Researchers from the University of Edinburgh (Scotland) reported that their study found that taking even a little too much acetaminophen over time is more dangerous, in fact, than taking a single much-too-large dose.

Dr. Kenneth Simpson of the University of Edinburgh, the study’s lead author, stated in a press release accompanying the study’s publication:

They haven’t taken the sort of single-moment, one-off massive overdoses taken by people who try to commit suicide, but over time the damage builds up, and the effect can be fatal . . . Staggered overdoses or patients presenting late after an overdose need to be closely monitored and considered for the (acetaminophen) antidote, N-acetylcysteine, irrespective of the concentration of (acetaminophen) in their blood.

(In the UK and other countries, acetaminophen is known as “paracetamol.”)

Additionally, patients who take some opioid pain medications along with acetaminophen should exercise even greater caution with their Tylenol doses, as many commonly-prescribed opioid medications contain acetaminophen as well, making the risk of an unwitting overdose even greater.

The FDA states that the maximum safe daily dose of acetaminophen is 4000 mg, and has taken steps to have manufacturers lower the per-unit dosage to 325 mg in an attempt to reduce the risk of accidental overdose.

Many of these fibromyalgia patients go from doctor to doctor looking for a cure, but, of course, there not only is no cure, but there is no consensus in the medical community as to how to objectively test for this condition.

Medical researchers have been working on this problem and over the past few years there have been a number of studies published that purport to identify unambiguous markers that will enable practitioners to objectively diagnose FM/CFS.

One of the more intriguing medical studies in recent years involved the Whittermore-Peterson Institute and researcher Judy Mikovits.

The fibromyalgia and Chronic Fatigue Syndrome (CFS – also sometimes referred to as “CFS/ME,” where “ME” stands for myalgic encephalomyelitis) community has been roiled by a controversy over the news, reported first in 2009, that a mouse retrovirus might be involved in CFS.  Now, the research group which first asserted the connection between xenotropic murine leukemia virus-related virus (XMRV) and CFS is at the center of another controversy – this one of a decidedly non-medical nature.

The Whittemore Peterson Institute in Nevada was “ground zero” for the XMRV/CFS news, and the name most frequently associated with the potential link is Judy Mikovits, one of the Institute’s lead researchers. In late September 2011, the Institute fired Mikovits, and a little over a month later, the Institute made headlines again by filing suit against her.

The suit, filed in a Nevada state court, focuses mainly on notebooks and other documents the Institute claims Mikovits removed unlawfully following her termination. Mikovits, through her attorney, rebutted the charges and said she wasn’t even in the Institute’s facility on the grounds of the University of Nevada when she received notice of her termination, and never returned to the facility after that point. Thus, Mikovits’ attorney asserted, she could not be responsible for the allegedly missing notebooks and research materials.

The Institute also secured a restraining order against Mikovits barring her from destroying or altering any of the missing files.

However, the lawsuit was just the beginning of the controversy.  A few weeks later came word that Mikovits was taken into custody on a fugitive warrant related to the civil lawsuit.

Mikovits and the Institute first announced they had found evidence of XMRV in the blood of over 60% of a sample of CFS patients back in 2009.   Subsequent studies, however, failed to demonstrate anything resembling that strong of a correlation or link, and one study’s results caused its authors to posit XMRV could not be transmitted to humans at all.

The question becomes even more confusing when reports suggest a greater occurrence of one disease in patients diagnosed with another illness. Take, for example, the studies suggesting that post-traumatic stress disorder (or PTSD) is more prevalent in fibromyalgia patients. The study linked to in the previous sentence was conducted by Drs. H. Cohen, L. Neumann, and others at the Ben-Gurion University of the Negev, in Israel.

The findings of this study indicate that a statistically significant portion of the fibromyalgia population studied also had PTSD. From the study’s abstract:

57% of the FM sample had clinically significant levels of PTSD symptoms. The FM patients with PTSD reported significantly greater levels of avoidance, hyperarousal, reexperiencing, anxiety, and depression than did the patients without clinically significant levels of PTSD symptoms. The prevalence of PTSD among the FM patients in this study was significantly higher than in the general population. Women with FM and PTSD reported a greater number of past traumatic events than did their male counterparts.

CONCLUSIONS: The results represent the first comprehensive study applying structured clinical assessment of trauma exposure and PTSD to a group of FM patients. This study shows a significant overlap between FM and PTSD, according to the currently accepted diagnostic criteria for each.

But does that mean that fibromyalgia is “caused by” or somehow “triggered by” PTSD? The study found nothing of the sort, of course, but these findings have been cited in news articles that can present misleading suggestions of some causative connection that hasn’t been proven yet. Another study from the same institution looked at whether PTSD and fibromyalgia were really the same illness. While they do share some symptoms in common, it is generally thought that fibromyalgia results from actual neurological changes as opposed to some psychological trauma. It could be that in many cases, an initiating physical trauma causes both PTSD and fibromyalgia.

