In 2010 I was diagnosed with Fibromyalgia and Chronic Fatigue Syndrome. Chronic pain and fatigue are part of my daily life. It also affects the members of my family so I feel it needs to be something I write about. (If you don’t have FM/CFS yourself, don’t leave yet! This post is talking more specifically about chronic pain overall.)
In 2014, my husband and I attended a seminar by Dr. Daniel Clauw called CHRONIC PAIN: MAYBE IT’S ALL IN THEIR HEAD. Dr. Clauw is a Professor of Anesthesiology, Medicine (Rheumatology), and Psychiatry at the University of Michigan. He also serves as Director of the Chronic Pain and Fatigue Research Center. Back in 1990, he was on the faculty at Georgetown University. While there, he founded the Georgetown Chronic Pain and Fatigue Research Center. He has become an internationally known expert in chronic pain, and especially the central nervous systems contributions to chronic pain.
During the workshop, he described the three mechanic characterizations of pain.
- Peripheral damage or inflammation is pain felt by an actual injury, brought on by diseases such as arthritis, or even pain caused by cancer.
- Neuropathic pain is caused by damaged nerves such as lower back pain.
- Central pain is pain that is felt by a type of volume control switch in the brain that is turned all the way up.
Most chronic pain sufferers have at least two, if not all, types of pain.
For most people with fibromyalgia, the central nervous system’s volume control is set too high for all sensory issues.
That leads an individual to experience actual irritation and pain from a number of causes.
These causes may include:
- loud noises
- changes in weather
- smells
- bright lights
- stress
These patients feel pain at levels where a “healthy” person may experience none.
When pain occurs due to something that makes more sense to us, like an accident or injury, the pain can often become unbearable and linger for days on end.
Dr. Clauw informed us of a number of functional neuroimaging tests that are being performed as a way to study chronic pain. Functional MRIs are allowing doctors to see changes in blood flow with various stimulants such as pressure and heat. Hopefully, this will bring them closer to finding prescriptions that will help with these brain functions and allow the body to turn down the central nervous system’s volume control.
The doctor also believes opioids are given too often to individuals to help with the pain. Especially to those who are experiencing central pain as the opioids can’t alter this type. Not that opioids should never be used, for some it’s the only thing that works.
Certain patients may feel some relief from taking these medications, however, the relief felt is from the drugs affecting peripheral damage or inflammation that is also in the body. (Remember that chronic pain sufferers usually have at least two of the three pain types.) For example, a person with arthritis may experience some relief from the opioids controlling the pain from arthritis. Some fibro patients may not even be aware they have peripheral damage or inflammation due to the overall feeling of pain caused by fibromyalgia.
Dr. Clauw’s current preferred drugs are Flexeril (primarily to aid in better sleep habits which lead to a decrease in pain sensitivity) and Neurontin which affects the central nervous system.
In clinical studies, he has seen overwhelming evidence that leads him to believe a patient can greatly help their pain sensitivity levels by making some lifestyle changes.
For instance, he mentioned exercise. Even if a patient can only walk 2 minutes a day, he recommends they start there and after a week or so increase to 4 minutes and so on. The exercise will release dopamine in the brain. Dopamine functions as a happy neurotransmitter—a chemical released by nerve cells to send signals to other nerve cells saying all is well. Several important symptoms of a dis-functioning nervous system, such as restless leg syndrome (suffered by many FM patients), are showing connections to dopamine levels in the body.
After the seminar was over I registered to be a lab rat for a 15-month clinical study regarding pain and stress management in fibro patients.
You can read more about the process and things I learned and observed in this post. It was not concerning drugs of any sort and we were instructed to stick with our regular prescription routine and continue meeting with our regular doctors throughout the study. It was a pretty interesting process!
Do you suffer from chronic pain? If so, what two types plague you? Or are you hit with all three?
