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Fibromyalgia And Parkinson’s Disease

Other Symptoms: Aging Or Pd

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Because the biggest risk factor for developing PD is age , skeletal problems associated with aging are often experienced by people with PD. While it is not clear that PD increases the risk or even the severity of these other skeletal conditions, the problems of PD can make the symptoms of these conditions more prominent.

  • Osteoarthritis, the joint damage associated with general wear and tear on the joints, is nearly universal in aging. Osteoarthritis tends to affect larger joints such as the hip and knee.
  • Arthritis of the spine is also very common. This may contribute to the development of spinal stenosis, narrowing of the canal in the spine that houses the spinal cord. In severe cases, spinal stenosis causes damage to the nerves as they exit the spine or even to the spinal cord itself.
  • Disorders of the fibrous discs between the bones of the spine can also cause pain, or limb numbness or weakness.

Common Skeletal & Bone Changes With Pd

  • Frozen shoulder: stiffness, pain and loss of range of movement in the shoulder, many people experience this symptom before a PD diagnosis.
  • Flexed fingers, toes or feet : one finger may extend, the thumb may fold inwards, fingers may clamp down onto the palm. In the leg, the foot may flex down or turn in, the big toe may flex upward while the other toes curl under.
  • Stooped posture : the spine bends forward when walking, in the most severe cases by as much as 90 degrees. This posture arises because the hips and knees are flexed and will go away when lying down.
  • Leaning sideways : involuntarily tilting of the trunk to one side when sitting, standing or walking always to the same side.
  • Scoliosis: sideways twisting, or curvature, of the spine.
  • Dropped head : the head and neck flex forward the chin may drop all the way down to the sternum or breastbone .
  • Bone fractures: people with PD are at risk of broken bones from falling, especially from landing on the hip. Kneecap fractures also are common, painful and sometimes overlooked.
  • Low bone density/osteoporosis: bones may become weak and at risk for osteoporosis from lack of weight-bearing exercise, like walking, and from too little calcium and vitamin D. Other risk factors for osteoporosis include older age, female sex, low body weight, and smoking. A person with PD who has osteoporosis is more likely to break a bone if they fall.

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The team searched the Clalit Health Services database between the years 2000 and 2015 for people diagnosed with Parkinsons and fibromyalgia. Researchers identified Parkinsons patients through the application of a medication tracer algorithm, and those with fibromyalgia based on medical records.

During this 15-year period, 2,606 people were diagnosed with Parkinsons and 60 of them also had fibromyalgia .

The majority of those with both the neurodegenerative and rheumatic disorders were women diagnosed at a mean age of 63.95 for Parkinsons, while their age at fibromyalgia diagnosis varied from 51.68 to 76.22 years. A majority 77% also received a fibromyalgia diagnosis after that of Parkinsons disease.

This particular patient population also had a higher prevalence of depression, anxiety, dementia, hypertension, and heart failure.

Compared to those with Parkinsons, patients with both conditions used different analgesics at higher rates as well as more antidepressants.

This FLISPAD subgroup of patients are mostly female, younger at PD diagnosis with a higher rate of cigarette smoking, anxiety, and depression, the researchers wrote. And they consume more analgesic drugs, both over-the-counter and prescription medications, including opioids.

A diagnosis of depression or use of antidepressants tended to come a mean 3.5 years before a fibromyalgia diagnosis.

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Types Of Pain In Parkinsons

One review classified the types of PD pain as follows:

  • musculoskeletal, in which the pain results from problems with the muscles , bones or joints
  • dystonic, which is due to abnormal muscle contractions caused by PD or the medications used to treat it
  • radicular pain or nerve pain
  • central pain, which is poorly understood and thought to be due to abnormalities in the brain itself

Autonomic Nervous System Breakdown

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Recent findings suggest that autonomic nervous system problems run rampant in Parkinsons. As in ME/CFS and FM, parasympathetic nervous system functioning is impaired. Problems with orthostatic intolerance are being found as well.

