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Many women, feel the joy of pregnancy, often when they were not troubled by pain in people with fibromyalgia (caused by patients with chronic pain, fatigue) of women this is not more serious.
Preliminary study, researchers found that women with fibromyalgia than in normal women during pregnancy is not on the more serious complaints. Although many actin fibers for pain medication, but is not suitable for pregnant women. Temple University Health Nursing, School of Medicine, Associate Professor Karen M. Schaefer, said: "Fibromyalgia is more worried for pregnant women."
Fibromyalgia is a chronic disease for an unknown reason, the United States out of 1 in every 50 people with fibromyalgia patients, and most of them are women. Some people think that rheumatoid arthritis, lupus, spondylitis, or genetic factors are the main The causes of fibromyalgia. Its symptoms include specific parts of the body such as shoulders, back, arm and leg pain, fatigue, headache, numb hands and feet, severe memory loss.
The question is, pregnancy can cause similar symptoms with fibromyalgia. Therefore, pregnant women suffering from fibromyalgia is difficult to discern the physical discomfort is not a real illness or pregnancy or both together results.
The best proof is the current condition and the consolidated results during pregnancy is not the real evidence comes from exacerbations during pregnancy, women with fibromyalgia provided a small amount, can not determine the existence of su


bjective factors in the report. Therefore, in order to measure the discomfort of fibromyalgia during pregnancy, what percentage of in the end, Schaefer and colleagues 14 of more than 7 months pregnant women were investigated. Subjects between the ages of 29-31 years, of which 7 is the fibromyalgia patients, no one except people with chronic diseases other than fibromyalgia. The researchers of their fatigue, pain, stress levels and reproductive function were investigated. Survey of pregnant women suffering from fibromyalgia than in normal pregnant women in daily activities function more inconvenience, fatigue, stiffness and more body parts feeling pain.
Schaefer said: "Until now, pregnant women who suffer from fibromyalgia is not to say no more definitive evidence. These data clearly show the first time, pregnant women, fibromyalgia impact of fibromyalgia during pregnancy will help us identify disease. "
Schaefer admitted that he initially only in small-scale experimental investigations, also confirmed the need for more data and the need to identify the relationship between fibromyalgia and pregnancy. He suggested that if pregnant women suffering from fibromyalgia are particularly suited to do during pregnancy to go for medical treatment, this could make these women may be prepared for what happened.
Overfibromyalgia syndrome fibromyalgia syndrome (fibromyalgia syndrome, FS) is a non-articular rheumatism, musculoskeletal system and clinical manifestations of multiple pain and stiff, and in special parts of a tender point. Fibromyalgia syndrome may be secondary to trauma, a variety of rheumatic diseases such as osteoarthritis (osteoarthritis, OA), rheumatoid arthritis (rheumatoid arthritis, RA) and various non-rheumatic diseases (such as hypothyroidism, malignant tumor) and so on. This type of fibromyalgia syndrome is called secondary fibromyalgia syndrome (secondary fibromyalgia syndromen), if not accompanied by other disorders, is known as primary fibromyalgia syndrome (primary fibromyagia syndrome). Treatment of fibromyalgia syndrome is an idiopathic disease, its pathophysiology is still unknown, so it does not have many treatment. Its main clinical manifestations of diffuse chronic pain, in addition to "tender points," but no objective signs. So not only treatment options is not easy, therapeutic effect is also quite difficult. Current treatment focuses on improving sleep, reducing the sensitivity of sensory pain, improve muscle blood flow and so on. It is believed that these areas and on the causes of fibromyalgia syndrome. The effect is mainly based on the number of tender points after treatment and to determine changes in symptoms. Treatment of the more important point is to comfort and explanation to patients. Tell patients it is not a life-threatening disease, it will not cause permanent disability, to relieve the patient's anxiety and depression. In drug treatment, the majority of the reports and the tricyclic antidepressants amitriptyline heptene amine benzene ring is an ideal drug to treat the disease. They passed: antidepressant; increase non-REM sleep the Discovery to reduce the