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  • Central Sensitivity Syndromes

    It's commonly understood that a IC/BPS is probably a syndrome of conditions. Think about it. Why do some patients have Hunner's ulcers and others don't. Why do some patients have vulvodynia or IBS while others don't. Why do some patients just have frequency while others have pain? We're still trying to figure it out.. but one piece of the puzzle for SOME patients is what this study is talking about... "central sensitivity syndrome." I think that this explains why so many IC patients have other related conditions like IBS, vulvodynia, etc. I do think this is at the root of my personal health struggles. I am the sensitivity queen.. GRRRR!!! - Jill

    Pain Manag Nurs. 2011 Mar;12(1):15-24. Epub 2009 Dec 2.
    Central sensitivity syndromes: mounting pathophysiologic evidence to link fibromyalgia with other common chronic pain disorders.
    Kindler LL, Bennett RM, Jones KD.

    Center for Comprehensive Pain Research, University of Florida, Gainesville, Florida.
    Abstract

    The aim of this study was to review emerging data from the fields of nursing, rheumatology, dentistry, gastroenterology, gynecology, neurology, and orthopedics that support or dispute pathophysiologic similarities in pain syndromes studied by each specialty. A literature search was performed through PubMed and Ovid using the terms fibromyalgia, temporomandibular joint disorder, irritable bowel syndrome, irritable bladder/interstitial cystitis, headache, chronic low back pain, chronic neck pain, functional syndromes, and somatization. Each term was linked with pathophysiology and/or central sensitization. This paper presents a review of relevant articles with a specific goal of identifying pathophysiologic findings related to nociceptive processing. The extant literature presents considerable overlap in the pathophysiology of these diagnoses. Given the psychosomatic lens through which many of these disorders are viewed, demonstration of evidence-based links supporting shared pathophysiology between these disorders could provide direction to clinicians and researchers working to treat these diagnoses. "Central sensitivity syndromes" denotes an emerging nomenclature that could be embraced by researchers investigating each of these disorders. Moreover, a shared paradigm would be useful in promoting cross-fertilization between researchers. Scientists and clinicians could most effectively forward the understanding and treatment of fibromyalgia and other common chronic pain disorders through an appreciation of their shared pathophysiology.

    Copyright © 2011 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
    PMID: 21349445 [PubMed - in process]
    Last edited by icnmgrjill; 03-25-2011, 12:48 PM.
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  • #2
    central sensitivity syndromes

    Jill,
    This article is so interesting. I wish I could show it to everyone, including many of my doctors, who think I'm just strange,or a bit nutty, because my body is so sensitive. Okay could be I am a bit nutty, but my body is still sensitive!
    Laurie

    Comment


    • #3
      How cool. I'm a sensitive body as well, it does not take much to set my system off, and over the last few years my pain has spread from my bladder to other parts of me. This article makes total sense to me.
      Clark College Junior, wanting to go to UW for Fine Art Degree
      Major: Fine Art
      Taking a course in medical transcription, must work from home
      IC diagnosed 07/07
      PFD developed sometime during late 07
      Uterine Cyst removed 12/09
      Chronic Pelvic pain developed in 09
      Chronic Back Pain developed in 09
      Possible vulvodynia

      Medications: Elmiron, Detrol LA, BC, Prosed DS, Celexa for anxiety, depression, and pain,
      No longer taking: Atarax (No help),Amytriptalene (no effect, became suicidal), Ditropan (no effect), Probiotics (sick to stomach), Bactrim (hopefully cleared up my UTI!), avoiding Pyridium unless absolutely needed (sick to stomach), Prozac (helped anxiety, no pain relief), Pamelor (gained nearly 20 lbs in a short time, no anxiety relief), Valium, Vicodin, percocet (none of these meds even touch my pain >_<)

      Current Therapies: acupuncture, heat, Vicodin if needed, lots of laying down, gaming as a distraction, Pain Management classes started 9/22, Wanting to try TENS therapy

      Comment


      • #4
        They could have done this study just by reading our signatures on this board, to find all of that out.

        I suffer from IC, Fibromyalgia probably combined with Chronic Fatigue Syndrome and Chemical and scent sensitivities, those being the ones I know about.

        I really tend to believe that chemicals are one of the things that instigates these conditions. Between the chemicals used in building homes, carpeting, vinyl floors, air and furniture etc. fresheners, detergents, fabric softeners, perfume, cleaners, dry cleaning, pesticides, fertilizers, additives to our food supply and the list goes on, we bombard ourselves to the point of oversataration. The chemical companies keep coming out with more and more stuff, then convince everyone that they must have it.

        I never thought about it until now, but I realize my bladder symptoms, the frequent nd urgent urination started after I started wearing more clothes that needed dry cleaning. I rarely wore clothes that needed dry cleaning until big jackets etc came into style and it was around that time that it all started in the mid 1980s. It took about 10 years before the pain started. I also spent my first 33 years surrounded by family that smoked heavily, my parents and 2 of my sisters. I worked in a small basement with no ventilation with my sister and brother-in-law that also smoked, for 11 years.


