FMS, Non-Allergic Rhinitis and Central Sensitivity
Ah, Spring. Ah-choo. With the coming of spring and the warmer months, people with allergies invest more in tissues and allergy medications as they just try to keep up with the sneezing, coughing, runny nose and watery eyes. They know that within a few weeks the pollen count will drop and they'll be okay again. Lucky them.
Those who suffer with non-allergy rhinitis, that is having all of the symptoms of allergies without the histamine reaction in the body, can't always pinpoint exactly what it is that is eliciting the reaction, it's just happening and they feel miserable. A chronic runny nose, head congestion, and post-nasal drip that lend to a throat-clearing cough are part of the plague of non-allergy rhinitis. People with fibromyalgia syndrome (FMS) tend to have a higher incidence of non-allergy rhinitis than those who do not have the syndrome. There are a number of theories as to why, but the one that probably makes the most sense is the central nervous system connection.
Central Sensitization and FMS
Central sensitization is common in people with FMS. It means that the entire central nervous system becomes sensitized to a stimulus. Sensitization gradually changes the way the immune system reacts to a particular substance with the result of the sensitization being an allergy. Many people with FMS suffer with symptoms that are directly connected to central nervous system disorders, including sensitivity to light, sound, smells, and amplified pain responses.
If FMS Isn't Central Sensitization, What is It?
Other possible reasons that have been mulled over include sinus problems as a result of muscle tension. FMS can cause muscular pain and spasm in the face and head (as well as the rest of the body), and tight muscles can press on fluid passages causing them to narrow and become backed up. The result of this muscle pressure is post-nasal drip, which can happen even if the nose itself is dry. Drainage causes coughing that causes a sore throat - and everyone thinks the person has a cold.
TMJ (temporomandibular joint) pain is common to more than one-third of FMS sufferers. The muscles around the jaw can go into spasm or develop trigger points that can elicit a sinus response, sore throat, itchy ears, and coughing. Myofascial trigger points in the sternocleidomastoid muscles (the big muscles at the front of the neck) also cause what appear to be allergy responses. The trigger points can cause nasal discharge, congestion in the sinuses, sore throat or cough and dizziness. So, it is difficult to determine exactly what causes non-allergy rhinitis in FMS victims. It does seem to come with the FMS package, though, since so many with FMS deal with it.
FMS Non-allergic Rhinitis Irritants
Although all of these situations can cause the symptoms of rhinitis, FMS sufferers tend most often to react because of sensitivity to a variety of elements in the environment:
· tobacco smoke
Irritant rhinitis is the most common rhinitis in those with FMS and, as mentioned earlier, the probable cause is a hyperactive central nervous system response that causes the body to over-react to sensory stimuli.
Research on Central Sensitivity to Confirm Non-Allergic Rhinitis in FMS Patients
Over recent years, the idea of environmental sensitivity has been taken more seriously by researchers investigating the rhinitis phenomenon in FM patients. Studies completed in the US in 1998 and 2000 along with others that have been completed more recently have investigated the nerve connection between responses of FM and chronic fatigue patients with those who do not have either syndrome. They have discovered that the body mechanisms involved in irritant rhinitis probably operate through the activation of various nerves. Of course, more research will have to be done to confirm completely, but it is a great relief to FMS and CFS victims to have validation for their suffering.
In the meantime, people with FMS who are dealing with irritant rhinitis are best served by seeing an allergy specialist who is familiar with fibromyalgia syndrome to determine where the symptoms originate and whether or not allergies are present. Appropriate medications can be administered to help with the symptoms. If the origin of the symptoms is TMJ or myofascial pain/trigger points, then a referral to a specialist for treatment should follow.
For a detailed explanation of rhinitis and fibromyalgia, check out the article on this site.