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2.4.0d FIBROMYALGIA

Fibromyalgia is the name for a condition that typically includes widespread muscle pain, fatigue and abnormal sleep patterns.

Until a few years ago, doctors called the condition fibrositis or muscular rheumatism and believed that for the most part, the condition was “all in the patient’s head.” Today, fibromyalgia is recognized by medical organizations as a genuine and serious problem.

The symptoms of fibromyalgia typically include pain in many muscles, and around ligaments and tendons, persistent fatigue, waking up feeling tired even after a full night’s sleep, headaches, bouts of constipation and diarrhea, abdominal pain, painful menstrual periods, sensitivity to cold, numbness or tingling, and difficulty exercising.

Symptoms vary widely among patients and tend to wax and wane over time. An illness, injury, cold weather or emotional stress may trigger a fibromyalgia episode or make ongoing symptoms worse.

A study at the Oregon Health Sciences University and Portland Adventist Hospital suggests hepatitis C may trigger fibromyalgia (“Fibromyalgia: A prominent feature in patients with musculoskeletal problems in chronic hepatitis C, A report of 12 patients,” by A. Barkhuizen, G.S. Schoepflin, and R.M. Bennett, Journal of Clinical Rheumatology, Vol. 2, No. 4, August 1996 ). This study is the first to show a link between the two illnesses. A more recent study (Curr Opin Rheumatol 2000 Jan;12(1):53-60) suggests that a causative role of HCV seems to be likely in the development of fibromyalgia.

It was determined that the relationship between the hepatitis C virus and fibromyalgia followed three distinct patterns:

In nine patients, fibromyalgia developed as a long-term complication of the hepatitis, arising on average 13.4 years after the virus was acquired.

In two patients, fibromyalgia arose simultaneously with the hepatitis C infection.

In one patient, pre-existing fibromyalgia was significantly worsened by the hepatitis C.

It is unknown why the hepatitis C virus and fibromyalgia may be linked, but the authors suggest that hepatitis C causes chronic activation of the immune system that leads to muscle aching, fatigue, mental changes, sleep abnormalities, and alterations of the neuroendocrine system.

The patients with both hepatitis C and fibromyalgia could be distinguished from most other patients with fibromyalgia alone because they had symptoms unusual to fibromyalgia. These symptoms included synovitis (inflammation of the membrane around a joint, bursa, or tendon) and vasculitis (inflammation of a blood or lymph vessel).

In addition, laboratory findings pointed to a disease process other than fibromyalgia.



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