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All About FibromyalgiaA Guide for Patients and their Families$
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Daniel J. Wallace and Janice Brock Wallace

Print publication date: 2002

Print ISBN-13: 9780195147537

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780195147537.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 13 June 2021

What’s Wrong with My Muscles?

What’s Wrong with My Muscles?

5 What’s Wrong with My Muscles?
All About Fibromyalgia

Daniel J. Wallace

Janice Brock Wallace

Oxford University Press

Since most fibromyalgia patients complain of aching and spasm in their muscles, common sense suggests that there must be something wrong with the muscle. This is easier said than agreed upon. For the last 80 years, researchers have been looking for the key to muscle pathology in fibromyalgia. As of this writing, there are highly respected investigators who feel that there is little if anything wrong with fibromyalgia muscles. However, other equally regarded researchers have presented evidence that abnormal muscle metabolism is the linchpin for what goes awry in the disorder. Why are there such discrepancies? Let’s explore what goes on in our muscles. Our body has 640 different muscles, which constitute as much as 40 percent of our weight. When physicians look at muscles of fibromyalgia patients under a simple microscope, they generally appear normal. In fact, muscles must be looked at under an electron microscope (which magnifies the tissue thousands of times) in order to find any consistent abnormalities. In this setting there are subtle alterations, including the deposition of a chemical, glycogen, swollen and abnormal cell organelles known as mitochondria, increased DNA fragmentation ragged red fibers, and smeared muscle cell membranes. Some investigators have shown that magnesium levels are low in the muscles of fibromyalgia patients. So where are the disagreements? Fibromyalgia patients are generally deconditioned. In other words, they are out of shape. Of course, many more people are out of shape than have fibromyalgia, but studies of muscles from out-of-shape people also show some of these alterations. If fibromyalgia muscles don’t look very different from normal muscles under themicroscope, where else can we look for muscle pathology? Muscle strength can be decreased or normal in fibromyalgia, and published studies conflict as to whether or not muscle fatigue is present. Nevertheless, people who are out of shape also have decreased muscle strength. Let’s look at blood flow to muscles. Muscles are fueled by oxygen, which is supplied and carried by arteries. Some muscles in fibromyalgia do not get enough oxygen. “Angina” of the muscles can develop, producing pain if the oxygen supply is decreased.

Keywords:   angina, bradykinins, histamine, magnesium, nerve fibers, oxygenation, potassium, sarcomeres, spasms

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