Fibromyalgia
What is Fibromyalgia?
The sensation of pain is an essential part of human experience. Pain functions as a primary method for protection from
and avoidance of harmful factors. When one feels pain, the body responds physically and emotionally. Physically, pain
sensations travel from the source, through peripheral nerves and into the central nervous system (CNS). Once it reaches
the brain, the body responds with a reflex, or involuntary response away from the source, and commits the incident to
memory. Emotionally, feelings such as discomfort, fear or aversion are associated with the brain’s reflex mechanisms
and contribute to an awareness of pain. Together, these processes are expected to end the offending pain, allow for
healing time and prevent further discomfort.1
Chronic pain becomes a problem when the interrelationship between the physical and emotional responses doesn’t
function properly.
Fibromyalgia is characterized by a state of chronic pain. When injury or inflammation generates pain impulses, the
body’s reflex mechanism can improperly perceive the severity and increase the sensation. With this type of pain, called
“central sensitization,” nerves in the CNS become over-sensitized, responding to painful and non-painful stimulations in
the same way and send stronger, constant pain impulses to the brain. In fibromyalgia pain, this is irreversible and
perpetuated by altered emotional responses. Since the brain associates specific mood states with the senses, protective
emotions such as fear and aversion become chronic as well in Fibromyalgia. The emotions related to pain and coping
with fibromyalgia can then amplify the sensation as well, leading to increased pain and additional problems of anxiety
and depression.2
The role of inflammation management in fibromyalgia is also of growing importance. Cytokines are chemical
messengers, working with the immune system to help regulate inflammatory responses whose presence may be
indicative of a more persistent problem. Researchers are finding connections between elevated cytokine levels,
compromised immune function and fibromyalgia. The presence of excess cytokines in autoimmune disorders has been
associated with symptoms like pain and fatigue. Elevated cytokines levels have been demonstrated in a number of
fibromyalgia patients as their symptoms worsen.3
Fibromyalgia Causes and Risk Factors
Fibromyalgia is considered a ‘syndrome,’ meaning many symptoms occur together. No single causation can be properly
defined. However, it is believed there are a number of contributing factors, including:
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Inflammation: elevated cytokine levels
Disturbed sleep patterns: sleep apnea, nighttime muscle spasms, restless leg syndrome
Infections: can trigger or aggravate fibromyalgia
Rheumatic disease: the presence of a preexisting rheumatic condition, such as rheumatoid arthritis or lupus,
increases the likelihood of developing fibromyalgia
Physical or emotional trauma: Post Traumatic Stress Disorder has been linked to fibromyalgia
Genetics: fibromyalgia tends to run in families; however, no specific gene mutation has been identified
Fibromyalgia Symptoms
The primary symptom of fibromyalgia syndrome is pain. The pain is primarily in the muscles, and is described as chronic
and widespread (the classification of widespread requires its presence on both sides of the body and above and below
the waist).
The most common symptoms of fibromyalgia include:
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Incapacitating fatigue
Decreased pain threshold
Multiple tender points
Sleep disturbances
Memory problems and difficulty concentrating (“fibro fog”)
Anxiety or depression
Symptoms vary from person to person, and external factors such as changes in weather, stress levels or physical activity
can affect their severity.
Fibromyalgia Complications and Prognosis
Fibromyalgia is not progressive. While some symptoms may be attributed to overlapping, preexisting conditions such as
depression or rheumatic diseases, fibromyalgia does not typically lead to other conditions or diseases. Despite this, living
with fibromyalgia can cause physical and psychological strains that continually impact the lives of those affected by it.
The struggle with chronic widespread pain, depression and lack of sleep can interfere with one’s ability to function at
home or work, as well as in personal relationships. Often times, understanding and coping with such a debilitating
disorder can be a complication in itself.
Fibromyalgia Treatment
There is no cure for fibromyalgia and no single treatment capable of addressing all symptoms. Therapies and treatment
plans have been established to help reduce pain, alleviate symptoms and improve quality of life. The most successful
treatment plans include a combination of medications, exercise and behavioral counseling.
