Fibromyalgia is a disease that causes constant widespread dull joint and muscle pains, adversely affecting daily activities. It is unfortunately a condition the medical community is still unsure about and serves as a black box label for a range of pain-related symptoms. What we do know is that fibromyalgia affects over five percent of the population with greater rates in women than men. It is typically diagnosed in people between the ages of 20-55, although it can affect children and elderly people as well. Current studies suggest that there might be a genetic component, given that it runs in families.
Others argue that an infection or intense physical or emotional trauma might be the root cause of the disease. A consensus agreement is that people who suffer from fibromyalgia have an increased neurological sensitivity to pain signals compared to others.
Symptoms and Diagnoses:
There is a long list of symptoms that are associated with the disease. Patients may experience some or all of them which makes diagnosing fibromyalgia tricky given that clinical presentations differ. Even factors such as time of day, weather, physical activity and stress could change symptoms in the same individual adding to the complexity of accurately diagnosing the disease. To help doctors, the American College of Rheumatology established two criteria that have to be met. A patient must have:
1) widespread pain lasting more than three months and
2) at least 11 positive tender points out of 18 areas (pain elicited by applying pressure to 18 specific parts of the body during a physical exam)
The list below from WebMD provides a very good description of other symptoms that might accompany fibromyalgia:
- Chronic muscle pain, muscle spasms or tightness, weakness in the limbs and leg cramps
- Moderate or severe fatigue and decreased energy
- Insomnia or waking up feeling just as tired as when you went to sleep
- Stiffness upon waking or after staying in one position for too long
- Difficulty remembering, concentrating, and performing simple mental tasks
- Abdominal pain, bloating, nausea, and constipation alternating with diarrhea (irritable bowel syndrome)
- Tension or migraine headaches
- Jaw and facial tenderness
- Sensitivity to one or more of the following: odors, noise, bright lights, medications, certain foods and cold
- Feeling anxious or depressed
- Numbness or tingling in the face, arms, hands, legs, or feet
- Increase in urinary urgency or frequency (irritable bladder)
- Reduced tolerance for exercise and muscle pain after exercise
- A feeling of swelling (without actual swelling) in the hands and feet
- Painful menstrual periods
- Dizziness
Treatment
Since fibromyalgia is essentially a pain-related disorder, treatment involves analgesics such as over-the-counter Extra-Strength Tylenol, Advil or Aleve in combination with other drugs. Anti-depressants have been found to be very effective in helping patients sleep better and reducing the fatigue usually found in fibromyalgia. Common anti-depressants typically prescribed include Prozac and Cymbalta. Some doctors recommend anti-seizure medication such as Gabapentin (Neurontin) or Lyrica. Others encourage their patients to combine drug therapy with physical or cognitive therapy. Ultimately, the goal of treatment is to help reduce symptoms as much as possible in order to allow the patient to resume his or her daily activities with very little discomfort.
No one deserves to be in pain especially for an extended period of time. Making our patients comfortable has become one of the focal points of medical care today. It is important to bring up the issue with your medical provider even if they fail to ask you directly about pain-related symptoms during your regular clinic visits. It is especially important to talk with them if you are experiencing the above symptoms chronically. It just might be fibromyalgia and fortunately, a lot can be done to make you feel much better.
All health articles at Obaasema are intended to educate and must not be substituted for professional medical advice.
Sources & for further information:
1) MayoClinic. Fibromyalgia. Available at http://www.mayoclinic.com/health/fibromyalgia/DS00079
2) WebMD. Fibromyaglia Symptoms. Available at http://www.webmd.com/fibromyalgia/understanding-fibromyalgia-symptoms
3) Picture: http://www.scientificamerican.com/media/inline/new-study-antidepressants-fibromyalgia_1.jpg