The autonomic nervous system findings in Parkinsons strongly correlate with findings of small nerve fiber neuropathy. These findings are particularly intriguing since they suggest that, just as in fibromyalgia, Parkinsons is more than a central nervous system disorder the peripheral nervous system is also affected.

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Is There A Connection Between Fibromyalgia And Ms

Ive often wondered if there may be a connection between fibromyalgia, multiple sclerosis , and other neurological conditions.

Back in the early 1990s, my doctor suspected fibromyalgia as the culprit for my fatigue, aches, and pains. At the time, doctors diagnosed fibromyalgia by the use of tender points. Additional criteria have been added to diagnostic guidelines since then. But in those days, the doctor would assess a patient by applying firm hand pressure to 18 specific areas of the body. If 11 of those 18 tender points reacted with additional pain, then the diagnosis was fibromyalgia.

I did have added pain with the applied pressure, and my doctor considered diagnosing me with fibromyalgia. But she decided against it. She reasoned that I might not be eligible for disability support in the future if I had fibromyalgia registered in my chart. Im glad that she didnt give me that diagnosis because I had no problems receiving disability payments when I was finally diagnosed with primary progressive multiple sclerosis in 2010.

During that in-between time, when I was unsure if I had fibromyalgia, I told friends about my possible diagnosis. My friends husband had received a diagnosis of fibromyalgia. I recently found out that he later developed Parkinsons disease. So was fibromyalgia a gateway to his Parkinsons and also to my PPMS?

Why It Is Important

A high prevalence of fibromyalgia has been found in patients infected with Hepatitis C, especially women. According to Israeli researchers, recognizing fibromyalgia in people with Hepatitis C will prevent misinterpretation of fibromyalgia symptoms as part of the liver disease and enable physicians to correctly focus on alleviating these symptoms.

A doctor well versed in fibromyalgia should be consulted if this syndrome is suspected. Because its diagnosis is not simple and symptoms often overlap with other conditions, a proper evaluation will test for fibromyalgia while ruling out other diseases. Doctors who are familiar with fibromyalgia typically make a diagnosis based on criteria established by the American College of Rheumatology . Those criteria are:

  • Widespread pain that lasts for more than 3 months.
  • Eleven or more tender points present at 18 specific sites on the body.
  • Whenever there is a profound crossover in a diseases symptoms, we can learn from their parallels. Although many questions shroud the connection between fibromyalgia and Hepatitis C, their relationship exists in many people with either condition. With their comparable symptoms, similar immune biochemistry and irrefutable statistics of simultaneous presentation, exposure to the Hepatitis C virus may be one of fibromyalgias triggers.

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    The Basal Ganglia And Movement

    The basal ganglia are not just about emotions and reward, though. The primary function of the basal ganglia is to ensure that voluntary movements are carried out smoothly. It does this by regulating the activities of the motor and premotor cortical areas.

    Could excitatory neurotransmitters be inhibiting movement in ME/CFS and FM?

    Excitatory neurotransmitters such as glutamate cause the basal ganglia to impair movement. Glutamate activates a pathway involving the basal ganglia which inhibits signals coming for the motor cortex. Dopamine-producing neurons in the basal ganglia, on the other hand, stimulate movement.

    In Parkinsons disease destruction of the dopamine-producing neurons puts the movement inhibiting portion of the brain on overdrive. Their muscles, for instance, remain in a state of contraction with a high muscle tone. This does not appear to be the result of muscle problems their brains have simply lost the ability to tell them to move.

    The Chronic Pain Connection

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    From hand-warmers to ion channel blockers to magnetic field generators more and more different approaches to get at the basis of chronic pain are being tried. Now comes an entirely different approach.

    Mice in chronic pain demonstrated reductions in dopamine.