rapid eye movement sleep; increase serotonin; relieve muscle spasm and so on to improve sleep, stiffness and pain reduction effect. Amitriptyline 10mg, according to a slow increase to 20-30mg, or aromatic amine heptene 10-40mg, are a service before going to bed. The side effects are dry mouth, sore throat, constipation, due to small doses, most patients can tolerate. In recent years, found that S-adenosylmethionine treatment of fibromyalgia syndrome have a certain effect. It is a lot of brain tissue methylation of methyl arch the body, and has antidepressant effect. In the non-drug treatment, reported in the literature to adapt to training cardiovascular (cardiovascular fitness training) and EMG biofeedback training (EMC-biofeedback training) have a certain effect. McCain and other immunogenicity of 42 patients with primary fibromyalgia patients were divided into cardiovascular training and flexibility to adapt to the exercise group (flexibilty exercises). Patients in each group training 3 times a week, every 60 minutes. To adapt to training cardiovascular pedal bicycle ergometer, heart rate during exercise required to exceed 150 times / min, and the duration of successive extension. Flexibility in the exercise group only do all sorts of activity, heart rate rarely reaches 115 beats / min. After 20 weeks, the two groups, cardiovascular adaptation training group the degree of tenderness at tender points, patients and doctors regard the overall assessment showed significant improvement. Furaccioli other of 15 patients with primary fibromyalgia for 5 weeks, 15 rice EMG training, 9 of them in the morning stiffness, tender point number and degree of tenderness was improved. After treatment, this improvement lasted for 6 months. Subsequent research has also been the same control results. Other treatments such as local sympathetic blockade, pain points closed, transcutaneous nerve stimulation, interference with electrical stimulation, acupuncture, etc. can be near Mount trial. The efficacy and mechanism of these treatments are still other further study. Pathogenesis of the disease mechanism is unclear. Reported in the literature and sleep disorders, abnormal secretion of neurotransmitters and immune disorders. 1. Sleep disorder sleep disorders involving 60-90% of patients. Performance of sleep fitfully, dreams, early morning lack of energy, fatigue, a general sense of pain and morning stiffness. Night EEG records were found involved in the wave sleep stage wave. Interference with the ring of non-rapid eye movement sleep volunteer (non rapid eye movement) can also be induced in the EEG graphic and clinical symptoms. Other factors that affect sleep, such as mental stress, environmental noise may increase the symptoms of fibromyalgia syndrome. It suggests that this stage sleep disorders in fibromyalgia syndrome play an important role in the hair straight to the point. 2. Neurotransmitter serotonin secretion abnormalities reported in the literature (serotonin ,5-HT) and substance P (substance P) and other neurotransmitters in the pathogenesis of this disease play an important role. Serotonin precursor tryptophan, tryptophan food protein is absorbed in the intestine, the majority of plasma protein binding, was a small part of the free state. Free tryptophan can be carried by the blood - brain barrier into the brain tissue. Then, in the 5-HT neurons in the formation by hydroxylation and decarboxylation of 5-HT. Released into the synaptic cleft 5-HT, in some re-uptake by presynaptic nerve terminals, in part by the role of mitochondrial monoamine oxidase activity generates no 5 - hydroxyindole acetic acid (5-hydroxyindole acetic acid). 5-HT is also present in the gastrointestinal mucosa, platelets and mammary gland cells, because it is difficult to pass the blood - brain barrier, so the central nervous system and peripheral blood in the 5-HT under two systems. The study found that: patients with fibromyalgia syndrome and plasma free tryptophan transfer rate (trannsport ratio) decreased. The degree of reduction was related to musculoskeletal pain, the plasma concentration and rotation rate, the lower, the more obvious pain. platelet membrane high affinity 5-HT receptors, imipramine can be competitive with the 5-HT receptors bind to platelets, labeled with tritium imipramine platelet membrane of 5-HT by density, found that fibromyalgia syndrome than normal by the role. muscle fibers before the syndrome is the human brain tissue 5-HT was significantly reduced compared with normal subjects. Experiments show that ,5-HT can regulate non-rapid eye movement sleep, reducing sensitivity to pain, improve depression, but also