May 12 was fibromyalgia awareness day. It’s never too late to cover the subject.

Danger level: Medium

What is it?

Fibromyalgia is a chronic syndrome characterized by muscle and joint pain (in Latin “fibro” means a fibrous tissue, and in Greek “myo” means muscle and “algia” means pain), stiffness and fatigue.

Who gets it?

In the US about 3.4% of women and 0.5% of men have fibromyalgia.

Fibromyalgia is about 9 times more common in women than in men. It usually starts between ages 30 and 55, but is more common after age 50. It’s more common as we age – it occurs in 7.4% of women between the ages 70 and 79.

The chances of developing fibromyalgia are increased eight fold in family members of people with fibromyalgia.

What causes it?

The cause is unknown. As you’ll see ahead, people with fibromyalgia experience pain in the muscles and soft-tissues, but there is nothing visible there to hint that  something is wrong.

It is believed that the pain experienced in the disease is perhaps caused by a change in the way we perceive pain, a phenomenon called “central sensitization”. (This phenomenon is possibly responsible for other conditions as well, such as irritable bowel syndrome, chronic fatigue syndrome, chronic headaches, and chronic jaw and facial pain).

How does it feel?

There are a few major symptoms in fibromyalgia:

1. Pain – It’s all over, chronic and persistent. People with fibromyalgia can sometimes also feel numbness or tingling in their arms and legs.

   Certain things can aggravate the muscle pain, such as anxiety or stress, poor sleep, exertion, or exposure to cold or dampness. Warmer weather and vacations improve the feeling.

   One of the most characteristic things in fibromyalgia are tender points or trigger points. These are sites on the body which, when touched, are more tender or painful than the same sites in someone who doesn’t have the disease. There are 18 such points in the body and they are similar between people with the disease.
   
   The tender points in fibromyalgia.

   People may feel joint pain or feel like their joints are swollen (while in reality they are not).

   Other pain related symptoms here can include headaches or migraines, symptoms of irritable bowel syndrome, bladder pain and pain in the face or jaw.

2. Muscle stiffness – It’s typically present upon waking up and improves during the day. In some people it lasts all day.
3. Sleep disturbances – More than 90% of people with the disease feel fatigued and exhausted and wake up tired. They also tend to awaken frequently at night and have trouble falling back to sleep.
4. Depression and anxiety – Both are more common in people with fibromyalgia.
5. Difficulty thinking – Some people will experience difficulty thinking and loss of short-term memory.

There are even more symptoms, but these are the main ones. A more complete list appear in the picture below.

How is it discovered?

There are no specific lab tests which can discover fibromyalgia. The physical examination and the patient’s story are usually used to diagnose the disease.

Sometimes blood tests are also performed, in order to rule out other things which may resemble fibromyalgia.

How is it treated?

There is no cure for fibromyalgia. It’s usually treated with a combination of things:

1. Medications – The most useful drugs here are those which are usually used for depression and for seizures. They target chemicals in our brain and spinal cord which are important in processing pain.
2. Exercise – Regular exercise which causes your heart to pump faster (such as walking, swimming, biking) is helpful in reducing the pain.
3. Relaxation techniques – Such as hypnosis, biofeedback and others, may help.
4. Alternative methods – Such as massages and acupuncture may help in some people.

What happens after treatment?

Most people continue to have chronic pain and fatigue, but most people can continue with their lives.

There is currently no known way to prevent fibromyalgia.

The video below tells about Holly Fraser, a young woman with fibromyalgia:

You can also read other personal stories in the fibromyalgia diary blog and at the Fighting fatigue CFS & fibromyalgia blog.

As always, you’re welcome to share your stories in the comments below.

Related posts:

1. Hashimoto’s Thyroiditis – Do You Suffer From Weight Gain, Fatigue or Hair Loss? This Might Just Be The Cause
2. Congenital Insensitivity to Pain – A Life Without Pain
3. Chest Pain – Is It a Heart Attack?

Danger level: Medium

What is it?

Gout is an inflammation of the joints caused by high blood levels of uric acid.

Who gets it?

Gout occurs in about 2% of the population. It’s about twice as common in men than in women. In men it tends to occur in the ages 30-45, while in women it’s more common in the ages 55-70.

The are a few risk factors which can increase your risk of developing gout -

1. Obesity
2. High blood pressure
3. Injury or recent surgery
4. Fasting
5. Consuming excess amount of alcohol on a regular basis (especially beer, whiskey, gin, vodka, rum).
6. Overeating
7. Eating large amounts of meat and seafood
8. Taking medications which can cause uric acid in the blood to rise (especially diuretics)

What causes it?

Gout is caused by having too much uric acid (also called urate) in the blood. When the levels of uric acid in the blood are high, they can form hard crystals, which can then accumulate in the joints.

 

Uric acid crystals. These accumulate inside the joints, causing the disease. Photo by Bobjgalindo.

Our body tries to dispose of those crystals by sending white blood cells to “eat” them. These cells cause inflammation in the joint, which brings about the disease.

How does it feel?

Gout occurs as attacks of sudden very severe joint pain, sometimes with redness, swelling, and tenderness of the joint. The attack is usually worst in the first hours, and improves completely within days to weeks.

Gout usually occurs in a single joint in the body. Usually it’s the big toe, the ankle or the knee.

After a few years with these attacks, uric acid crystals accumulate in joints, bones and cartilage in the body. This causes masses known as tophi.

A person with gout. You can see tophi in his elbow. Photo by NickGorton.

How is it discovered?

To discover if the inflammation in the joint is caused by gout, the doctor uses a needle and a syringe to take a sample of the fluid in the joint. Then this sample is looked at under the microscope to see the uric acid crystals.

Another thing your doctor can do is test your blood for levels of uric acid, to see if it’s high.

How is it treated?

There is a treatment for the attack itself and a treatment which is taken between attacks to prevent further attacks from happening:

1. Treatment for the attacks – To stop an attack a few drugs can be used, such as steroids, non-steroidal anti-inflammatory drugs (examples of those include ibuprofen and indomethacin) and a drug called colchicine (we’ve already talked about colchicine before, as a treatment for Familial Mediterranean Fever).
2. Treatment between the attacks – There are drugs that can lower the amount of uric acid in the blood. Examples of those include allopurinol, and probenecid.

What happens after treatment?

Relief from an attack usually begins within 24 hours if the treatment is started early in the attack. Taking allopurinol and following the measures below under “how do I prevent it” can help achieve a normal, attacks-free, life.

The bottom line – How do I avoid it?

Because of the risk factors above, if you’re prone to gout, the following things can lower your chances of developing it -

1. Losing weight – Since obesity is a risk factor for gout. However, starvation or fad diets aren’t recommended.
2. Reducing the amount of red meat and seafood in your diet
3. Increasing the  amount of low-fat dairy products and complex carbohydrates in the diet.
4. Drinking less beer, gin, vodka etc. (Drinking wine moderately, on the other hand (one to two 5 ounce servings a day) is not connected with an increase in gout attacks).
5. Drinking less drinks which contain a high level of fructose corn syrup (such as some types of non-diet soda). These drinks increase the level of uric acid in the blood.

This video sums everything up –

There are a few blogs you can visit to read more about gout: The gout diet blog, Beating gout blog, the gout blog and gout symptoms and cures blog.

Related posts:

1. Acute Pancreatitis – A Dangerous Condition Which Can Be Caused by Drinking Alcohol
2. Fibromyalgia – Chronic Pain and Fatigue
3. Pleural Mesothelioma – Cancer of The Lungs Caused by Exposure to Asbestos