Many types of medication have been established as treatments for fibromyalgia symptoms. These include:
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Analgesics: often used to help ease pain and stiffness; non-steroidal anti-inflammatory drugs (NSAIDs) have
been shown to be ineffective in treating fibromyalgia pain
Anti-seizure drugs
Antidepressants: shown to promote sleep and lessen the effects of depression associated with fibromyalgia
The inclusion of moderately intense aerobic exercise 2-3 times a week has been shown to reduce muscle pain.
Counseling and cognitive behavioral therapies help people cope with pain and provide emotional support. Alternative
treatments such as Tai Chi, acupuncture, massage therapy and chiropractic manipulations are also endorsed methods.
References:
1.
Mease P. Fibromyalgia syndrome: review of clinical presentation, pathogenesis, outcome measures, and treatment. J Rheumatology.
2005; 75:6-21.
2.
3.
Desmeules JA, Cedraschi C, Rapiti E, et al. Neurophysiologic evidence for a central sensitization in patients with fibromyalgia. Arth &
Rheum. 2003; 48(5):1420-1429.
Klimas. Cytokine and Other Immunologic Markers in Chronic Fatigue Syndrome and Their Relation to Neuropsychological Factors. Applied
Neuropsychology. 2001; 8(1):51.
The contents of inflammation-systemicenzymes.com website, including images, graphics, text and other material, are for informational purposes
only. The Content on the site is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of
your healthcare professional with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay
in seeking it because of something you have read on the inflammation-systemicenzymes.com website. If you think you may have a medical
emergency, call your doctor or 911 immediately.
Fibromyalgia and Systemic Enzymes
Limited treatment options have led to an increasing use of systemic enzyme therapy as a means to alleviate symptoms
and improve quality of life. Certain proteolytic (protein digesting) enzymes have been identified to have extremely
beneficial actions when applied to inflammation and pain related to this condition. Systemic enzymes, typically taken
orally and on an empty stomach, enter directly into the blood stream. Enzymes can then circulate throughout the body,
acting upon complexes in the blood as well as in tissues and organs.
Fibromyalgia and Pain
Systemic enzymes have successfully demonstrated the ability to reduce signs of pain throughout the body.
Serrapeptase, an enzyme extracted from silk worms, has been evaluated in numerous studies for its effectiveness in pain
reduction and shown favorable results.
The use of systemic enzymes in treating pain throughout the body was evaluated in several clinical studies. Rheumatic
conditions, including periarthritis of the shoulder, painful osteoarthritis of the knee and vertebral syndromes, were
evaluated based on pain scores before and after treatment with proteolytic enzymes and non-steroidal antiinflammatory drugs (NSAIDs). Evidence showed a statistical equivalence between oral enzyme therapy and conventional
drug therapy in the ability to significantly reduce pain in various rheumatic diseases.1
Researchers in India conducted a study to assess the response of serrapeptase in patients with carpal tunnel syndrome
(CTS). Twenty patients with CTS were evaluated clinically after six weeks of taking serrapeptase. Sixty-five percent
showed significant clinical improvement, which was supported by improvement in electrophysiological parameters
(measurements of nerve activity). The doctors concluded that serrapeptase therapy may prove to be a useful alternative
conservative treatment .2
Another study was conducted comparing the efficacy of two proteolytic enzymes in the treatment of venous
inflammatory disease. The efficacy of Serrapeptase and Seaprose S (a protease) was assessed using good or excellent
results as the measure of effective treatment. Serrapeptase was effective in 65 percent of the cases compared to 85
percent for Seaprose S. Serrapeptase specifically demonstrated a 63 percent reduction in spontaneous pain and 57
percent reduction in pain on pressure. Though Seaprose S had better overall results, both enzymes were effective. It can
thus be confirmed that both enzymes were effective in patients with inflammatory venous disease.3 (Note: Seaprose S
has since been withdrawn from the market).
