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Focusing on
Fibromyalgia
A Puzzling and Painful Condition
You’ve probably heard of fibromyalgia, but you may not
know what it is. Fibromyalgia is a long-term (chronic) pain
condition that affects 5 million or more Americans ages 18
and older. For unknown reasons, most people diagnosed
with fibromyalgia are women, although men and children
also can be affected. People with certain disorders, such as
rheumatoid arthritis or lupus, may also have fibromyalgia,
which can affect their disease course and treatment.
Fibromyalgia can take a powerful toll on health, well-being,
and quality of life. “People with fibromyalgia suffer from
severe, daily pain that is widespread throughout the body,”
says Dr. Leslie J. Crofford, an NIH-supported researcher at
Vanderbilt University. “Their pain is typically accompanied
by debilitating fatigue, sleep that does not refresh them,
and problems with thinking and memory.”
People with fibromyalgia often see many doctors before
finally receiving a diagnosis. The main symptoms – pain
and fatigue – overlap with those of many other conditions,
which can complicate the diagnosis.
“To make things more challenging, there are no blood tests
or X-rays that are abnormal in people with the disorder,”
says Crofford. With no specific diagnostic test, some doctors
may question whether a patient’s pain is real. “Even
friends, family, and coworkers may have a difficult time
understanding the person’s symptoms,” Crofford says.
Inside
This
Issue:
A doctor familiar with fibromyalgia can make a diagnosis
based on the criteria established by the American College
of Rheumatology. Diagnostic symptoms include a history
of widespread pain lasting more than 3 months and other
symptoms such as fatigue. In making the diagnosis, doctors
consider the number of areas throughout the body where
the patient had pain in the past week, and they rule out
other causes of disease.
What causes fibromyalgia isn’t fully understood. Many
factors likely contribute. “We know that people with
fibromyalgia have changes in the communication between
the body and the brain,” Crofford says. These changes may
lead the brain to interpret certain sensations as painful that
might not be bothersome to people without the disorder.
Researchers have found several genes that may affect a
person’s risk of developing fibromyalgia. Stressful life
events may also play a role.
cont'd. on page 2
Focusing on Fibromyalgia..................................................................................................................................1
When Your Back Hurts ........................................................................................................................................2
Soothing a Sore Throat.......................................................................................................................................3
Researchers Examine the Structure of Zika Virus.............................................................................................4
Avoid Mosquito Bites! ........................................................................................................................................4
Focusing on Fibromyalgia, cont'd.
FEELING BETTER WITH FIBROMYALGIA
Fibromyalgia isn’t a progressive disease, so it doesn’t get
worse over time and may even improve. It’s never fatal,
and it won’t harm the joints, muscles, or internal organs.
Medications may help relieve some – but not all – symptoms
of fibromyalgia. “Drug treatments by themselves don’t
result in remission or cure of fibromyalgia,” says Crofford.
“We’ve learned that exercise may work as well as or better
than medications. In addition, therapies such as tai chi,
yoga, and cognitive behavior therapy can also help to
reduce symptoms.”
People with fibromyalgia often have the best results when
treated with multiple therapies. “It’s critically important
for health care providers to help patients develop an
understanding of fibromyalgia, and to provide realistic
information about treatments, with an emphasis on using
exercise and other physical therapies in conjunction with
medications,” Crofford says.
Get enough sleep. Getting the right kind
of sleep can help ease pain and fatigue.
Discuss any sleep problems with
your doctor.
•
Exercise. Research has shown that regular
exercise is one of the most effective
treatments for fibromyalgia.
•
Try a complementary health approach.
Practices such as tai chi, qi gong, yoga,
massage therapy, and acupuncture
may help relieve some symptoms.
•
Consider medicines. Talk to your health
care provider about an approved
medication for treating fibromyalgia.
more comfortably and reduce pain. She and other NIHfunded teams are also seeking markers of fibromyalgia
in the blood that might ultimately lead to more targeted
and effective treatments.
