Effectiveness of Painkillers in the Treatment of Fibromyalgia

When a person feels overly exhausted and constantly hurting all over, they may have fibromyalgia. This is a chronic condition characterized by widespread pain in the muscles, ligaments, and tendons of a person, as well as fatigue and multiple tender points. These points are places in a person's body where a slight hint of pressure causes pain. Also called fibrositis, chronic muscle pain syndrome, psychogenic rheumatism and tension myalgias, fibromyalgia is more common to women than men.

People dealing with this condition often report that they do not respond to the types of medication that relieve other people's pain. A new research from Michigan explains that this might be because patients with fibromyalgia were found to have a reduction in the binding ability of a type of receptor in the brain that is the target of opioid painkiller drugs such as morphine. The study includes PET scans (Positron Emission Tomography) of the brains of patients with fibromyalgia, and an equal number of people without the said condition. Results indicate that the patients with fibromyalgia have reduced their mu-opioid receptor (MOR) availability within the parts of the brain that normally process and dampen pain signals, specifically the nucleus accumbens, anterior cingulate and the amygdala. According to one of the research investigators, the reduced availability of the receptor was closely associated with greater pain for people with fibromyalgia. He said that these findings could explain why opioids are anecdotally thought to be ineffective for people with fibromyalgia. He also added that this particular finding is significant because it has been hard to determine the cause of pain in patients with the said condition, to the point that acceptance of the condition by medical practitioners were slow.

Opioid pain killers work by binding to opioid receptors in the brain and spinal cord. In addition to morphine, they include codeine, medications like Darvocet, Vicodin and Oxycontin. Researchers in this study theorized from their findings that with the lower availability of the MORs in three regions of the brain of people with fibromyalgia, such opioid based pain killers may not be able to bind as well to the receptors as they can in the brains of those people without the condition. To make it more simple, when the pain killers cannot bind to the receptors, they cannot relieve the patient's pain as effectively. The reduced availability could result from a reduced number of opioid receptors, enhanced release of endogenous opioids, or both.

The research also found a possible link with depression. The PET scans showed that fibromyalgia patients with more depressive symptoms had reductions of MOR binding potential in the amygdala, a region of the brain thought to adjust mood and the emotional dimension of pain.

In knowing this, people should be more aware of their body and how it reacts to pain. Fibromyalgia is a condition where the intensity of symptoms actually vary. It is best if people are informed of this condition, specifically, that this health problem is not progressive nor life threatening. Self-care can help reduce fibromyalgia's symptoms by getting enough sleep, exercising regularly, and maintaining a healthy lifestyle.

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