Learn About Chronic Pain Syndrome Video

Get it off your chest – be the first to comment on this video!

Learn About Chronic Pain Syndrome

Susan Solovic: Hello everyone and welcome to SBTV.com’s special segments on Fibromyalgia in the workplace. I’m Susan Wilson Solovic and we appreciate you joining us. And my guest today in the studio is Dr. Richard Bligh, who is an internal medicine doctor specializing in AH Management. Welcome to the program Dr. Bligh. Now in full disclosure I should tell everyone that you are my primary care physician. Alright, well I appreciate you coming in and doing this for me. Let’s talk about Fibromyalgia. SBTV has really been focusing on Fibromyalgia and trying to raise awareness about what it is. So let’s just start off with that simple question. What is Fibromyalgia? Dr. Bligh: Fibromyalgia is truly, it’s a syndrome and it’s a pain syndrome. It’s associated most likely with some sort of dis-regulation within the central nervous system in terms of the way we sense pain. Susan Solovic: And why is it, I mean we hear a lot about Fibromyalgia now but ten years ago, you really didn’t hear anything about it. Why is that? Dr. Bligh: I think because ten years ago, we really didn’t feel like it existed. If it came in with the constellation of symptoms we often see, most people thought it was a psychiatric disorder at that point. Susan Solovic: Why is there, I read in New York Times article not too long ago that basically said, Fibromyalgia doesn’t exist. Why is there so much controversy over Fibromyalgia, because even the male clinic has a special treatment clinic for it now? Dr. Bligh: I think the problem is that as with anything in medicine, that if we can’t have a test that shows it exactly what it is, or if we don’t have a specific set of signs and symptoms that are universal for everybody, we always put something in its pigeon hole and often you can’t do that in medicine. And then I think that is why it’s so difficult and why so many people don’t believe that it’s truly a disease. Susan Solovic: What are some of the symptoms that the patient might experience and then how do you go about diagnosing and if there is no like whip__ test? Dr. Bligh: Oh it’s difficult. The most common symptoms are just widespread pain. And they’re generally in all four quadrants of the body. People typically have specific tender points within the body and generally the diagnosis of Fibromyalgia has to do with people having this pain syndrome for at least three to four months. Generally, they typically will have pain at, at least a lot of the pressure points that are normally associated with Fibromyalgia. We also see a lot of fatigue with Fibromyalgia. That’s very common. You see a lot of non-restored tip sleep disorders. That’s the common part of it. You can see issues with depression and then the question is, is the depression part of the Fibromyalgia and it’s kind of which come first. Is the individual depressed because of the chronic pain or is depression overlying on the Fibromyalgia. Susan Solovic: So it’s which came first, the chicken or the egg, right? Exactly. Now I have heard that some insurance companies, there are few drugs or at least one drug now that is for Fibromyalgia specifically, and some of the insurance companies are saying, “Wait a minute doctors, we’re not just going to pay for that. At first, we’re going to expect the patient to try variable treatments”. What’s your take on that? If you’ve seen that or what, what do you feel? Dr. Bligh: I think that’s common with any new drug that comes out. The insurance companies can sometimes take months before they’ll start paying for it. Reality is they want to pay for the cheaper drugs that have been used in the past. Some of the generic drugs that may have been used, they may not be as effective but they want to use. They have a trial on one of the generics before they use one of the newer drugs around. Susan Solovic: Speaking of drugs and other treatments, __ is the only one drug right now in the market. What are some of the treatments that Fibromyalgia patients might be able to do to relieve some of their pain? Dr. Bligh: A lot of the treatments of the past have been sent around using some if the anti-depressants. Some of the older anti-depressants like Amitriptyline are used. We know that a big part of this disorder is sleep disorder. So using some of the older anti-depressants like Trazodone, medications that improve the quality of stage program sleep will help. We also use just a lot of the different pain medications. We use anti-inflammatories, you know, that has sort of been the main state of treatment for years. Other things are just, you know, common sense things. Getting enough sleep, reducing your levels of stress, you know those are the big things I think we can start out doing. You know some of the trigger point injections can help some people but there’s still so much we don’t know about Fibromyalgia, that we just really have not find during the treatment and everyone’s symptoms are somewhat different. Susan Solovic: But they are focusing more on research in terms of finding a cause and of course if you find the cause, you