Yet a lazy researcher could well take that association as grounds for concluding that fibromyalgia is “all in your head” — which is clearly not the case. And given that fibromyalgia is too often relegated to some behavioral issue, as opposed to a systemic or neurological malfunction, that’s unfortunate.

It’s important for fibromyalgia patients to educate and inform themselves, but it’s also important to keep an objective view of studies that are reported in the press.

According to the FDA, Xyrem, or sodium oxybate, “is much better than the stuff you get on the street, and that is the problem.  Approving it for such a large patient population — 5 million people are estimated to suffer from fibromyalgia — would risk flooding the streets with a pharmaceutical-grade version of the highly controlled substance.

Xyrem is currently available for the treatment of narcolepsy.  It is a central nervous system depressant.

In a study of 334 patients suffering with fibromyalgia, researchers found that over half of the individuals taking Xyrem reported a thirty percent improvement in their pain.  The participants were initially split into two groups.  One group took Xyrem while the other participants took a placebo over a period of fourteen weeks.  At the conclusion of the study, fifty-four percent of participants taking a lower dose of the drug and fifty-six percent of participants taking a higher dose reported a thirty percent reduction in pain, WebMD reports.  This is compared with thirty-five percent of patients taking the placebo reporting less pain.  The researchers noted that the thirty percent reduction in pain showed an average improvement of pain, whereas the fifty percent reduction indicated a significant improvement.  What’s more is that many of the participants taking Xyrem noted that they felt an improvement in pain as early as the first week.

Participants did, however, report some side effects such as headache, nausea, and dizziness.  Additionally, the drug is made up of GHB, otherwise known as the “date rape drug,” and has the potential to be abused.  The researchers and doctors, however, argue that there are enough systems in place to prevent such abuse, and since its inception and use for narcolepsy, no abuse has been reported.

What is very interesting about this particular drug is that, according to this study, it outperforms the other drugs on the market specifically for fibromyalgia.  Xyrem is not a narcotic type drug like those marketed for fibromyalgia treatment, and that may be an added benefit for patients.  This study shows that there is the possibility of more drugs for the treatment of fibromyalgia, as well as the possibility of combining certain drugs, including Xyrem, to elicit an effective and quick response.  Despite the apparent success of this study, the FDA has still not approved the sleeping pill for use in fibromyalgia patients.  As with all new treatments, make sure to discuss using Xyrem in your daily treatment for the disorder.

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An individual’s walk is examined using various parameters, including: step length, time on each foot, time on both feet, walk spend, and sole pressure on the ground (Eureka Alert). The lead researcher believed that people living with fibromyalgia had decreased motor skills and also showed low performance in strength tests, body constitution, and psychological evaluations. From this belief came his theory that people with this disability have altered motion parameters that are then linked to decreased physical and psychological abilities, thereby limiting their quality of life. He decided to test whether fibromyalgia could be diagnosed on these altered motion parameters reliably.

The study focused on sixty-four women and twelve men diagnosed with fibromyalgia, as well as forty-five women and twelve men who were healthy and had no signs or symptoms of the disability. The participants underwent various tests regarding their medical and physical conditions. They found that those individuals who lived with fibromyalgia presented with definite altered motion capabilities compared to those who did not have the condition. Moreover, the fibromyalgia sufferers also had other symptoms that impacted their overall quality of life.

Although observing a person’s gait may not be likely used alone to diagnose fibromyalgia, it may be used in addition to diagnostic criteria to produce a more reliable result. The current testing criteria can often be misinterpreted and evaluating the way a person walks may provide that extra evidence needed to make a correct diagnosis. The earlier a person can be diagnosed with the condition, the easier it will be for them to get the necessary treatment and improve other areas of their life. Additionally, if the condition is so debilitating that they must stop working, having an accurate fibromyalgia diagnosis will allow them to seek disability benefits through the Social Security Administration.

This new study is important because a lack of balance, coupled with crippling pain, can lead to many accidents and falls.  The condition is difficult on its own without having to then worry about falling on top of it.  The researchers noted that approximately half of those individuals living with fibromyalgia suffer with poor balance.  They also knew that tilt platform vibration improved balance, bone mass, and motor skills in elderly individuals, therefore, they wanted to test it with fibromyalgia participants.  The Spanish research team separated forty-one women, ages forty-one to sixty-five, with fibromyalgia into two groups.  Twenty-one were provided with vibration therapy, while the other twenty received their normal treatment regime without the vibration therapy.

Those who received the vibration therapy had three sessions with the platform providing vibration at a low frequency for twelve weeks.  They had a ten minute walking warm-up and up to six repetitions with the tilt platform.  The researchers found that the dynamic balance index improved by thirty-six percent in the vibration therapy group, while it remained the same in the control group.  Additionally and most welcome is that the women who weighed the most and had the worst balance saw the greatest improvement.

