Is Your Fibromyalgia Primary or Secondary?

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Is Your Fibromyalgia Primary or Secondary?

This question will seem strange to many. But it is in fact very applicable. What we meant is really this: is your fibromyalgia triggered by an unknown cause (therefore primary), or did it evolved from a former medical condition (hence, secondary)?

Based on research done till date, fibromyalgia can manifest from other medical condition especially those which are pain related illnesses. For example, arthritis, rheumatoid arthritis (RA), myofascial pain syndrome (MPS), multiple sclerosis (MS), lupus, irritable bowel syndrome (IBS). Experts explain that the constant pain experience in these pain conditions can cause changes in the how our brain and nervous system perceive pain, eventually leading to increased central sensitivity.

Causes 

Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. While we still don’t know exactly what’s going on in the body that leads to fibromyalgia, we do know that chronic pain can cause changes in the brain and central nervous system that lead to central sensitization essentially making the body overreact to pain and other stimuli (noise, smell, bright lights, etc.). That’s why it’s believed people with rheumatoid arthritis (RA), lupus, multiple sclerosis (MS) and other chronic pain conditions frequently develop FMS.

Why you need to know the category of your fibromyalgia?

The reason why you need to know if your fibromyalgia is primary or secondary because it can determine the direction of your treatment, For instance, if you were suffering from myofascial pain syndrome prior to being diagnosed with fibromyalgia, treating the symptoms of your primary medical condition, in this case, it would be trigger points, may help you alleviate fibromyalgia symptoms.

Two categories of fibromyalgia

Fibromyalgia is grouped into two categories: primary and secondary. Primary FMS is the most common and is also called “idiopathic” FMS, meaning it has an unknown cause. Secondary FMS is associated with other causes of chronic pain.

1.  Primary (Idiopathic) Fibromyalgia

Suspected causes of primary FMS include abnormalities in the brain and hormones, chronic sleep disturbance, psychological and social effects, and muscle abnormalities. Research is also looking in multiple other directions, with varied success.

2.  Brain & Hormonal Abnormalities

Studies show, with FMS, the parts of your central nervous system that deal with pain signals work differently from other people. This is called central sensitization. Researchers know people with FMS can have numerous abnormalities in their hormonal, metabolic and brain-chemical activity, but they’re not sure whether these are causes of fibromyalgia or the effect of pain and stress on the central nervous system. Some physical changes in the brain have been discovered, as well.

 

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Norepinephrine & Dopamine: low levels

Low levels of norepinephrine can lead to loss of alertness, mental fog, depression, and apathy. Your body uses norepinephrine to create dopamine, and low dopamine results in muscle pain, further cognitive dysfunction, and movement-related problems (i.e., tremor, poor balance, clumsiness.)

Causes of Secondary Fibromyalgia

Secondary fibromyalgia has similar symptoms as primary fibromyalgia. Possible causes of secondary fibromyalgia include:

  • >Physical injury. For example, secondary fibromyalgia sometimes develops in people who have had neck injuries.
  • >Ankylosing spondylitis. Ankylosing spondylitis is a form of chronic inflammation of the spine and the sacroiliac joints located in the low back where the sacrum meets the iliac bones.
  • >Surgery. Trauma, particularly in the upper spinal region, may trigger the development of fibromyalgia.
  • >Lyme disease. 
  • >Hepatitis C. 
  • >Endometriosis. 

Why people with fibromyalgia respond to different treatments or drugs differently

If your fibromyalgia is secondary and the primary medical condition is MPS, acupuncture or stretching therapy can work exceptionally well for you. However, a fibromyalgia patient with rheumatoid arthritis as their primary medical condition may not see result from the same two treatments. Instead, treating the characteristic inflammation of RA with nonsteroidal anti-inflammatory drugs (NSAIDs) could work the best for the latter. The above example could also explain why people with fibromyalgia respond to different treatments or drugs differently.

Primary vs. Secondary and Treatments

It’s important to make the distinction between primary and secondary when we talk about treatments. For example, some people have success with acupuncture in treating their fibromyalgia. It could be because acupuncture is one of the best treatments for an original condition, myofascial pain syndrome (MPS, or CMP for chronic myofascial pain). While it is impossible to say for sure whether acupuncture relieves fibromyalgia symptoms directly (some studies show it can), or whether relieving the MPS symptoms had a secondary effect of calming fibromyalgia symptoms.

Diagnosing secondary FMS

When there’s another condition at work, it can give doctors a real a challenge when it comes to diagnosing secondary FMS. First, it can be difficult to sort out what condition is causing what symptoms. Second, FMS is considered a diagnosis of exclusion because anything reversible has to be treated before a doctor can diagnose it. It is important to find the root of your fibromyalgia or rather what triggered your fibromyalgia. Discuss with your doctor to find out if you have any underlying medical conditions or even food sensitivities that could be causing your fibromyalgia symptoms.

Many medical conditions that triggers fibromyalgia can remain undiagnosed for years

Another reason why you should really be ask yourself whether your fibromyalgia is primary or secondary is because many medical conditions that triggers fibromyalgia can remain undiagnosed for years. This is because the symptoms can blend seamlessly with the large pool of fibromyalgia symptoms. An expert in Fibromyalgia & Chronic Fatigue and author in About.com, Adrienne Dellwo wrote that she would not be as functional if she did not find out that she is also suffering from MPS after being diagnosed with fibromyalgia.

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