enhance the analgesic effect of anesthesia. Amitriptyline (amitriptyline) and aromatic amine-heptene (cyclobenzaprine) may be 5-HT to 5 - hydroxyindoleacetic B enzymatic conversion of 5-HT concentrations increase, so the fibromyalgia syndrome have a certain effect. On the contrary, given tryptophan hydroxylase inhibitor - p-chlorophenyl alanine (parachlorophenylalamine) appears like the pain of fibromyalgia syndrome, disable this drug, the pain disappeared. Another with fibromyalgia syndrome is related to the neurotransmitter substance P. Littlejohn found that physical or chemical stimuli can induce fibromyalgia syndrome patients have significant skin hyperemic response, which may be related to the existence of overreaction going on peripheral nociceptive stimuli. Because of these stimuli, many types of skin nociceptors (polymodal cutaneous nociceptor) reflex pathology from the amount of nerve endings release substance P, which can also cause local vasodilation, vascular permeability enhancement and a neurogenic inflammation (neurogenic inflammmation). Nerve endings release substance P, dorsal root ganglia primary sensory neurons of substance P to produce more in order to maintain a constant level. Synthesis of substance P to both the peripheral and central Arthraxon flea flea Xing Essentials hole in a wall crisp low car Mei material content increased. Because of its slow but persistent and strong stimulant, central nervous system will certainly be affected. Also found in normal or high levels of the presence of 5-HT, P substance on the release of sensory nerve impulses have a damping effect. The lack of 5-HT, it will lose this control action, resulting in hyperalgesia. 3. Some of immune disorders in fibromyalgia syndrome patients reported the dermal - epidermal junction deposition of immune response, observed by electron microscopy comprehensive fibromyalgia patients swelling of the muscle capillary endothelial cells, suggesting that acute vascular injury; Organization hypoxia and increased permeability. Patients are referred to in unexplained weight gain, diffuse swelling of hands and nocturia may be associated with increased permeability enhancement. In addition, preliminary study found that interleukin -2 (interleukin-2, IL-2) levels increased in fibromyalgia syndrome. Receiving IL-2 treatment of cancer patients will be born in fibromyalgia syndrome-like symptoms, including widesppain, sleep disturbance, morning stiffness and tender points, and so appear. Also found that IFN- can cause fatigue. The phenomenon prompted immune disorders. Abnormal levels of cytokines in vivo may be sent straight to the point fibromyalgia syndrome related. Epidemiological comprehensive piece on the fibromuscular epidemiological situation before, the domestic has not been reported, no precise statistics on the foreign, but some preliminary information appears, the disease is not uncommon. A British survey showed that the population can not work due to illness, 10.9% caused by rheumatoid disease, which accounts for about half of fibromyalgia syndrome. American Rheumatism Association pointed out that the primary fibromyalgia syndrome, one of the most common rheumatic diseases, second only to the RA and OA, third place. Yunus and other treatment in a total of 285 cases during a musculoskeletal disease patients, of which 29% of OA, 20% of primary fibromyalgia syndrome, 16% RA. Asian countries, Japan has a story to illustrate the 2 years they were in the connective tissue disease diagnosis and treatment of 182 rheumatology clinic patients, including 11 cases of fibromyalgia syndrome, accounting for 6%. Column was rheumatoid arthritis (27.5%), systemic lupus erythematosus (16%), systemic sclerosis (10.4%), dry syndrome (7.7%), and after, ranking seventh. Clinical manifestations of fibromyalgia syndrome more common in women, the most common age of onset 25-45 years old. The clinical manifestations are diverse, but mainly has the following 4 symptoms: 1. The main symptoms: general widesppain in all patients with fibromyalgia syndrome symptoms. Although some patients complained of only one or several of pain, but the 1 / 4 of the patients up to 24 over the painful area. Disease throughout the body over, especially in the axial skeleton (cervical, thoracic, lower back) and shoulder girdle, pelvic girdle, etc. is common. Other common sites were the knees, head, elbow, ankle, foot, upper back, middle back, wrist, hip, thigh and calf. Most patients this pain will be described as tingling, pain is upset. Another all patients with symptoms of widesptenderness, these tender points exist in the tendon, muscle and other tissue, often showed symmetrical. Tender point sites in patients with normal to "push" the reaction of different, but there was no difference in the other parts. 