenosis nerve root compression, pain in the buttocks, thigh, or leg, low back pain, inability to walk, numbness tingling or weakness in lower extremities certain positions relieve pain. Polycystic Ovary Syndrome PCOS findings suggest that many women suffering PCOS also suffer from hashimoto's autoimmune thyroiditis. Infertility, fatigue, weight gain or inability to lose weight, irregular menstrual period, cramping, excess hair, acne. Some evidence that PCOS,

5 Fibromyalgia, and Primary hyperparathyroidism form a very prevalent triad. PCOS and endometriosis fall in similar categories.