    First, studies indicated that in rodents, chronic pain neurons thought to be associated with negative emotions showed increased activity after the onset of the pain. Those neurons connections to other parts of the brain associated with depression, also increased. The neuronal activity was associated with a drop in dopamine levels.

    Combining a Parkinsons drug called L-dopa with a non-steroidal anti-inflammatory drug completely eliminated any signs that an animal model was feeling pain. A clinical trial in humans is underway.

    L-dopa isnt the first Parkinsons disease drug found to reduce pain. Pramipexole, another dopamine enhancer, had a similar effect on rats with chronic pain. Pramipexole did pretty well in a 2005 controlled, double-blinded fibromyalgia study. FM patients reported a 35% decrease in pain and about 40% had a 50% or greater reduction in pain. Fatigue dropped by an average of 30%.

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    Parkinsons Drug For Fibromyalgia

    In 2007, the United States Food and Drug Administration gave its approval to a drug called Neupro, a transdermal patch for the delivery of rotigotine for the treatment of the symptoms associated with the onset of Parkinsons disease. Now phase II trials are being held to test whether Neupro might also alleviate fibromyalgia symptoms. Another goal of this trial is to find the smallest and safest dose of this medication for the relief of fibromyalgia. The smaller the dose, the better chance there is that a patient wont suffer too many side effects. The sponsor for this trial is Schwarz Biosciences, Inc.

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    Pesticides And Parkinsons Disease

    The connection between pesticides and Parkinsons has been raised many times, which led some researchers to look into specific pesticides. However, these efforts are difficult because they require data which already exists in the population. Researchers cant simply expose individuals to pesticides and record the data, so they must use information from pre-existing patients and study their findings based on the patients accounts.

    However, despite these difficulties, there have been specific chemicals which have been studied, as there is enough data to do so. The chemical paraquat has been the most studied chemical in this timespan and seems to pose a significant risk to triggering Parkinsons in patients.

    The chemical is associated with a likelihood of disease development two or three times the control group. Another chemical which is concerning to the scientific community is rotenone, which acts to disrupt mitochondria during its use. Rotenone is actually extracted from plants, making it a natural pesticide though it has still been associated with Parkinsons Disease and its development.

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    What Are The Management Options For Canadians Living With Parkinsonism

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    There is currently no cure for Parkinsons disease and most other parkinsonism cases. However, treatment options are available to help mitigate the symptoms and health impacts associated with these conditions. Most often the primary treatment is pharmacological, but it may also include other therapeutic options and, in the case of Parkinsons disease, surgical interventions. Studies have shown that specially tailored exercise programs, supervised by physiotherapists or other trained professionals, may help affected individuals maintain or improve their physical functionality and general well-being.Footnote 2 Footnote 3 Footnote 4 Footnote 5

    Box 1: What’s in the data?

    The data used in this publication are from the Canadian Chronic Disease Surveillance System , a collaborative network of provincial and territorial chronic disease surveillance systems, led by the Public Health Agency of Canada . The CCDSS identifies chronic disease cases from provincial and territorial administrative health databases, including physician billing claims and hospital discharge abstract records, linked to provincial and territorial health insurance registry records using a unique personal identifier. Data on all residents eligible for provincial or territorial health insurance are captured in the health insurance registries.

    Definition of diagnosed parkinsonism, including Parkinsons disease, in the CCDSS

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    Fact: Although Fibromyalgia Is More Common Among Women It Affects Men And Children As Well

    Twice as many women as men suffer from the condition. No one knows exactly why.

    “Women are more likely to develop chronic illnesses that overlap like migraines, irritable bowel syndrome and pain disorders,” says Goldenberg. Researchers suspect that estrogen and other hormones may play a part, but so far no one has found clear biological reasons why women may be more susceptible. “We do know that women are more likely to complain of conditions and to go to physicians earlier than men do,” he says.

    Among children, it turns out, what used to be thought of as “growing pains” may in fact be undiagnosed fibromyalgia.