2. Characteristics of the disease: This group of symptoms including sleep disturbance, fatigue and morning stiffness. About 90% of patients with sleep disorders, manifested as insomnia, easy to wake up, dreams, lack of energy. EEG wave night showed support intervention to non-rapid eye rhythm, suggesting a lack of sleep. 50-90% of the patients had fatigue, about half of the patients with more severe symptoms of fatigue that was "too tired, can not work." Morning stiffness seen in 76-91% of the patients, their severity and disease activity and sleep related. 3. Common symptoms: this group is the most common symptoms of numbness and swelling. Patients often complain about joint, swelling around the joints, but no objective signs. Followed by headache, intestinal bowel syndrome. Separable or non-migraine headache migraine headache, which is a head in the occipital region or the whole oppressive dull pain. Psychological abnormalities including depression and anxiety are more common. In addition the patient the ability to work down, about 1 / 3 of patients need to change jobs, a few people who can not adhere to the daily work. Symptoms often tide over the cold weather, stress, overwork increase, local heat, mental relaxation, good sleep, moderate activity can alleviate the symptoms. 4. Mixed symptoms: Primary fibromyalgia syndrome is rare, the majority of fibromyalgia syndrome patients are also suffering from some kind of rheumatism. At this time the symptoms of clinical symptoms is the two intertwined and overlapping. Fibromyalgia syndrome often co-exist with them rheumatic symptoms that appear to be more serious, such as failing to recognize the latter case often leads to over-treatment and examination. Auxiliary examination unless combined with other diseases, muscle fibers before the syndrome in general no laboratory abnormalities. But there are reports of fibromyalgia syndrome patients increased levels of IL-1, natural killer cells and reduced serotonin activity in the cerebrospinal fluid substance P concentrations. Medicine 1 / 3 patients have Raynaud's phenomenon, in this group of patients may have antinuclear antibodies, C3 levels reduced. Smythe first time since the 70's diagnostic criteria for fibromyalgia syndrome since many of the diagnostic criteria have to come out. However, these standard methodologies, and content are different, giving the epidemiology and clinical research to bring some difficulties. Through this multi-center collaboration of foreign scholars in the past on the basis of the standard study of the large number of patients in clinical symptoms and tender points, selected from one of the most significant clinical symptom identification and the 18 tender points, muscle fiber in 1990 proposed pain syndrome classification criteria. 1. More than 3 months of pain the whole body: the body of the left and right upper back, lower, and axial skeleton (cervical spine or anterior chest or thoracic spine or lower back) and other parts of the body while the pain when that pain is . 2. Thumb press (at pressure of about 4kg) 18 tender point pain in at least 11. These 18 (9 pairs) tender point sites are: the muscle attachment of the occipital bone; trapezius muscle on the edge of the mid-point; 5 to 7 in front of cervical transverse gap; the beginning part of the supraspinatus muscle, the scapular spine near the top of lateral margin; epicondyle of the humerus at the distal 2cm; the second rib and the cartilage at the junction, just outside the upper edge of the junction; hip my upper quadrant, buttock fold at the front; the rear of the greater trochanter; knee joint medial fat pad wrinkle line proximal. At the same time these two conditions satisfied, could a diagnosis of fibromyalgia syndrome. Application of this standard definition of fibromyalgia syndrome can be more consistent. Emphasized by the standard of fibromyalgia syndrome and other similar diseases, the difference between Office, which did not include syndrome characteristic features, such as fatigue, sleep disturbances, morning stiffness and so on. Application of this standard to take into account the above characteristics, will increase the reliability of diagnosis, accuracy. But this standard can not distinguish between primary and secondary fibromyalgia syndrome fibromyalgia syndrome. Therefore, after the establishment of fibromyalgia syndrome, you must also check for other concomitant diseases, in order to distinguish between primary and secondary muscle fiber syndrome. This distinction and therapeutic clinical research is clearly necessary. Differential diagnosis of fibromyalgia syndrome symptoms such as fatigue, pain is a common clinical symptoms. It needs to be differentiated from the following types of diseases. 