Fibromyalgia arthritis needs to be well understood to be treated effectively

Fibromyalgia arthritis needs to be well understood to be treated effectively

Fibromyalgia arthritis:Fibromyalgia and arthritis or arthrosis are often confused. We've seen the high frequency of joint pains in fibromyalgia. This is due to 2 processes: the muscle spasms and the toxins released.

In fact, the confusion was so frequent that it lead to coin fibromyalgia: muscular rheumatism (or muscle rheumatism) which was a very good name because it indicated that the joint pain was not due to joint destruction or joint disease as such.

Fibromyalgia and tmj: another classical confusion is the presence of temporo-mandibular joint pain in fibromyalgia that is still confused with the Sadam Costen Syndrome which is due to a myofascial pain dysfunction.

Once again, a complete recollection of all symptoms should arise suspicion as to the presence of fibromyalgia and avoid unnecessary and detrimental investigations or and treatments.

Fibromyalgia and Joints Pain

Joints are made of articulation(s) between two or more bones. The joint is a complex structure with cartilage, adjoining bones, a synovial membrane that covers the cartilage and the capsule, lining the whole joint and producing the synovial fluid.The synovial fluid is a kind of oil that allows the joint to be mobile without gripping.
Around the joint is the capsule that is made of fibrous tissue reinforced by ligaments and extensions from tendons of muscles.

Inside the joint there can be sometimes structures such as ligaments that protect the joints from excessive movements and / or meniscus that act as cushions for the joint.

For example, the knee has ligaments inside the joints such as the anterior cruciate ligament and meniscus. Those are exposed to excessive movements that can sometimes rupture them (a common accident in football players).

All those structures have blood supply and innervation and all those structures are alive. They may have amorphous parts such as the nucleus pulposus in the intervertebral disc but are not per se isolated from the body.

Because a joint is not only defined by the bones but also by the muscles around it that allow it to move, it is easy to understand how much a dysfunctional muscle such as in fibromyalgia can easily disturb its function and make movements painful. No joint moves without stretching on muscles and without muscles movements.

Because a joint can also become painful because of pro-inflammatory products released in it, it is easy to understand that the release of toxins and substance P by the fibromyalgia muscles increase the pain of the joint.

But the main characteristic of the painful joints in fibromyalgia is that they are essentially normal without joint destruction. The painful joint in fibromyalgia is not a destructive arthrosis or an auto-immune or infectious arthritis. This is why, the name that was given before to fibromyalgia as being a muscular rheumatism was so appropriate.

However we must make 2 caveats:

1- fibromyalgia through its painful condition can lead to abnormal posture and gait disturbances that can be the cause of secondary arthrosis.
2- fibromyalgia patients have a high number of associated co-morbidities (other diseases) and it is not rare that an osteoarthritis condition is associated with fibromyalgia.

In a pure fibromyalgia (without co-morbidities) there is essentially normal but often painful joints. This joint may present at times signs of inflammation but they do not last. The joint dynamic is normal, X-rays are normal, there are usually no biological markers of inflammation or cytokines. The MRI is normal and the arthroscopy is useless, normal but may aggravate the condition of these fragile patients.

Arthroscopic lavage of the joint, as is so often done in fibromyalgia knee pain, is totally useless in general (as many studies have shown it) and should be considered negligent nowadays. In fibromyalgia, it is even more negligent as it tends to aggravate the fibromyalgia. If this has happened to you, you may consider making a claim as you would be due a compensation.

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Last updated : 5th February 2009