A prospective study was conducted on the effect of serrapeptase on post-operative swelling and pain of the ankle. In the
serrapeptase group, the swelling decreased by 50 percent on the third post-operative day, while in the control groups
(no treatment and treatment with ice) no reduction in swelling occurred. A decrease in pain correlated for the most part
with the reduction in swelling. On the basis of these results, serrapeptase would appear to be an effective preparation
for the post-operative reduction of swelling, in comparison with classical conservative measures, such as the application
of ice.4
Fibromyalgia and Inflammation
Reducing the amount of pain is only one aspect of how systemic enzymes can function. Chronic inflammation is often
the root cause of a number of conditions and controlling the process can help alleviate symptoms.
A clinical evaluation of serrapeptase was conducted to determine its efficacy in reducing inflammation in patients with
breast engorgement. Serrapeptase was noted to be superior to placebo for improvement of breast pain, breast swelling
and induration, with 85.7 percent of patients receiving serrapeptase having "Moderate to Marked" improvement. No
adverse reactions were reported with the use of serrapeptase. The researchers conclude serrapeptase is a safe and
effective method for the treatment of breast engorgement.5
The efficacy of serrapeptase was evaluated in a multi-centre, double-blind, placebo-controlled study of 193 subjects
suffering from acute or chronic ear, nose or throat disorders. After three to four days of treatment, significant symptom
regression was observed in serrapeptase-treated patients. Statistical comparison confirmed the greater efficacy of
serrapeptase against all of the symptoms examined. It was concluded that serrapeptase has anti-inflammatory, antiedemic and fibrinolytic activity, and acts rapidly on localized inflammation.6
Bromelain, a proteolytic enzyme extracted from pineapple, has also been found to be effective in reducing inflammation
by blocking chemical signals called cytokines, which promote and increase inflammation.7,8 Research shows bromelain
disrupts the migration of neutrophils to an inflamed area, where they would otherwise propagate the process. One
study measured a 50-85 percent decrease in the migration of neutrophils after bromelain treatment.9
References:
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9.
Klein G, Kullich W. Reducing pain by oral enzyme therapy in rheumatic diseases. Wien Med Wochenschr. 1999; 149(21-22):577-80.
Panagariya A, Sharma AK. A preliminary trial of serratiopeptidase in patients with carpal tunnel syndrome. J Assoc Physicians India. 2000;
48(11):1130.
Bracale G, Selvetella L. Clinical study of the efficacy of and tolerance to seaprose S in inflammatory venous disease. Controlled study
versus serratio-peptidase[Article in Italian] Minerva Cardioangiol. 1996; 44(10):515-24.
Esch PM, Gerngross H, Fabian A. Reduction of postoperative swelling. Objective measurement of swelling of the upper ankle joint in
treatment with serrapeptase-- a prospective study (German). Fortschr Med. 1989; 107(4):67-8, 71-2.
Kee WH, Tan SL, Lee V, Salmon YM. The treatment of breast engorgement with Serrapeptase (Danzen): a randomised double-blind
controlled trial. Singapore Med J. 1989; 30(1):48-54.
Mazzone A, Catalani M, Costanzo M, et al. Evaluation of Serratia peptidase in acute or chronic inflammation of otorhinolaryngology
pathology: a multicentre, double-blind, randomized trial versus placebo. J Int Med Res. 1990; 18(5):379-88.
Onken JE, Greer PK, Calingaert B, et al. Bromelain treatment decreases secretion of pro-inflammatory cytokines and chemokines by colon
biopsies in vitro. Clin Immunol. 2008; 126(3):345-352.
Secor ER, Carson WF, Singh A, et al. (2008) Oral bromelain attenuates inflammation in an ovalbumin-induced murine model of asthma.
Evid Based Complement Alternat Med. 2008; 5(1):61-69.
Fitzhugh DJ, Shan S, Dewhirst MW et al. Bromelain treatment decreases neutrophil migration to sites of inflammation. Clin Immunol.
2008; 128:66-74.
The contents of inflammation-systemicenzymes.com website, including images, graphics, text and other material, are for informational purposes
only. The Content on the site is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of
your healthcare professional with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay
in seeking it because of something you have read on the inflammation-systemicenzymes.com website. If you think you may have a medical
emergency, call your doctor or 911 immediately.