1. Spirituality rheumatic pain: fibromyalgia integrated chip easily confused with the spirit of rheumatism, but both were significantly different. With the spirit of rheumatism have emotional symptoms. If the pain and inflammation described as a knife-like pain burning, or described as numbness, tight, needle-like pain or pressure. These symptoms are often vague position. Changing, no anatomical basis, and not the impact of weather or activity, patients often have mental or emotional disorders, such as mental neuropathy, depression, schizophrenia or other mental illness. Difference between the two is important, since the former more difficult to handle, which require the treatment of psychiatric experts. 2. Chronic Fatigue Syndrome: chronic fatigue syndrome, including chronic active EB virus infection and idiopathic chronic fatigue syndrome. Manifested as fatigue, weakness, but the lack of basic causes. Check whether patients with fever, pharyngitis, neck or armpit lymph nodes to determine anti-EB virus envelope antigen-antibody IgM, may help differentiate the two. 3. PMR: PMR showed extensive neck, shoulder girdle, back and pelvic girdle pain. However, according to ESR faster, more common in people over the age of 60 synovial biopsy showed inflammatory changes, such as hormone-sensitive, and can be differentiated with fibromyalgia syndrome. 4. Rheumatoid Arthritis: RA and fibromyalgia syndrome patients have widespbody pain, feeling stiff and swollen joints. However, before the syndrome of joint muscle fibers without objective evidence of swelling, morning stiffness of its shorter time than RA, laboratory tests including rheumatoid factor, ESR, joint X-ray film, are also political. Fibromyalgia syndrome pain in a wider range, less confined to the joints, and more in the lower back, thighs, abdomen, head and hip, and pain in RA are distributed in the wrist, fingers and toes and other parts. 5. Myofascial pain syndrome: myofascial pain syndrome, also known as the limitations of fiber inflammation, but also learned tenderness, muscle fiber easily confused with symptoms before the point. But in terms of diagnosis, treatment and prognosis on both different. Myofascial pain syndrome is often called the excitation point of tenderness, pressing this point, the pain can radiate to other sites. Although the patient felt pain, but they may not know of any at the excitation point. Myofascial syndrome is usually only one or a few gathered in the local excitation point. Exciton originated in the muscles, limited mobility affected muscle, passive stretch or active contraction of muscles can cause pain. With 1% procaine excitation point can be partially closed temporarily eliminate pain. It is different with the fiber inflammation, there is no widesppain, stiffness and other symptoms of flu or fatigue. However, if persistent pain caused by , sleep disorders, myofascial syndrome may evolve into fibromyalgia syndrome. Myofascial syndrome is usually caused by trauma or fatigue. Prognosis is usually good. Treatment: treatment of the more important point is to give patients the comfort and explanation. To remove the patient's anxiety and depression. In drug treatment, the majority of the reports and the tricyclic antidepressants amitriptyline heptene amine benzene ring is an ideal drug to treat the disease. They passed: antidepressant; increase non-rapid eye movement sleep, decreased rapid eye movement sleep; increase serotonin; relieve muscle spasm and so on to improve sleep, stiffness and pain reduction effect. Amitriptyline 10mg, according to a slow increase to 20-30mg, or aromatic amine heptene 10-40mg, are a service before going to bed. The side effects are dry mouth, sore throat, constipation, due to small doses, most patients can tolerate. S-adenosyl methionine in recent years that ammonia treatment of fibromyalgia syndrome have a certain effect. It is a lot of brain tissue methylation of methyl arch the body, and has antidepressant effect. In the non-drug treatment, reported in the literature to adapt to training cardiovascular and EMG biofeedback training for a certain effect. Other treatments such as local sympathetic blockade, pain points closed, transcutaneous nerve stimulation, interference with electrical stimulation, acupuncture, massage can try. The efficacy and mechanism of these treatments are still other further study.


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