    What Is The Trend Over Time In The Prevalence And Incidence Of Parkinsonism In Canada

    Between 20042005 and 20132014, the number of Canadians living with diagnosed parkinsonism increased from approximately 61,000 to 84,000, while the number of Canadians newly diagnosed increased from approximately 8,000 to 10,000. However, during the same period, there was no significant change in the age-standardized prevalence proportion, which remained at 0.4%, or the incidence rate, which went from 51.6 per 100,000 to 52.6 per 100,000. The sex differential also remained constant over time for both indicators .

    Figure 3: Age-standardized prevalence and incidence of diagnosed parkinsonism, including Parkinsons disease, among Canadians aged 40 years and older, by sex, 20042005 to 20132014

    Figure 3: Age-standardized prevalence and incidence of diagnosed parkinsonism, including Parkinsons disease, among Canadians aged 40 years and older, by sex, 20042005 to 20132014

    Indicator
    67.8 40.3

    Notes: Age-standardized estimates to the 2011 Canadian population. The 95% confidence interval shows an estimated range of values which is likely to include the true value 19 times out of 20. The 95% confidence intervals of the prevalence estimates are too small to be illustrated.Data source: Public Health Agency of Canada, using Canadian Chronic Disease Surveillance System data files contributed by provinces and territories, July 2017.

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    Question: How Worried Should We Be About Virus Variants Does That Level Of Worry Change If Weve Been Vaccinated

    Dr Okun: Mutations are very common in coronaviruses. Sometimes the mutations are easier to treat and sometimes theyre harder to treat. The vaccine is still active, but the longer we give the virus to continue to mutate the worse chance we have of beating this thing. This is why its important for us to get our vaccines, put our masks on and distance. If we dont do these things and we let this virus crawl back in, and keep mutating, eventually it could beat the vaccinations. Thats why its so important for us to continue masking even though we are vaccinating.

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    A Retrospective Fibromyalgia Study

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    According to researchers in Germany, there is a higher incidence of neck and jaw problems in patients with fibromyalgia. How was this link discovered? Is there a good reason for these conditions to be connected? How can you find relief from the chronic pain and other debilitating symptoms of fibromyalgia? These are the questions you need answers too. Lets start with a brief look at the study.

    The 555 patients in the study were all experiencing either neck problems, jaw issues, or both. Of the 555, 63% met the criteria for a diagnosis of fibromyalgia. In fact, 83% of the patients with fibromyalgia were experiencing facial asymmetry. What can cause these neck and jaw problems?

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    Fact: Fibromyalgia Is A Neurological Disease Affecting A Person’s Sensory Processing System

    Fibromyalgia does not involve inflammation or damage to joints. Brain imaging and studies have shown that fibromyalgia is a disorder of the central nervous system.

    “It’s a neurological disease driven by the central nervous system,” says Clauw. “The brain and spinal cord in people with fibromyalgia process pain signals differently than in other people so that they have heightened sensitivity to pain.”

    Other sensory reactions response to light and noise, for instance are amplified as well, says Clauw, noting that brain imaging has helped cement such observations: “The brain regions that are more active in people with fibromyalgia are the multisensory areas” those that respond to pain, heat, pressure.

    Highlights From The Canadian Chronic Disease Surveillance System

    Parkinsonism, including Parkinsons disease, can have significant impacts for those affected, their caregivers, and society. With a growing and aging population, it is estimated that the number of Canadians living with parkinsonism will double between 2011 and 2031 and that the incidence will increase by 50%.Footnote 1

    The Public Health Agency of Canada , in collaboration with all Canadian provinces and territories, conducts national surveillance of parkinsonism to support the planning and evaluation of related policies, programs, and services. This fact sheet presents an overview of the data on diagnosed parkinsonism, including Parkinsons disease, from the Canadian Chronic Disease Surveillance System .

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