Below are some few facts about a little known condition called Fibromyalgia…..even the Microsoft Word dictionary doesn’t recognize it yet
Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals. Most patients say that they ache all over, like a chronic case of a bad flu. Their muscles may feel like they were pulled or overworked. Sometimes the muscles twitch and other times they burn. More women than men are afflicted with fibromyalgia (75% versus 25%) and it shows up in people of all ages.
Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event.
Women are much more likely to develop fibromyalgia than are men. While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Exercise, relaxation and stress-reduction measures also may help.
- What causes fibromyalgia?
Although the cause is not known, there appear to be many triggering events that often precipitate its onset. Examples include: infections (bacterial or viral), physical trauma (such as an automobile accident), or the development of another disorder, such as rheumatoid arthritis, lupus, or hypothyroidism. These triggering events probably do not cause fibromyalgia, but rather, they may awaken an underlying physiological abnormality that is already present.
- How is fibromyalgia diagnosed?
For the most part, routine laboratory testing reveals nothing. However, upon physical examination, patients will be sensitive to pressure in certain areas of the body, called tender points. To meet the diagnostic criteria (set forth for research purposes), patients must have widespread pain in all four quadrants of their body for a minimum duration of three months and at least 11 of the 18 specified tender points.
- How is fibromyalgia treated?
Traditional treatments are geared toward reducing pain and improving the quality of sleep because the sleep disorders that frequently occur in fibromyalgia patients should probably be treated first because they may aggravate the symptoms of this condition. For addressing the pain and the symptoms in general, medications that boost serotonin and norepinephrine (neurotransmitters that modulate sleep, pain, and immune system function) are commonly prescribed in low doses, such as amitriptyline, cyclobenzaprine and Cymbalta. Ultram may help with the pain, although stronger opioids may be needed. Muscle relaxants, anti-epileptics (such as Neurontin and Lyrica) and other drug categories may be prescribed as well.
In addition to medications, most patients will need to use other treatment methods, such as trigger point injections with lidocaine, physical therapy, occupational therapy, acupuncture, acupressure, relaxation/biofeedback techniques, osteopathic manipulation, chiropractic care, therapeutic massage, or a gentle exercise program.
- What is the prognosis?
Long term follow-up studies have shown that fibromyalgia is chronic, but the symptoms may wax and wane. The impact that fibromyalgia can have on daily living activities, including the ability to work a full-time job, differs among patients. Overall, studies have shown that fibromyalgia can be as disabling and life-impacting as rheumatoid arthritis.
- What can I do to help myself?
Lifestyle modifications may help you conserve energy and minimize pain. Learn what factors aggravate your symptoms and avoid them when possible. Many patients find warm water (hot tub or shower) to be soothing. Hot wraps for particularly painful areas are also beneficial. Maintaining a rigid sleep schedule (e.g., ensuring that you receive at least eight hours of sleep per night and that you have a routine for easing you into sleep) is one method endorsed by patients to help minimize daytime fatigue and reduce night-time sleep difficulties. Gentle movement and stretching exercises will help you maintain your function, which is essential when the body is tired and the muscles hurt.
- Is there a cure?
No, but there are researched treatments that have been shown to be helpful for reducing the symptoms. Patients need to beware of the many bogus cures that are being promoted on the Internet and in the media. Many businesses count on people who are desperate to get rid of chronic, unrelenting pain (such as that produced by fibromyalgia). If a remedy sounds too good to be true, it probably is.
- Why do some doctors think that the pain is all in my head?
Doctors cannot “see” and may not understand the sources of your pain or fatigue. However, what they do observe is your anxiety and frustration with having to deal with these symptoms around-the-clock, which may wrongfully lead them to conclude that your symptoms are of a psychological nature. Also, the old school of thought regarding pain is that it is produced by tissue injury, and there is no obvious source of tissue injury in patients with fibromyalgia. Regardless, if your doctor does not believe that your symptoms are real, you owe it to yourself to find another doctor who believes in you and will work with you to help reduce your symptoms.
- Why does my doctor think I just need to exercise?
Although some degree of regular exercise is essential for maintaining function, and if done in warm water, it can improve circulation. Yet, exercise alone will not be enough to treat your fibromyalgia. Many studies on the use of exercise to treat fibromyalgia have been published over the years, and while the documented benefits are minimal, these studies are heavily promoted at medical conferences and widely publicized in the medical journals. Exercise is easy to prescribe and doesn’t cost anything, so it tends to be one of the first therapies that a doctor recommends for fibromyalgia. Yet, you have to be careful because over-working any one muscle will cause others to hurt more.
