More Information on Fibromyalgia

Some scientists believe an unidentified infectious agent, such as a virus, may trigger fibromyalgia in certain people. Extreme stress, injury and trauma are also believed to trigger the syndrome. When confronted in this way, the brain moves into a defensive posture to protect itself. "A lot of things showing up [in research] are very complex," says Tamara Liller, head of the Fibromyalgia Association of Greater Washington, Inc. Liller, who has suffered with the condition for 20 years, this is why the average primary care physician still does not have a good handle on the condition. "You're getting into heavy duty brain theorizing."

Some of the most exciting research on fibromyalgia involves the Flexyx Neurotherapy System (FSN). Developed a decade ago by California social psychologist Len Ochs for research on learning disabled kids, FSN uses pulsed radio waves to subtly manipulate brain wave activity and help the brain function normally.

Coping with fibromyalgia is "like peeling an onion," Liller says. With so many symptoms, "you have to peel away at the layers to get people to feel better. What's tough with fibromyalgia is that not everyone responds the same way [to treatment]." What works for one fibromyalgia sufferer may not work for another, however, medication and exercise are known widely for helping to manage the condition. Like many fibromyalgia sufferers, Paduano takes low-level doses of the antidepressant Elavil which helps her relax and break the cycles of disturbed sleep that exacerbate her pain. The same antidepressant also helped Saathoff drop what had become mandatory naps and to feel better overall.

Exercise is also critical to combating the symptoms of this condition. Paduano finds that water exercises are particularly helpful. She also believes that meditation has helped her to limit the medications that she would otherwise need to help manage her symptoms. "The people who seem to do well are the ones who are open-minded and open to working with others in a multi-practice approach," Liller says.

Such an approach may include one or more of the following:

In their "Encyclopedia of Natural Medicine," noted naturopaths Michael Murray and Joseph Pizzorno recommend that those with fibromyalgia take 100 mg of 5-Hydroxytryptophan (100 mg), St. John's Wort extract (300 mg, 0.3% hypericin content) and magnesium (150 to 250 mg) three times a day. 5-HTP is converted to serotonin. Low levels of serotonin levels are linked to depression and to fibromyalgia. St. John's Wort extract together with 5-HTP were shown to have "significantly better results" than either one alone, the authors said. Magnesium helps to boost energy. But Goldenberg of the Arthritis Foundation says getting a correct diagnosis and information on the syndrome goes a long way to help sufferers manage fibromyalgia. He and others also stress the importance of finding a physician who is familiar with the syndrome—and to find one who will listen.

By Adam Brochert, MD

Temporomandibular joint disorder, which is also known as TMJ, is a painful condition that affects the joint connecting the jawbone to the skull. TMJ may also involve the surrounding muscles and soft tissues. What is going on in the body? Temporomandibular joint disorders are poorly understood. They are thought to involve a disturbance of the joint that connects the back of the jaw to the skull. This joint is located just in front of the ear and can be felt when the jaw opens and closes.

What are the signs and symptoms of the condition?
Temporomandibular joint disorders may cause a wide variety of complaints, such as:

Certain other symptoms are often seen in people who have temporomandibular joint disorders. These symptoms may be part of the TMJ. Sometimes they may be caused by another condition that is also occurring at the same time. These symptoms include:

What are the causes and risks of the condition?
The exact causes of temporomandibular joint disorders are still a subject of debate. Ninety percent of the people with TMJ are women in their childbearing years. Many times, TMJ is linked to inappropriate activities, such as:

Other causes of TMJ are as follows:

What can be done to prevent the condition?
Prevention of temporomandibular joint disorders is not always possible. However, these measures may be helpful in avoiding or minimizing TMJ:

How is the condition diagnosed?
The results of a medical history and physical exam often cause a healthcare provider to suspect a temporomandibular disorder. Blood tests and X-rays are often used to make sure more serious diseases are not causing the symptoms. No single test can confirm the diagnosis. Dental X-rays can sometimes help make the diagnosis.

What are the long-term effects of the condition?
Prolonged temporomandibular joint disorders may result in deformity of the joint. Poor alignment of the jaw or teeth can also result. The main long-term effect is frustration from the symptoms. For many people with TMJ, there are no long-term effects.

What are the risks to others?
Temporomandibular joint disorders are not contagious. They pose no risk to others.

What are the treatments for the condition?
Initial treatment of temporomandibular joint disorders involves identifying actions that cause symptoms to get worse, such as clenching or grinding the teeth. Many people may not realize they are doing these things. Some other measures used to treat TMJ are as follows:

If these treatments fail, referral to a dentist who treats TMJ may be needed. Special bite appliances may be used. In severe cases of TMJ that do not respond to other treatments, surgery to realign the jaw is sometimes helpful. Joint replacement or a joint implant may be considered.

What are the side effects of the treatments?
Pain medicines may cause stomach upset and allergic reactions. Medicines to relax the muscles may cause drowsiness or allergic reactions. Other side effects depend on the drug used. Surgery may cause bleeding, infection, or allergic reaction to anesthesia. Surgery does not always cure TMJ.

What happens after treatment for the condition?
If symptoms go away, no further treatment is generally needed for the temporomandibular joint disorders. The person should take care to avoid factors that may cause another episode of TMJ, such as teeth grinding.

How is the condition monitored?
Symptoms and a physical exam are used to monitor temporomandibular joint disorders. Sometimes, X-rays may be used to monitor the condition. Any new or worsening symptoms should be reported to the healthcare provider.

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