can hopefully find a cure. Dr. Bligh: Sure. And I think a lot of the research has been based on signaling pain and pulses from the central nervous system and that’s where a lot of the neuro-medications like Pregabalin. Lyrica which is the only one approved, and what it works is it helps to modulate those pain receptions and it sort of like tuning down the stereo. You’re just tuning down the noise there and that’s basically how those drugs work. There are drugs that have been used for partial seizures. We use it for diabetic neuropathies. We use it in people who’s had shingles, and have post traumatic neuropathy from that. But what these drugs do is they work centrally within the brain and like I said, they just sort of tune down the volume so that the pain is not as severe. Susan Solovic: So they’re not really getting the source of it. They’re just trying to camouflage some of the symptoms? Dr. Bligh: I think that’s basically what they’re doing because we don’t know what causes it. We know that there are some things that can predispose to Fibromyalgia. Often you’ll see it in people who’ve had trauma, individuals who’ve had whiplash. You see it much more commonly in females than males, sort of a six to one ratio. You see it more commonly in females who are about child-bearing age so that may be some hormonal issues associated with that. We know that sleep is a huge problem of Fibromyalgia, and they’ve even looked at studies using human growth hormone in triggering the Fibromyalgia, because a lot of individuals with Fibromyalgia do not get adequate rest or sleep which means it’s not the number of hours you sleep but are you reaching that stage for REM sleep where you’re getting most of your rest. Susan Solovic: Right, ok, now most people who have Fibromyalgia, if you look at them, you would never know they’re sick or they’re suffering. (True.) That’s difficult because a lot of people say “You know I don’t feel well.” They drop out of the work force. Eventually they even isolate themselves socially. What could you tell people, like co-workers or friends or family members to do or to think about in order to help the Fibromyalgia patient stay more active? Dr. Bligh: I think that they need to be empathetic. They need to understand a little bit more about the disease. I think so much in the past, there’s been thought to be predominantly a psychological issue. And now we know that that’s probably about 20 percent of those individuals. I think the first thing to do with anyone who’s been you know, possibly diagnosed with Fibromyalgia is to make sure there’s nothing else going on, because you see the most associated connective tissue disorders, like rheumatoid arthritis, lupus can be associated. You can see individuals with significant psychiatric issues like bipolar disease. You need to rule these things out. There could even be underlying malignancies, malignancies that sort of mimic the pain syndromes. So we all make sure first that you have the right diagnosis. Susan Solovic: It’s a process of elimination obviously. What about non medical treatments for patients? I’ve heard about myofascial release massage, other therapies, anything that you recommend or you see that might work. Dr. Bligh: I think the myofascial release techniques work great. Some of the trigger point injections. Generally you have people who have either myofascial pain or they have what’s called alodenia and those individuals have pain either with light touch. The pain doesn’t radiate. Myofascial pain tends to be more pain associated within the muscle or the junction between the muscle and the tendon. With the myofascial pain, a lot of that can be improved with massage. Acupuncture can improve it. You can get improvement with trigger point injections. Even things like improving your posture, improving your flexibility, all of those things can improve symptoms. Susan Solovic: And some of those things are hard to do, because the pain and the stiffness that makes you not want to do it. Absolutely. Any advice for someone who may be listening today and think, “Wow, I may have Fibromyalgia” but they’re not getting any diagnosis. Any tips to help them find the right diagnosis? Dr. Bligh: I think sometimes they need to go to a rheumatologist. Most internal medicine specially should be able to recognize Fibromyalgia. And then I think they have to have other testing done to make sure there aren’t any hormonal deficiencies. Hypothyroidism can cause exacerbation or problems with, very similar to Fibromyalgia. You can see women as they’re heading pre-menopause or menopause, sudden drops in estrogen and testosterone kind of crank up the pain. So you have to start looking at other associated co-morbid diseases. Susan Solovic: Ok great. Well thank you very much. This is enlightening and I know it helps a lot because this is sort of a, as we’ve said earlier, misunderstood disease. Yeah, thanks for joining us Dr. Bligh. And thanks to all of you for watching us and being part of SBTV.com’s Fibromyalgia Awareness series. I hope you watch some of our podcasts and video segments. And remember to stay tuned to SBTV.com where small business is our only business.

