The Physiology of Stress Illness (2)

To review from yesterday’s post, studies have revealed that people with Fibromyalgia (FM) experience pain differently.*  (Studies in other forms of Stress Illness are similar.)  Here are some additional research results that support the idea of altered underlying physiology, presented with minimal jargon.

1. In FM patients the stress hormone cortisol is higher than normal in the bloodstream, doesn’t have its usual 24 hour variation (normally higher in the morning, declining in the evening) and doesn’t increase as much as it should in response to stress.  Similar abnormalities in cortisol have been found in patients with Depression and in people who were abused as children.

2. FM patients are more likely than healthy people to have anxiety or depression though it is not clear which came first.

3. FM patients are more likely than healthy people to have been abused as children.  Another study showed that pain processing in the brain in adults abused as children differs from processing in adults not abused as children.

4. FM patients are more likely than healthy people to have post-traumatic stress disorder.  Symptoms of this were found in over 50% of FM patients in two recent studies.

5. 153 patients seen in an Emergency Room for whiplash were followed for 15 months.  Only 1 developed fibromyalgia.  This implies that physical trauma is unlikely to be the cause of FM.

In summary,  research on FM patients is beginning to reveal abnormalities in how the brain and spinal cord process pain signals.  Some day, this improved understanding will lead to better treatment.  In the mean time, if you suffer from stress illness, you can take heart from the fact that medical science is beginning to understand you.

* Abeles et al.  The Pathophysiology of Fibromyalgia. Ann Intern Med. 2007; 146:726-734.

(The authors are from NYU and the University of Connecticut.)

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