Fibromyalgia and Chronic Fatigue Syndrome

Back muscles

 

Fibromyalgia symptoms arise from poor oxygenation of the muscle tender points and the skin overlying these tender points.  This lack of oxygenation results from a decreased number of capillaries (small terminal blood vessels) compounded by thickened capillary walls.  Hyperbaric oxygen therapy (HBOT) can successfully break the vicious cycle of pain and microcirculatory impairment by delivering much needed oxygen to the dysfunctional muscles.

Similarly, it has been shown that reduced oxygen delivery to the brain contributes to the symptoms of chronic fatigue syndrome.  For these people, HBOT can decrease the severity of symptoms, increase exercise capacity, and improve quality of life.

 

fibromyalgia-symptoms

 

Facts:

Fibromyalgia is a chronic widespread musculoskeletal disorder characterized by pain at specific areas (tender points) of the body.  This is accompanied by numerous symptoms such as fatigue, sleep disturbance, irritable bowel syndrome, stiffness, muscle spasm, cognitive or memory impairment, anxiety, depression, and functional impairment.

Chronic fatigue syndrome (also known as systemic exertion intolerance disease or myalgic encephalomyelitis) is a disorder characterized by a longstanding fatigue of more than 6 months.  This is accompanied by numerous symptoms such as cognitive or memory impairment, muscle pain, joint pain, sleep disturbance, and excessive post-exertional malaise lasting more than 24 hours.

 

Statistics:

Fibromyalgia affects 1.5 % of Canadians aged 12 years and older.  Chronic fatigue syndrome affects 1.4% of the same target population, while 0.3% suffer from both fibromyalgia and chronic fatigue syndrome.  Women account for 80% of all cases of fibromyalgia.  Half of those affected are between 40 to 60 years of age, coinciding with an individual’s period of maximum economic productivity.  Thirty one percent of all Canadians with fibromyalgia have unmet healthcare needs (2010 Canadian Community Health Survey).

 

 

Benefits of hyperbaric oxygen therapy (HBO) in Fibromyalgia and Chronic Fatigue Syndrome

 

  • Delivers oxygen to poorly oxygenated muscles and skin, effectively breaking the pain-hypoxia (low oxygen) cycle
  • Prevents lactic acid build-up in the muscle, thereby reducing muscle fatigue
  • Improves exercise capacity
  • Down-regulates nitric oxide (a potent signaling molecule thought to be involved in pain processing) in the brain, potentially aiding to decrease pain intensity
  • Decreases severity of symptoms and improves quality of life

 

References:

  1. Akarsu S, Tekin L, Ay H, Carli AB, Tok F, Simsek K, Kiralp MZ. The efficacy of hyperbaric oxygen therapy in the managment of chronic fatigue syndrome. Undersea Hyperb Med. 2013 Mar-Apr;40(2) : 197-200. Erratum in:  Undersea Hyperb Med. 2013 May-Jun;40(3) : 312.
  2. Patrick Neary J, Roberts AD, Leavins N, Harrison MF, Croll JC, Sexsmith JR. Prefrontal cortex oxygenation during incremental exercise in chronic fatigue syndrome. Clin Physiol Funct Imaging. 2008 Nov;28(6) : 364-72.
  3. Kasikcioglu E, Dinler M, Berker E. Reduced tolerance of exercise in fibromyalgia may be a consequence of impaired microcirculation initiated by deficient action of nitric oxide. Med Hypothesis. 2006;66(5) : 950-2.
  4. Yildiz S, Kiralp MZ, Akin A, Keskin I, Ay H, Dursun H, Cimsit M. A new treatment modality for fibromyalgia syndrome: hyperbaric oxygen therapy. J Int Med Res. 2004 May-Jun;32(3) : 263-7.
  5. Van Hoof E, Coomans D, De Becker P, Meeusen R, Cluydts R, De Meirleir K. Hyperbaric Therapy in Chronic Fatigue Syndrome. J Chronic Fatigue Syndrome. 2003 Jan; 11(3) : 37-49.
  6. Jeschonneck M, Grohmann G, Hein G, Sprott H. Abnormal microcirculation and temperature in skin above tender points in patients with fibromyalgia. Rheumatology (Oxford). 2000 Aug;39(8) : 917-21.
  7. Larson AA, Giovengo SL, Russell IJ, Michalek JE. Changes in the concentrations of amino acids in the cerebrospinal fluid that correlate with pain in patients with fibromyalgia: implications for nitric oxide pathways. Pain. 2000 Aug;87(2) : 201-11.
  8. Olsen NJ, Park JH. Skeletal muscle abnormalities in patients with fibromyalgia. Am J Med Sci. 1998 Jun;315(6) : 351-8.
  9. Lund N, Bengtsson A, Thorborg P. Muscle tissue oxygen pressure in primary fibromyalgia. Scand J Rheumatol. 1986;15(2) : 165-73.

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