Small Business Television Network

For More Small Business Advice, visit the SBTV website.

http://www.sbtv.com/

Featured Links:

wikiHow Health

Find more articles on health topics, specific conditions and treatments and medical information on wikiHow.

http://www.wikihow.com/Category:Health

Susan Solovic: Hello everyone and welcome to SBTV.com’s special segments on Fibromyalgia in the workplace. I’m Susan Wilson Solovic and we appreciate you joining us. And my guest today in the studio is Dr. Richard Bligh, who is an internal medicine doctor specializing in AH Management. Welcome to the program Dr. Bligh. Now in full disclosure I should tell everyone that you are my primary care physician. Alright, well I appreciate you coming in and doing this for me. Let’s talk about Fibromyalgia. SBTV has really been focusing on Fibromyalgia and trying to raise awareness about what it is. So let’s just start off with that simple question. What is Fibromyalgia?
Dr. Bligh: Fibromyalgia is truly, it’s a syndrome and it’s a pain syndrome. It’s associated most likely with some sort of dis-regulation within the central nervous system in terms of the way we sense pain.
Susan Solovic: And why is it, I mean we hear a lot about Fibromyalgia now but ten years ago, you really didn’t hear anything about it. Why is that?
Dr. Bligh: I think because ten years ago, we really didn’t feel like it existed. If it came in with the constellation of symptoms we often see, most people thought it was a psychiatric disorder at that point.
Susan Solovic: Why is there, I read in New York Times article not too long ago that basically said, Fibromyalgia doesn’t exist. Why is there so much controversy over Fibromyalgia, because even the male clinic has a special treatment clinic for it now?
Dr. Bligh: I think the problem is that as with anything in medicine, that if we can’t have a test that shows it exactly what it is, or if we don’t have a specific set of signs and symptoms that are universal for everybody, we always put something in its pigeon hole and often you can’t do that in medicine. And then I think that is why it’s so difficult and why so many people don’t believe that it’s truly a disease.
Susan Solovic: What are some of the symptoms that the patient might experience and then how do you go about diagnosing and if there is no like whip__ test?
Dr. Bligh: Oh it’s difficult. The most common symptoms are just widespread pain. And they’re generally in all four quadrants of the body. People typically have specific tender points within the body and generally the diagnosis of Fibromyalgia has to do with people having this pain syndrome for at least three to four months. Generally, they typically will have pain at, at least a lot of the pressure points that are normally associated with Fibromyalgia. We also see a lot of fatigue with Fibromyalgia. That’s very common. You see a lot of non-restored tip sleep disorders. That’s the common part of it. You can see issues with depression and then the question is, is the depression part of the Fibromyalgia and it’s kind of which come first. Is the individual depressed because of the chronic pain or is depression overlying on the Fibromyalgia.
Susan Solovic: So it’s which came first, the chicken or the egg, right? Exactly. Now I have heard that some insurance companies, there are few drugs or at least one drug now that is for Fibromyalgia specifically, and some of the insurance companies are saying, “Wait a minute doctors, we’re not just going to pay for that. At first, we’re going to expect the patient to try variable treatments”. What’s your take on that? If you’ve seen that or what, what do you feel?
Dr. Bligh: I think that’s common with any new drug that comes out. The insurance companies can sometimes take months before they’ll start paying for it. Reality is they want to pay for the cheaper drugs that have been used in the past. Some of the generic drugs that may have been used, they may not be as effective but they want to use. They have a trial on one of the generics before they use one of the newer drugs around.
Susan Solovic: Speaking of drugs and other treatments, __ is the only one drug right now in the market. What are some of the treatments that Fibromyalgia patients might be able to do to relieve some of their pain?
Dr. Bligh: A lot of the treatments of the past have been sent around using some if the anti-depressants. Some of the older anti-depressants like Amitriptyline are used. We know that a big part of this disorder is sleep disorder. So using some of the older anti-depressants like Trazodone, medications that improve the quality of stage program sleep will help. We also use just a lot of the different pain medications. We use anti-inflammatories, you know, that has sort of been the main state of treatment for years. Other things are just, you know, common sense things. Getting enough sleep, reducing your levels of stress, you know those are the big things I think we can start out doing. You know some of the trigger point injections can help some people but there’s still so much we don’t know about Fibromyalgia, that we just really have not find during the treatment and everyone’s symptoms are somewhat different.
