Fibromyalgia is a chronic pain syndrome.Historically, fibromyalgia has been difficult to diagnose and treat due to a lack of well-categorized tissue pathology and symptoms that overlapwith other common chronic illnesses. Paucity of specific biomarkers and unsatisfactory outcome of the current therapeutic regimes further complicate fibromyalgia management. However recent research findings have uncovered novel mechanisms underlying fibromyalgia, ways for diagnosis and treatment.
Using functional MRI scans researchers at the University of Michigan and Colorado identified a series neurological patterns specific for fibromyalgia.These patterns correlated with the changes in glutamate and/or glutamine in the brain structure known as the insula. Collectively these findings not only shed light on neural mechanisms of fibromyalgia but also give point towards possible diagnostic biomarkersThese neuroimaging studies were however performed on a small group of patients and need to be replicated in bigger cohorts before such methods enters into clinical practice for the diagnosis of fibromyalgia. Nevertheless it is a significant advancement on the diagnostic front.
Pharmacologic treatment of fibromyalgia historically targeted pain with opioids or muscle relaxants, depression with antidepressants, and sleep with anxiolytics or hypnotics. These unspecific broad spectrum drugs are often the result of unsatisfactory outcome in majority of Fibromyalgia. Due to this reason treatment is often coupled with nonpharmacologic strategies including relaxation techniques, physical therapy, biofeedback, and other cognitive therapies.Use of whole-body cold applications (called cryotherapy) has historically been used as preferred non pharmacological therapeutic strategy for fibromyalgia patients, with reported short-term pain relief. In some studies, pain reduction is felt two hours after the application and may last up to 24 hours. Recently a study investigated the effects of local cold application on fibromyalgia pain using gel packs. The findings of this study show that pain scores in fibromyalgia patients decreased 10 minutes and 90 minutes after the local cold applications. Overall the study indicates that local cold treatment is fast acting if not more effective than whole-body cold applications.
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