The researchers also believe that the vibration therapy slows bone mass loss and improves strength, which helps individuals to respond better to falling or the loss of balance.  They do note that more studies will be needed to see if the vibration therapy also reduces pain associated with fibromyalgia, as well as if the number of overall falls decreases.  If your balance has suffered as a result of fibromyalgia, you may want to discuss this type of physical therapy with your doctor.  It may just help you to better “balance” the effects of this chronic condition.

One of the articles, from the Black Women’s Health Alliance and detailed on PRNewswire, discussed a study conducted in Pennsylvania which found that many of the state’s women suffered from chronic pain but did not seek help for it.  Specifically, the study found that two-thirds of Pennsylvania women suffer from chronic pain, and over half of them do not seek treatment for their pain, even when it is so severe that they have trouble completely daily tasks or working.  When asked why they would not get treated, a majority of the women stated it was because they felt that insurance companies would not cover treatment for pain, unlike more traditional conditions, such as heart disease.  Additionally, the women felt that the pain was not something to worry about and that it could be handled privately.

The other article, from Pain Medicine News, discussed how twice as many women as men feel that they are not being taken seriously when they complain about their pain.  This perceived lack of sympathy often causes these women to refrain from seeking medical treatment even though their condition often impairs their daily activities and work environment/ability to work.  What is even more troubling is that fibromyalgia impacts seven times more women than men, so not only are more women not seeking help for their pain, but more women are suffering from a serious chronic condition and are not seeking help!  Fortunately, some researchers, medical writers, and health professionals have launched a website, www.healthywomen.org , to address these issues and educate women on fibromyalgia and pain management.  It provides references for doctors who specialize in treating fibromyalgia and how women can fully engage in their daily lives.

Knowing that this painful condition we call fibromyalgia is real and not something to be taken lightly is the first step to getting the necessary treatment.  Once you know what you are dealing with, you can then take the necessary steps to get the right therapy for you, file for social security disability benefits if you can no longer work due to your condition, and generally manage your life better.  Although men and women are very different, this type of chronic pain can impact us all the same.  It is important to seek help and educate yourself so that you can live the healthiest life possible.

In the studies, scientists examined people who took half as many breaths as the average, healthy adult, which is approximately between twelve and eighteen breaths per minute. They found that individuals who cut those breaths in half were able to tolerate short-term pain from burns or cuts, as well as the chronic pain affecting muscles and joints. The research indicated that by reducing breaths to as few as six breaths a minute had a radical effect on pain experienced by individuals over the long term.

In the United States study, researchers evaluated a group of healthy, middle aged women and a group of women suffering from fibromyalgia, a chronic pain condition, for which there is currently no cure. The research team exposed the women to various probes that generated heat against their hands at different temperatures. The scientists wanted to measure how much pain they could tolerate. The women were instructed to take fewer breaths while handling the probes. After taking half the amount of normal breaths, the women reported that the pain was less intense than when they breathed normally. The researchers found that the pain was rated about the same in both groups when fewer breaths were taken.

The theory behind why fewer breaths may ease pain stems from the idea that slow, measured breathing has a direct impact on the sympathetic nervous system. Fibers within the nervous system help to regulate blood flow and skin temperature. It appears that taking fewer breaths dampens the sympathetic nervous system, which in turn blocks pain. Other believe that taking shallow, slow breaths help to get the oxygen to the tissues in a more effective fashion, thereby helping the body react to pain. Breathing techniques have been around a very long time and in various cultural settings. Practicing breathing is cost-effective, easy, and can fit into your everyday schedule with relative ease. If you do suffer from pain associated with fibromyalgia, try to decrease the amount of breaths you take and truly concentrate on your breathing. It could just be that you find some of your pain minimized upon taking a deep breath.

EmaxHealth, who highlighted the reports, found that the failure to adequately treat chronic pain associated with various medical conditions resulted from an array of circumstances. Some of the reasons include physician bias, inadequate pain management training, and risks associated with prescription drug abuse. One of the experts of the study, pharmacist Kathryn Hahn, stated that these situations must change before the undertreatment becomes a critical problem.

Many chronic pain sufferers have been on some type of medication, and despite some relief, most individuals found that taking certain drugs diminished their quality of life, did not help the condition, and caused depression and insomnia. These patients continued to be prescribed variations of medications by their doctors, who are often biased toward a specific drug or pharmaceutical company. Further complicating this matter is the fact that pain management is not a focal point in medical school training. Therefore, doctors often do not know all of the options available to their patients and how various drugs may interact. Some are also unwilling to engage in or recommend alternative, unorthodox treatment methods.

The studies further found that those most impacted by undertreatment were the elderly and those on Medicare. Hahn notes that educating healthcare providers and patients about pain management and the reality of prescription drug abuse was paramount in solving the problem of inadequate treatment. She also suggests that patients cooperate with their healthcare providers when it comes to pain management, including exercise, prescription drugs, massage, physical therapy, and meditation, among other types. On the other hand, however, patients dealing with chronic pain should be dogged in their pursuit of a solution to their pain. If a therapy is not working for you, it is necessary to become educated about the options available to you and discuss them with your doctor. When it comes to adequate pain management, you are your own best advocate.