Fibromyalgia is a common and chronic syndrome of persistent widespread pain, stiffness ,mental distress and sleep or memory issues.
Symptoms of fibromyalgia can be confused with those of arthritis, or joint inflammation. However, arthritis, it has not been found to cause joint or muscle inflammation and destruction like arthritis. It is seen as a rheumatic condition, in other words, one that lead to soft tissue pain or myofascial pain.
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), around 5 million adults of 18 or more years of age in the United States face fibromyalgia, and 80 to 90 percent of fibromyalgia patients are women.
- Fibromyalgia causes widespread pain, fatigue, and other types of problems.
- Symptoms are similar to those of arthritis, but fibromyalgia affects the soft tissue, not the joints.
- The cause is not clear, but risk factors are traumatic injury, rheumatoid arthritis and other autoimmune disorders, like lupus, and genetic factors.
- There is no permanent treatment, but medications, exercise, acupuncture, and behavioral therapy can help reduce symptoms and improve sleep quality.
Common symptoms include:
- widespread pain and tenderness
- jaw pain and stiffness
- pain and tiredness in the face muscles and adjacent fibrous tissues
- stiff joints and muscles in the morning
- uneven sleep patterns
- irritable bowel syndrome (IBS)
- painful menstrual cycles
- tingling and numbness in the hands and feet
- restless leg syndrome (RLS)
- sensitivity to cold or heat
- trouble with memory and concentration, known as “fibro-fog”
The following conditions can also possible:
- vision related problems
- pelvic and urinary problems
- weight gain
- cold or flu-like symptoms
- skin issues
- chest symptoms
- depression and anxiety
- breathing problems
Symptoms can occur at any time during a life time of person, but they are most commonly arrived around 45 years of age.
Medical attention is required as fibromyalgia can be difficult to control. As it is a syndrome, each patient will feel a different set of symptoms, and an individual treatment plan will be essential.
Treatment may envolve some or all of the following:
- graded exercise therapy
- cognitive behavioral modification therapy
- chiropractic care
- physical therapy
- low-dose anti-depressants, although these are not a first-line treatment
People with fibromyalgia required to consult with their doctor to think up a treatment plan that gives the best results.
Drugs may be suggested to treat certain symptoms.
These may include over-the-counter (OTC) pain killers. However, the European League Against Rheumatism (EULAR) issued a recommendation against using non-steroidal anti-inflammatory drugs (NSAIDs) to treat fibromyalgia in their upgraded 2016 guidelines.
Antidepressants, like duloxetine, or Cymbalta, and milnacipran, or Savella, may help relieve pain. Anti-seizure drugs, such as gabapentin also known as Neurontin, and pregabalin, or Lyrica, may be prescribed.
However, a review has suggested that patients usually stop taking these drugs because they are not successful in relieving pain or because of their disadvantageous effects.
Patients should inform the doctor about any other medications they are taking to avoid side-effects and interactions with other drugs.
Pain, tenderness, stiffness and sleep disruption can be reduced by following a combination of aerobic exercise and resistance training, or strength training in some patients.
If exercise is helping with relieve of symptoms, it is necessary to follow regularly in order to notice improvement.Working out with a partner or personal trainer may help to maintain consistency in the exercise plan.
Some patients have experienced improvements in their quality of life after initiating acupuncture therapy for fibromyalgia. The number of sessions needed will depend on the symptoms and their seriousness.
One study found that 1 in 5 people with fibromyalgia follow acupuncture within 2 years of diagnosis. The researchers concluded that it may improve pain and stiffness. However more detailed studies are required.
Behavior modification therapy
Behavior modification therapy is a form of cognitive behavioral therapy (CBT) that aims to reduce negative, stress- or pain-raising habits and improve positive, sensible behaviors. It includes learning new coping skills and relaxation exercises or yogas.
The accurate cause of fibromyalgia is unknown. However, current thinking in the field of Rheumatology recomends that fibromyalgia is a problem with central pain processing in the brain, where there may be enhanced sensitivity or perception of pain to a given trigger.
There is a range of possible risk factors, which includes:
- a stressful, traumatic physical or emotional event, such as any accident
- reccuring injuries
- rheumatoid arthritis or other autoimmune diseases, like lupus
- central nervous system (CNS) issues
- the way our genes manage how we process painful stimuli
Fibromyalgia may also be hereditary. Females who have a family history of fibromyalgia have a increased risk of experiencing it themselves.
It can take some time to confirm a diagnosis of fibromyalgia as the symptoms resemble those of other conditions, such as hypothyroidism or arthritis. These conditions must be prevented first before making diagnosis of fibromyalgia.
There are no lab tests for the condition, and this, too, can cause delayed or missed diagnosis.
The American College of Rheumatology has confirmed three criteria for making diagnosis of fibromyalgia.
- pain and symptoms over the one week, out of 19 recognized body parts, along with levels of fatigue, Disturbed sleep, or cognitive issues
- symptoms that have been persisting for at least 3 months
- no presence of another health condition that would explain the symptoms
Earlier, ‘tender points’ were used to diagnose the condition. However, these are no longer suggested to used as the diagnosis of fibromyalgia.