Arthritis Treated with Alternative Medicine

ScienceDaily (Mar. 30, 2010) — Short bursts of physical activity can ease fibromyalgia symptoms. Researchers writing in BioMed Central’s open access journal Arthritis Research & Therapy have shown that encouraging patients to undertake ‘Lifestyle Physical Activity’ (LPA) can markedly increase the average number of steps taken per day and produce clinically relevant reductions in perceived disability and pain.

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Kevin Fontaine, from Johns Hopkins University School of Medicine, worked with a team of researchers at the Johns Hopkins Bayview Medical Center campus to investigate the effects of 30 minutes of LPA, five to seven days a week, on physical function, pain and other measures of disability in 84 fibromyalgia patients. He said, "Fibromyalgia is estimated to occur in 2% of the U.S. general population, affecting about eight times more women than men. Although exercise has been shown to be beneficial, the symptoms often create obstacles that deter many from exercising consistently enough to derive benefits."

LPA involves moderate-intensity physical activity based around everyday life such as taking the stairs instead of using an elevator, gardening and walking. In this study, participants were taught to perform LPA intense enough to cause heavy breathing, but not so heavily that they could not hold a conversation. During subsequent sessions participants were taught self-monitoring of LPA, goal setting, dealing with symptom flares, problem solving strategies to overcome barriers to being more physically active, as well as instruction in finding new ways to integrate short bouts of LPA into their daily lives.

At the end of the study, the participants randomized to LPA increased their average daily steps by 54%. Compared to the controls, the LPA group also reported significantly less perceived functional deficits and less pain. Speaking about these results, Fontaine said, "The nature of fibromyalgia’s symptoms, the body pain and fatigue, make it hard for people with this malady to participate in traditional exercise. We’ve shown that LPA can help them to get at least a little more physically active, and that this seems to help improve their symptoms."

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ScienceDaily (Apr. 30, 2010) — Fibromyalgia is a condition that causes chronic, widespread pain throughout the body. In a new study, University of Missouri researchers are examining how the diagnosis of Fibromyalgia can affect marriages. Initial findings reveal that diagnosed spouses have considerably higher levels of depressive symptoms and pain and report more marital instability and anger than their spouses. For both spouses, the symptoms can trigger increased emotional withdrawal and mental strain.

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"Preliminary research suggests that fibromyalgia is very hard on both spouses because their lives are changed dramatically," said Christine Proulx, assistant professor of human development and family studies in the College of Human Environmental Sciences. "There appears to be a strong link between fibromyalgia and feelings of depression and fatigue, which can be debilitating for those diagnosed and their marriages. The mental strain felt by both spouses can negatively affect marital quality."

Proulx found that individuals with fibromyalgia were almost three-times more depressed than their spouses. The diagnosed spouses reported higher levels of marital instability and more marital anger, indicating they were more likely to consider divorce than their spouses. The healthy spouses reported that it was difficult to watch their spouses experience pain.

"Both spouses are put in difficult positions when one partner is diagnosed with fibromyalgia," Proulx said. "Spouses must balance the presence of the disease, which can produce hostility or withdrawn behavior in the marriage, with the difficulty of being sick or being supportive to the spouse who is sick. These factors can create a cycle that can be very negative if it can’t be broken."

In the study, Proulx is studying the interactions of married couples that include one spouse who has been diagnosed with fibromyalgia or chronic widespread pain. The spouses record diary entries about their marital interactions and personal feelings. Proulx is examining the associations between marital quality, daily interactions, social support and the spouses’ personal well-being.

Fibromyalgia is controversial because there is no consensus on the cause of the chronic pain symptoms it causes, Proulx said. It has no cure, so many of the couples who participated in the study reported that they were constantly trying different treatments to manage the symptoms.

Findings from the pilot study, "Fibromyalgia, Chronic Pain, and Marriage: A Daily Diary Pilot Study," were presented last November at the National Council of Family Relations Conference.

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ScienceDaily (May 4, 2010) — Researchers at the Norwegian University of Science and Technology have found an association between the level of leisure time physical exercise and a future risk of developing fibromyalgia. The research team also identified BMI as an independent risk factor for fibromyalgia.

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Details of the study appear in the May issue of Arthritis Care & Research, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology.

Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread pain lasting more than 3 months, and tender point sites in the neck, shoulders, back, hips, arms, and legs. Associated features often include unexplained fatigue, sleep disturbances, headache, cognitive difficulty, and mood disturbances. The prevalence of FM increases with age and is considerably higher among women than men. Although the etiology of FM is poorly understood, many authors have suggested that a dysfunctional autonomic nervous system involving deficiencies in the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system contributes to the development of FM by altering pain perception and endogenous pain inhibition.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, FM has been linked to stressful or traumatic events, such as car accidents, repetitive injuries, illness, certain diseases, or FM can occur spontaneously. Some scientists speculate that a gene or genes might be involved in fibromyalgia that could make a person react strongly to things that other people would not find painful.

Longitudinal studies have shown that physical exercise is associated with less musculoskeletal pain and stiff or painful joints among aging women. The Norwegian researchers, led by Paul Mork, D.Phil., proposed that first, there is an association between levels of leisure time physical exercise and future risk of FM and, second, being overweight/obese may represent an independent risk factor for future development of FM. Data for the study was collected from the Nord-Trøndelag Health (HUNT) Study, the first part conducted in 1984-1986 (HUNT 1) and the second in 1995-1997 (HUNT 2). During the 11 years between HUNT 1 and HUNT 2, 380 cases of incident FM were reported among 15,990 women who provided information on relevant variables at both surveys and who reported no FM or physical impairment at HUNT 1.

"Women who reported exercising 4 times per week had a 29% lower risk of FM compared with inactive women," says Dr. Mork. "Similar results were found in the analysis of the summary score combining information on frequency, duration, and intensity of exercise; women with the highest exercise level had a somewhat lower risk than inactive women. The study further shows that a high BMI (i.e., being overweight or obese) is a strong and independent risk factor for future development of FM. Moreover, the higher relative risks for the combined effect of being overweight/obese and inactive, relative to being overweight/obese alone, point to a further disadvantage for overweight women who do not exercise."

While the causal relationship between obesity and FM remains unknown, there are some etiologic factors in common. Studies suggest that proinflammatory cytokines play a role in FM and the relationship between FM and obesity. Other studies point to dysregulation of the HPA axis, which has been observed in both FM and obesity. Finally, increased sympathetic tonus and reduced sympathetic reactivity, as recorded by heart rate variability, has been observed in patients with FM as well as in overweight and obese subjects. Dr. Mork concludes, "These findings, together with the current study, indicate that regular physical exercise, and thereby improved physical fitness, may serve as a buffer against the perpetuation of musculoskeletal symptoms that eventually lead to the development of FM."

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