December 16, 2007

The Unrecognized Connection: Peripheral Neuropathy And Fibromyalgia

The complex and controversial syndrome of fibromyalgia has gained increasing medical status among physicians as being a "real" condition instead of the "depressed woman's hypochondria." After nearly 150 years of medical research, this syndrome is now well-recognized, with a particular set of symptoms. Although there is no cure for fibromyalgia, its painful and exhausting symptoms can be medically managed. However, there is one symptom of fibromyalgia that is only now gaining recognition as yet another common manifestation of this syndrome: peripheral neuropathy associated with fibromyalgia.

Peripheral neuropathy in general is a tingling, burning, twitching or numbness of the hands and/or feet. It is most commonly associated with many metabolic conditions such as diabetes, liver disease, connective tissue diseases and auto-immune disorders like lupus. Peripheral neuropathy is often present with fibromyalgia because fibromyalgia is considered as both a connective tissue condition and an auto-immune disorder. Many rheumatologists regard fibromyalgia as a form of sub-clinical lupus, the only difference being that in fibromyalgia, there are two key lupus symptoms missing; the infamous red "butterfly rash" on the patient's chest or face, and a definitive lab test called a "sed rate." Apart from these elements, lupus and fibromyalgia are almost indistinguishable. Thus, peripheral neuropathy present in fibromyalgia is much more common than previously considered.

Treating Fibromyalgia's Peripheral Neuropathy

The accepted medical protocols for treating peripheral neuropathy associated with fibromyalgia differ only slightly than conventional treatment for other types of peripheral neuropathy. Since neither fibromyalgia nor peripheral neuropathy can be cured, the focus is on managing symptoms. The medication Neurontin (gabapentin) is very helpful in relieving the pain, burning and numbness of peripheral neuropathy. This is not a narcotic pain-relieving medication; it acts by interrupting pain signals to the brain rather than masking them with an addictive opiate. The old-style tricyclic antidepressant medications like amytriptaline (Elavil) in low doses are proven, dependable treatments for fibromyalgia with or without peripheral neuropathy.

Also useful are the NSAIDs - Non-Steroidal Anti-Inflammatory Drugs - such as ibuprophen (Aleve, Motrin, and Naproxen) which helps relieve the swelling and pain associated with fibromyalgia peripheral neuropathy. For simple pain relief, acetaminophen (Tylenol) is helpful. Keeping hands and feet warm is also important; many sufferers wear gloves and heavy socks year-round to reduce flare-ups. Others find wearing tight but comfortable canvass shoes, and even sleeping in them, very helpful. Finding a regimen that works and using it consistently is the key to comfort.

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