Crofford and her colleagues are exploring whether a
treatment called TENS (transcutaneous electrical nerve
stimulation) can help people with fibromyalgia exercise
When Your Back
Hurts
•
imaging scans. But such changes to the back are also seen
in a lot of people who don’t have back pain. So it’s hard to
know if the changes are actually what’s causing the pain.
Don’t Let
Back Pain
Knock
You Flat
People with obesity are more likely to have low back pain,
as are people who smoke. Back pain is also more common
in people who don’t exercise much, or in people who are
mostly inactive but have occasional bursts of exercise.
Is your back hurting? You’re in good company. In any 3month period, about 1 in 4 adults in the U.S. has at least
one day of back pain, mostly in the lower back.
What doctors do about chronic pain depends on the source
of the pain. Some chronic back pain requires prolonged
medical attention. If the pain comes from a fracture or
tumor, those problems can be treated. Surgery can help
if the pain is caused by a ruptured (herniated) disc or
certain other conditions like spinal stenosis (narrowing of
the spinal column, which can put pressure on the nerves)
or degenerative spondylolisthesis (when one vertebra
slips over another). But surgery isn’t the right choice
for everyone.
The back is a complicated structure. Its center is the spine,
which is made up of 33 bones called vertebrae, stacked
in a column. The nerves of the spinal cord run in a tunnel
through the middle of those bones. Spongy discs between
the vertebrae act as cushions. Ligaments and tendons
hold everything together.
A lot of things can go wrong with your back. A strained
muscle or a problem with a disc or a bone can cause pain.
Back pain might also arise from a fracture or tumor.
Your back naturally changes as you age. Discs degenerate
and arthritis may develop in the small joints of the back.
Those changes may show up on an MRI or other types of
The good news is most back pain goes away by itself. But
for some people, the pain continues. If your back hurts
most of the time for more than 3 months, you have
chronic back pain.
There are many treatment options for back pain, so be sure
to talk to your health care provider about which approach is
right for you. For most people, even chronic pain eventually
clears up without surgery. Research has shown that patients
who stay active are better off. Just be sure to avoid activities
that might strain the back.
2
Soothing a Sore Throat
What To Do When Your
Throat Hurts
We’ve all had sore throats. Your throat feels scratchy
and may hurt when you swallow. What can you do to
soothe a sore throat? And when is it a sign of a more
serious infection?
Most sore throats are caused by viral infections such as
the common cold or the flu. These throat problems are
generally minor and go away on their own.
To soothe your irritated throat, keep it moist. “Ever notice
that a sore throat seems worse in the morning? It’s
because your throat gets so dry overnight,” says Dr.
Valerie Riddle, an infectious disease expert at NIH.
“Having lozenges or hard candies – or anything that
stimulates saliva production – will keep your throat
moist. It’s also important to drink plenty of fluids.”
Strep is highly contagious. Treat it quickly to prevent it
from spreading to others. Riddle says, “Not only can the
infection be transmitted, but there are potential
complications from untreated strep throat.” These include
ear infections, rheumatic fever and kidney problems.
Another fairly common throat infection is tonsillitis,
which occurs when you have sore, swollen tonsils.
It’s caused by many of the same viruses and bacteria
that cause sore throats. If you have frequent bouts of
tonsillitis or strep throat, you may need surgery (called
a tonsillectomy) to have your tonsils removed.
The best way to protect yourself from the germs that
cause these infections is to wash your hands often. Try to
steer clear of people who have colds or other contagious
infections. And avoid smoking and inhaling second-hand
smoke, which can irritate your throat.
For young children who might choke on hard candies
or lozenges, try cold liquids and popsicles. Throat pain
might also be soothed by throat sprays and over-thecounter pain relievers such as acetaminophen, ibuprofen
or aspirin, but don’t give aspirin to young children.
