Fibromyalgia Research Paper

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Locomotor PBL 3 Write-up:
Fibromyalgia

1. Skeletal muscle structure and function
Skeletal, cardiac, and smooth muscles constitute the three main types of muscle in the human body. The focus of this part of the PBL will be skeletal muscle as these are mostly associated with the symptoms of fibromyalgia. Skeletal muscles attach to bones via tendons, which are very strong collections of collagen fibres.
The functional unit of a skeletal muscle is the sarcomere, which consists of thin actin and thick myosin proteins, appearing as light and dark filaments, respectively. The distance between the two Z-lines defines the physical length of the sarcomere, whilst the I-band represents the parts of the thin actin filaments which are not covered by the thick myosin bands. The H-zone is the area of thick myosin filament which is not covered by thin actin filaments.
Skeletal muscle contraction can be described using the sliding filament theory. As an action potential arrives at the neuromuscular junction, it depolarises the membrane effecting the opening of the voltage-gated calcium channels leading to an influx of calcium. This leads to further depolarisation of the T-tubule network within the muscle fibre, eventually leading to release of calcium from the sarcoplasmic reticulum. The increased concentration of calcium results in the increased binding of calcium ions to troponin, found on the actin filaments. Troponin changes the shape of tropomyosin, reversing its obstruction of the myosin binding sites on the actin filament. The binding of myosin to the actin filament causes movement of the bands and a release of ADP, essentially causing the shortening of the sarcomere, and, therefore, the entire length of the skeletal muscle, when consid...

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... and codeine), or dihyrdocodeine (a weak opioid analgesic). If the pain persists or the patient becomes sensitized to the analgesics, the level of pain management can be escalated to include a stronger opioid, such as morphine, in combination with adjuvant therapy.

Ropinorole is a dopamine agonist which can also be administered, as well as muscle relaxants.

Exercise, especially long-term cardiovascular exercise, has been shown to be effective in relieving the symptoms of pain in patients with fibromyalgia. Exercise may have direct and indirect positive effects on the patient’s mood levels, and may alleviate their fatigue, as well as reduce symptoms of pain around their body.

Although fibromyalgia is not a degenerative or immediately fatal disease, it is debilitating for the patient and can penetrate every aspect of the patient’s life, limiting their social life.

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