Susan Solovic: But they are focusing more on research in terms of finding a cause and of course if you find the cause, you can hopefully find a cure.
Dr. Bligh: Sure. And I think a lot of the research has been based on signaling pain and pulses from the central nervous system and that’s where a lot of the neuro-medications like Pregabalin. Lyrica which is the only one approved, and what it works is it helps to modulate those pain receptions and it sort of like tuning down the stereo. You’re just tuning down the noise there and that’s basically how those drugs work. There are drugs that have been used for partial seizures. We use it for diabetic neuropathies. We use it in people who’s had shingles, and have post traumatic neuropathy from that. But what these drugs do is they work centrally within the brain and like I said, they just sort of tune down the volume so that the pain is not as severe.
Susan Solovic: So they’re not really getting the source of it. They’re just trying to camouflage some of the symptoms?
Dr. Bligh: I think that’s basically what they’re doing because we don’t know what causes it. We know that there are some things that can predispose to Fibromyalgia. Often you’ll see it in people who’ve had trauma, individuals who’ve had whiplash. You see it much more commonly in females than males, sort of a six to one ratio. You see it more commonly in females who are about child-bearing age so that may be some hormonal issues associated with that. We know that sleep is a huge problem of Fibromyalgia, and they’ve even looked at studies using human growth hormone in triggering the Fibromyalgia, because a lot of individuals with Fibromyalgia do not get adequate rest or sleep which means it’s not the number of hours you sleep but are you reaching that stage for REM sleep where you’re getting most of your rest.
Susan Solovic: Right, ok, now most people who have Fibromyalgia, if you look at them, you would never know they’re sick or they’re suffering. (True.) That’s difficult because a lot of people say “You know I don’t feel well.” They drop out of the work force. Eventually they even isolate themselves socially. What could you tell people, like co-workers or friends or family members to do or to think about in order to help the Fibromyalgia patient stay more active?
Dr. Bligh: I think that they need to be empathetic. They need to understand a little bit more about the disease. I think so much in the past, there’s been thought to be predominantly a psychological issue. And now we know that that’s probably about 20 percent of those individuals. I think the first thing to do with anyone who’s been you know, possibly diagnosed with Fibromyalgia is to make sure there’s nothing else going on, because you see the most associated connective tissue disorders, like rheumatoid arthritis, lupus can be associated. You can see individuals with significant psychiatric issues like bipolar disease. You need to rule these things out. There could even be underlying malignancies, malignancies that sort of mimic the pain syndromes. So we all make sure first that you have the right diagnosis.
Susan Solovic: It’s a process of elimination obviously. What about non medical treatments for patients? I’ve heard about myofascial release massage, other therapies, anything that you recommend or you see that might work.
Dr. Bligh: I think the myofascial release techniques work great. Some of the trigger point injections. Generally you have people who have either myofascial pain or they have what’s called alodenia and those individuals have pain either with light touch. The pain doesn’t radiate. Myofascial pain tends to be more pain associated within the muscle or the junction between the muscle and the tendon. With the myofascial pain, a lot of that can be improved with massage. Acupuncture can improve it. You can get improvement with trigger point injections. Even things like improving your posture, improving your flexibility, all of those things can improve symptoms.
Susan Solovic: And some of those things are hard to do, because the pain and the stiffness that makes you not want to do it. Absolutely. Any advice for someone who may be listening today and think, “Wow, I may have Fibromyalgia” but they’re not getting any diagnosis. Any tips to help them find the right diagnosis?
Dr. Bligh: I think sometimes they need to go to a rheumatologist. Most internal medicine specially should be able to recognize Fibromyalgia. And then I think they have to have other testing done to make sure there aren’t any hormonal deficiencies. Hypothyroidism can cause exacerbation or problems with, very similar to Fibromyalgia. You can see women as they’re heading pre-menopause or menopause, sudden drops in estrogen and testosterone kind of crank up the pain. So you have to start looking at other associated co-morbid diseases.
Susan Solovic: Ok great. Well thank you very much. This is enlightening and I know it helps a lot because this is sort of a, as we’ve said earlier, misunderstood disease. Yeah, thanks for joining us Dr. Bligh. And thanks to all of you for watching us and being part of SBTV.com’s Fibromyalgia Awareness series. I hope you watch some of our podcasts and video segments. And remember to stay tuned to SBTV.com where small business is our only business.

Transcription by: Scribe4you Transcription Services