Contact a doctor if your sore throat is severe, doesn’t feel
better after a few days, or is accompanied by a high fever
or swollen glands. These symptoms could be signs of a
bacterial infection, such as strep throat. Taking antibiotics
won’t help at all if your sore throat is caused by viruses,
but they’re essential for fighting bacterial infections
like strep.
Strep is the most common bacterial throat infection.
Although it can occur in adults, strep throat is more
common in children between ages 5 and 15. Riddle says
strep can be harder to detect in younger children,
because it can cause a runny nose and other symptoms
that make it seem like a cold. “If your child has severe
throat pain, a fever above 100.4 degrees, or swollen
glands, you should get medical attention right away,”
advises Riddle. Children with strep also may experience
nausea, vomiting and stomach pain.
To see whether you have strep throat, the doctor will take
a throat swab. If test results confirm strep, your doctor will
prescribe antibiotics. After 24 hours of taking them, you
should no longer be contagious. You’ll likely begin feeling
better within a couple of days, but to fully recover it’s
important to finish all of the medicine.
3
Health Postings
AVOID Mosquito Bites!
• Use insect repellents. Products containing
DEET, picaridin, lemon eucalyptus, paramenthane-diol, or IR3535 can be applied
to skin. Follow label instructions.
• Cover up. When outside, wear long sleeves,
pants, and socks. Mosquitoes may bite
through thin fabric, so spray thin clothes with
an EPA-registered repellent like permethrin.
Don’t apply permethrin directly to skin.
Researchers Examine the
Structure of Zika Virus
• Mosquito-proof your home. Install or repair
screens on windows and doors to keep insects
out. Use air conditioning if you have it.
• Get rid of mosquito breeding sites.
Scientists found a structural detail on the surface of the Zika virus
that distinguishes it from similar viruses. Continuing to study this
tiny difference might help researchers develop targeted therapies
and better ways to diagnose Zika infections.
Zika virus is mainly transmitted to humans by the bite of infected
mosquitoes. It’s in the same family of viruses – called flaviviruses –
that can cause the mosquito-borne diseases dengue, yellow fever,
or West Nile illness. Most people infected with Zika virus don’t get
sick. If symptoms appear, they tend to be mild and go away within
a week. Symptoms can include fever, rash, and joint pain.
But if a pregnant woman becomes infected with Zika virus, her
unborn child may be at risk. Recent evidence confirms that Zika
virus can cause severe fetal brain abnormalities, including
microcephaly, a rare condition in which an infant’s head is
unusually small.
To learn more about Zika virus, NIH-funded researchers examined
its structure at near-atomic resolution. They used a technique called
cryo-electron microscopy. The process involves freezing viruses and
firing a stream of high-energy particles through the sample to
create tens of thousands of images. These 2-D images are then
combined to create a detailed 3-D view of the virus.
The 3-D images showed that Zika virus is structurally similar to
other flaviviruses. But one difference in a protein on the virus
surface may help it attach to and enter human cells. This detail
might be something that researchers can take advantage of in
efforts to develop Zika drugs or vaccines.
“The structure of the virus provides a map that shows potential
regions of the virus that could be targeted by a therapeutic
treatment,” says study co-author Dr. Richard Kuhn of Purdue
University. The structure might also point to new approaches for
vaccine development or improved diagnostics for Zika infection,
the researchers say.
Reference:
The 3.8 Å resolution cryo-EM structure of Zika virus. Sirohi D, Chen Z, Sun L, et al.
Science. 2016 Mar 31. pii: aaf5316. [Epub ahead of print]. PMID: 27033547.
Funding: NIH’s National Institute of Allergy and Infectious Diseases (NIAID).
4
Empty standing water from flowerpots,
gutters, buckets, pool covers, pet water dishes,
and birdbaths on a regular basis.
All articles reprinted from the National Institutes of
Health’s NIH News in Health. For more information,
visit: www.newsinhealth.nih.gov