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Fibromyalgia Diagnosis? Chronic Fatigue Syndrome? Finally! Answers in this video will help you gain control over your life. Commonly people hear: “Fibromyalgia is a mysterious disorder of unknown cause characterized by widespread pain, abnormal pain processing, sleep disturbance, fatigue and psychiatric and psychological…” Watch this video so you can begin to see the light at the end of the tunnel.
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New Wayne State research findings offers hope to people with fibromyalgia
CAPTION
Mark Lumley is a distinguished professor of psychology in the College of Liberal Arts and Sciences at Wayne State University
CREDIT
Julie O’Connor, Wayne State University
A novel psychological therapy that encourages addressing emotional experiences related to trauma, conflict and relationship problems has been found helpful for people with the chronic pain condition fibromyalgia. A research team led by Mark A. Lumley, Ph.D., distinguished professor of psychology in the College of Liberal Arts and Sciences at Wayne State University, in collaboration with a team from the University of Michigan Medical Center led by David A. Williams, Ph.D., professor of anesthesiology, has released the results of its research in the prestigious journal, PAIN.
In the randomized clinical trial, 230 adults with fibromyalgia received one of three treatments, each of which was presented for eight weekly sessions to small groups of patients. The new therapy, which Lumley and co-developer Howard Schubiner, M.D., director of the Mind Body Medicine Program at Providence Hospital, call Emotional Awareness and Expression Therapy (EAET), helps patients view their pain and other symptoms as stemming from changeable neural pathways in the brain that are strongly influenced by emotions. EAET helps patients process emotional experiences, such as disclosing important struggles, learning how to adaptively express important feelings — especially anger and sadness but also gratitude, compassion, and forgiveness — and empowering people to be more honest and direct in relationships that have been conflicted or problematic.
The EAET intervention was compared to both an educational intervention as well as the gold standard psychological approach in the field, cognitive behavioral therapy. Six months after treatments ended, patients were evaluated for the severity and extent of their pain and other problems that people with fibromyalgia often experience.
Patients who received EAET had better outcomes — reduced widespread pain, physical impairment, attention and concentration problems, anxiety, and depression and more positive emotions and life satisfaction — than patients who received the education intervention. More than twice as many people in EAET (34.8 percent) reported that they were “much better” or “very much better” than before treatment, compared to 15.4 percent of education patients. An important additional finding was that the new emotion therapy also had greater benefits than cognitive behavior therapy in reducing widespread pain and in the number of patients who achieved at least 50 percent pain reduction.
“Many people with fibromyalgia have experienced adversity in their lives, including victimization, family problems and internal conflicts, all of which create important emotions that are often suppressed or avoided. Emerging neuroscience research suggests that this can contribute strongly to pain and other physical symptoms,” Lumley said. “We developed and tested an approach that tries to help people overcome these emotional and relationship problems and reduce their symptoms, rather than just help people manage or accept their fibromyalgia. Although this treatment does not help all people with fibromyalgia, many patients found it to be very helpful, and some had dramatic improvements in their lives and their health.”
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“Sometimes we can easily pinpoint what is causing a person pain,” says Richard Harris, Ph.D., associate professor of anesthesiology and rheumatology at Michigan Medicine. “But, there are still 1 in 5 Americans who suffer from persistent pain that is not easily identifiable.”
Whenever someone experiences pain, they often think about how intense the pain is — but rarely do they also consider how widespread the pain is.
Harris is the senior author on a new study, published in Pain, that sought to find what underlies widespread pain.
“We examined data from the brains of participants in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network study,” Harris says. “We compared participants with a clinical diagnosis of urological chronic pelvic pain syndrome to pain-free controls and to fibromyalgia patients.”
Harris and colleagues examined if widespread pain, thought to be a marker of centralization in the nervous system, actually originates in the brain.
Functional and structural neuroimaging
The research team used data from 1,079 participants from the MAPP study that included questionnaires capturing their pain severity and function. They were also asked to draw on a body map where they were experiencing pain.
Researchers then had a subset of the participants undergo functional and structural MRIs.
“Surprisingly, many of the individuals, in addition to having pain located in the pelvic region, had pain also widely distributed throughout their body,” Harris says. “Interestingly, when we put these individuals into the brain imaging scanner, we found that those who had widespread pain had increased gray matter and brain connectivity within sensory and motor cortical areas, when compared to pain-free controls.”
Urological chronic pelvic pain syndrome patients with widespread pain showed increased brain gray matter volume and functional connectivity involving the sensorimotor and insular cortices.
“What was surprising was these individuals with widespread pain, although they had the diagnosis of urological chronic pelvic pain, were actually identical to another chronic pain disorder: fibromyalgia,” Harris says.
The team notes the changes in brain gray matter volume and functional connectivity were identical to outcomes present in fibromyalgia patients, but were not seen in the pain-free control group.
“This study represents the fact that pelvic pain patients, a subset of them, have characteristics of fibromyalgia,” Harris says. “Not only do they have widespread pain, but also they have brain markers indistinguishable from fibromyalgia patients.”
Harris and colleagues hope this study provides physicians with the opportunity to look at new ways of treating chronic pain patients — as there might be similarities across pain conditions if both show widespread pain.
“We think that this type of study will help treat these patients because if they have a central nerve biological component to their disorder, they’re much more likely to benefit from targets that affect the central nervous system rather than from treatments that are aimed at the pelvic region,” Harris says.