        Symptoms since '86 starting with frequency(told I had a small bladder)
        Diagnosed with medium IC in 2004 when pain started

        Medications:
        For IC Elavil 50 mg - Atarax 50 mg - Fentanyl 25 Patch replaced every 72 hrs

        For HBP Norvasc 5mg -Diovan 320 mg

        For Depression Wellbutrin XL 300mg

        Sinus Problems Flonase 2x daily-Alegera D when needed

        And Now Fibromyalgia


        Have Tried Elmiron (made me sick and hair loss)
        DMSO and Heparin instills no help
        All and every urgency pill
        Trileptal, Neurontin, Tramdol did nothing
        Cymbalta which made me dizzy and flushed
        Lyrica gave me night terrors each night a different family member died very vivid now I know how they got the name night terrors

        Comment


        • #5
          sensitivity syndromes

          Terri,
          In many ways your body sounds just like mine. IC, IBS, Fibro. Migraines, and major chemical sensitivites

          I'm so sensitive to chemicals and smells that we had to sell a house we had just finished having built, because I couldn't stand to be in it. I actually got so sick one day when we were moving things in,(not even living there yet), that I ended up in the hospital. Since, I've heard of this happening to other people as well. Luckily, we hadn't sold the house we were living in, so we were not homeless!
          Sorry, got off topic there! I think a lot of what you said makes sense. We are always bombarded by chemicals and perhaps some of us, or many of us, are just more sensitive to them than other people. I wish more doctors understood or at least recognized that.
          Okay, enough ranting for now.
          Thanks for the posting.
          Laurie

          Comment


          • #6
            environmental contributions

            Interesting! Now that I think about it my IC started right after we had the house tented for termites. I was the first one back in the house to open the windows after it was declared safe to enter....HMMMMM. I am very sensitive to medication,makeup,shampoo, sun protection . I am very sensitive to wool and tags at the neck in clothes.

            Comment


            • #7
              Is that the same as Pain Sensitization Syndrome? My rheumatologist just diagnosed me with that a couple days ago and says its like fibro. I basically have lots of pain, fatigue, and brain fog...but not in the tender points that fibro patients have. I have corneal neuralgia, migraines, IC, vulvodynia, PFD, pudendal neuralgia, and possibly endo. According to this:

              http://www.arthritiscenter.ae/wp-con...bromyalgia.pdf

              practically all of the conditions I've listed are considered Central Sensitivity Syndromes!

              This is another good paper:
              http://infolib.hua.edu.vn/Fulltext/C...7/CDe150/2.pdf

              It says that IC is included.

              I personally think its great that most research and interest is being generated about the mechanisms of central sensitization, and finding out similiar mechanisms in FM, IC, IBS, exist because that way the knowledge discovered from FM may also be helpful to other conditions!
              Current treatment:
              Elmiron 100mg 3x a day
              Hydroxyzine 75mg
              Lyrica 100mg 3x a day
              Pelvic Floor Physical Therapy started 12/10
              Ativan 1-2mg as needed


              Bloging my thoughts at www.thispatientperspective.blogspot.com

              Comment


              • #8
                environmential contributions

                SF,
                I read part of the first article. Very, very interesting. I think I have just about everything on the list of related conditions.
                I would like to give these articles to all of my doctors!
                Thanks so much for posting them.
                Laurie

                Comment


                • #9
                  I'm a believer of the central sensitization idea

                  I'm not sure if I was born with this or when it started but I had my first documented UTI when I was 3. When I was 19 I had a urine culture as a health thing, not because I thought I had a UTI and it was all white blood cells and epithelial tissue, no bacteria. That was without symptoms (that I was aware of).

                  20 years later and I have IC, endo, celiac, migraines (my whole life), a bad back in three places, a separated shoulder, joint sprains or injuries in both feet that haven't recovered fully (6+ months now), and seriously have only one good smiley day about every four weeks. And then that next day, something bad always happens, like my back goes out or I have a flare. Like clockwork.

                  And yet - my rhemy I just started seeing again says he might call it fibro, though it's not really fitting the fibro "matrix" - I just feel like it makes no sense that I have so many physical issues and yet nothing tying them together. There must be! It's not like I'm an athlete or someone who does hard work for a living and has a reason for the repeatedly bad back, not like I worked fumigating houses, etc.

                  I just try to remain positive and keep a happy attitude as much as possible to reduce stress and hope for the best, even when I feel like the worst. Maybe we'll all get some answers, soon.
                  Stephanie
                  GutThinking.com

                  Dx's
                  2011 - Adenomyosis (172g uterus), Ovarian Cysts
                  2007 - Endometriosis, Interstitial Cystitis
                  2004 - celiac disease/autoimmune gluten intolerance
                  2004 - migraines
                  1999 - Nightshade intolerance
                  Sciatica, thoracic and cervical disk problems
                  Separated shoulder (a/c joint)
                  Positive ANA since 1990

                  Treatments

                  6/30/2011 - total hysterectomy (vaginal, lap assisted)
                  9/15/2010 - first instill (heparin, lidocaine, sodium bicarbonate) - adding Elmiron for the rest of the series (still doing this, 2 the week before my period)
                  11/2010 - Uterine ablation with hopes it would calm down abdominal activity - didn't work

                  Meds
                  Desert Harvest aloe vera
                  valium
                  vicodin
                  Vivelle Dot .1
                  ibuprofen
                  Imitrex
                  Singulair

                  Comment


                  • #10
                    How is the accupuncture going? Do you think it helps? My insurance will not cover it but am curious if it works or is it only a temporary fix? I like my tens unit. My insurance would not pay for that either so I bought a 7000 TENS on amazon.com for only $34 instead of the $400 the PT gave me which was an EMPI. She called it the cadilac of tens units but I find the cheap one from amazon feels the same. Good luck in your search for answers and pain relief.
                    sully

                    Comment

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