Abilene Reporter-News February 5, 2013
Medical Discovery News
Drs. David Niesel and Norbert Herzog
Pain. No one is a stranger to its physical, emotional and psychological effects. Some people live with it daily, without knowing the cause. This is the life of a patient with fibromyalgia, a condition affecting 2 to 4 percent of Americans. While physicians have documented this disorder for over 100 years, it wasn’t until 1987 that the American Medical Association recognized fibromyalgia. Recently, doctors realized that fibromyalgia may be due to a malfunction in the central nervous system, which consists of the brain, nerves and chemicals known as neurotransmitters or hormones. Studies show that patients have a dysfunction in the processing of pain.
Now, University of Alabama virologist Carol Duffy and gastrointestinal surgeon/chronic pain specialist William Pridgen think they may have found the cause of this mysterious disease – a virus called herpes simplex type 1, the same one that causes cold sores.
Based on their hypothesis, the doctors started prescribing a drug known to treat herpes simplex type 1 along with another antiviral drug. They claim that 90 percent of patients who took the combination had improved gastrointestinal, fatigue, anxiety, depression and fibromyalgia symptoms. Starting as soon as February 2013, they plan to recruit 140 fibromyalgia patients for a phase II clinical trial of the treatment.
The virus can become dormant and hide from the immune system in nerve cells, then reactivate and travel within the nervous system. The two drugs in the trial work together; one inhibits the active virus from replicating and the other inhibits the latent virus from reactivating.
Most fibromyalgia patients are women in their 20s to 50s. They usually present their doctors with complaints of gradual, chronic and widespread musculoskeletal pain. Often these patients will also suffer from sleep disturbances, fatigue, headaches, anxiety and depression. Generally their aches and pains are exacerbated during times of stress.
Diagnosis is not easy, but must include a thorough history and physical exam. Fibromyalgia is known as a diagnosis of exclusion, meaning a doctor must try to rule out other diseases that could cause the symptoms first. But if the clinical trial proves that herpes simplex type 1 causes fibromyalgia, it could lead to a new method of diagnosis.
Currently, the treatment for fibromyalgia can include prescription medications that act on the brain’s chemicals or other therapies. Several studies have shown the benefits of treatments such as biofeedback, cognitive behavioral therapy and relaxation techniques. Simply put, these are ways to train the mind to handle this condition. Physical therapy may also have some benefit. Although patients experience pain during exercise, they are encouraged to slowly start an exercise program as it may actually improve their condition.
Although medical research and advancements have improved the lives of fibromyalgia patients, further study is needed to understand this disease.
Medical Discovery News is hosted by professors Norbert Herzog at Quinnipiac University, and David Niesel of the University of Texas Medical Branch. Learn more at www.medicaldiscoverynews.com.UTMB
UTMB student Valerie Juarez contributed to this report.