- What is fibromyalgia pain like?
The pain of fibromyalgia has no boundaries. People describe the pain as deep muscular aching, throbbing, shooting, and stabbing. Intense burning may also be present. Quite often, the pain and stiffness are worse in the morning, and you may hurt more in muscle groups that are used repetitively.
- What is the fatigue like?
This symptom can range from mild to incapacitating. The fatigue has been described as “brain fatigue”—patients feel totally drained of energy. Many patients say that they feel as though their arms and legs are tied to concrete blocks, and they have difficulty concentrating (i.e., brain fog). Fibromyalgia fatigue is definitely not just being tired!
- How common are headaches in fibromyalgia?
Recurrent migraine or tension-type headaches are seen in about 70% of fibromyalgia patients and can pose a major problem in coping for this group. For some people, aggressive treatment of the migraines also provides tremendous relief of the overall pain of fibromyalgia. Myofascial trigger points, or those knots in your neck and shoulder muscles, are the primary cause of your headaches and they can be treated.
- What factors aggravate the symptoms of fibromyalgia?
Changes in weather, cold or drafty environments, hormonal fluctuations (premenstrual and menopausal states), stress, depression, anxiety, infections (flu or a cold), and over-exertion can all contribute to symptom flare-ups. Repetitive use of the same muscle group can strain the muscles and lead to more pain.
- Is fibromyalgia genetic (i.e., does it run in families)?
Fibromyalgia does run in families and there appears to be a strong genetic component. If one parent has this condition, the odds that a child will develop it is estimated to be 50%. Many research studies are under way to look at the genetic abnormalities that might be linked to various neurotransmitters involved in both pain and sleep regulation.
- What medical specialist should I see for treating my fibromyalgia?
The best doctor to see is one who has lots of experience treating fibromyalgia patients. There is no specific medical specialty that “owns” this condition, so it is important to inquire about a physician’s level of experience and their general philosophy for treating fibromyalgia.
- Does fibromyalgia get worse over time?
Studies show that roughly 25% of patients get worse over time, but another 25% get better. Some patients may be likely to improve because they have a good doctor willing to work with them to find which therapies they respond to. Also, as people age, other medical conditions can aggravate the symptoms of fibromyalgia, so it is imperative that patients seek aggressive treatment for age-related conditions, such as arthritis. A preventive medicine program with maintenance exercises and a healthy diet may prove worthwhile.
- Does weather affect symptoms and, if so, what climate is best for fibromyalgia?
Only a few studies have been conducted on this topic, and most indicate that variations in barometric pressure (which occur when a storm front moves in) may worsen the symptoms. In addition, extreme cold weather and cool drafts can cause you to shiver and this will make your tight, knotted muscles more sore.
- Is there a special diet I should be eating?
No, but a diet full of fruits and vegetables may supply your body with antioxidants, which are known to be useful for protecting your tissues and to minimize the development of “other” sources of pain.
A balanced plan for treating fibromyalgia should include both drug and nondrug therapies. Exercise, in particular, has been touted as a nondrug treatment for fibromyalgia. If approached the wrong way, however, exercise can cause pain and other symptoms of fibromyalgia to flare.
Is there a diet that will “cure” fibromyalgia? No. However, a diet full of fruits and vegetables may supply your body with additional antioxidants and nutrients like malic acid found in apples, and calcium found in deep green vegetables. Antioxidants are considered to be beneficial for minimizing the destructive effects that can occur in tissues when the body generates certain reactive chemicals, called free radicals.
In addition to a healthy diet, several vitamins and nutritional supplements have been found to be beneficial for a variety of chemical imbalances to help you improve the quality of your life. For example, melatonin is known to improve the quality of your sleep, although it may not be a strong enough hypnotic to get you to sleep.
Exercise will help you stay functional while giving you that positive mental boost. It is also known to decrease anxiety and depression, which can negatively impact the way you cope with your symptoms. Doctors agree that aerobic exercise increases blood flow and oxygen to the muscles and surrounding tissues to help nourish them. It also improves circulation, regulates blood pressure and body weight, and strengthens the heart, among other benefits. While this is all well and good, how will you face the challenge of beginning an exercise program without throwing your body into a flare up?
You need to take a mindful approach of what you are physically doing:
- Work with your doctor or physical therapist before starting any exercise program
- Avoid intense activity
- Think “moderate” exercise
- Understand your limitations
- Choose activities you can do and enjoy doing
- Start slowly in short increments of activity coupled with rest and build up slowly
- Stretch properly before each activity
In addition, there are several therapies involving massage, yoga, and self-help aids to ease soreness that may arise from exercise.