Fibromyalgia

Fibromyalgia

In a nutshell, fibromyalgia is a chronic central nervous system disorder that causes widespread pain, stiffness and tenderness of the muscles, tendons and ligaments. People who suffer from this condition have “tender points” in specific locations on their bodies (usually on the neck, collarbone, chest, upper back, sides of the spine, inside of either arm at the elbow, lower back, knee caps and buttocks) that hurt when touched or pressed.

A common misconception about fibromyalgia is that it is a “new condition.” However, it has existed for centuries. Historical records dating as far back as 1500 BCE report cases of people with fibromyalgia-like symptoms.

Throughout much of history fibromyalgia was considered a mental problem. It wasn’t until the early 1820s that it was classified as a rheumatoid disorder. Back then it was called fibrositis, because many doctors believed pain was caused by inflammation throughout the body.

In 1976, the condition was renamed fibromyalgia—a name derived from the Latin word “fibro” (fibrosis tissue), and the Greek terms for “myo” (muscle) and “algia” (pain). In 1987 the American Medical Association first recognized fibromyalgia as a disease entity and a cause of physical illness. Three years later in 1990, the American College of Rheumatology (ACR) established diagnostic criteria to help physicians diagnose fibromyalgia: that there must be a history of pain for at least three months, and pain in at least 11 of the body’s 18 “tender points.”

Today, it is estimated that between 2 and 5 percent of Americans suffer from fibromyalgia. The disease is seven times more common in women than men, and the majority of sufferers develop the condition between the ages of 25 and 55. Fibromyalgia is relatively uncommon in children and the elderly.

Causes

Doctors do not know the exact cause of fibromyalgia. However, research has shown that people with fibromyalgia have shortages of certain chemicals in the brain called neurotransmitters. These are the substances responsible for transmitting messages between brain cells and nerves. The low levels of neurotransmitters result in increased pain sensitivity and pain sensation.

Researchers believe certain factors may trigger the disorder. Having a family history of fibromyalgia, being sick with certain diseases (such as rheumatoid arthritis, lupus or Epstein-Barr virus), or exposure to traumatic or stressful events (such as a serious car accident or an act of violence) could predispose individuals to developing fibromyalgia.

Symptoms

In addition to widespread pain, fibromyalgia can also be accompanied by a wide range of other symptoms, including:

  • Sleep disturbances.
  • Chronic fatigue (despite getting plenty of rest).
  • Morning stiffness.
  • Sensitivity to loud noise or bright light.
  • Irritable bowel syndrome (diarrhea, constipation, abdominal pain and gas).
  • Tension headaches.
  • Dry mouth or eyes.
  • Leg cramps.
  • Cold or heat intolerance.
  • Problems with balance, coordination or dizziness.
  • Difficulty swallowing.
  • Numbness and/or tingling in the hands or feet.
  • Extreme mood swings.
  • Anxiety and/or depression.
  • Difficulty focusing or concentrating.
  • Cognitive dysfunction and poor memory.

Fibromyalgia symptoms may fluctuate in intensity from time to time, or may gradually improve or worsen. Factors such as changes in weather patterns, inadequate or excessive sleep, too much or too little physical activity, and facing stressful situations can affect the severity of your fibromyalgia and cause your symptoms to “flare up.” On the other hand, there may be other periods of time when your symptoms are hardly noticeable.

Diagnosis

Fibromyalgia can be difficult to diagnose. In big part that’s because there is no “standard” set of symptoms; what one sufferer experiences may be very different from another person. Furthermore, many of the symptoms of fibromyalgia overlap with other chronic pain conditions. That is why other potential causes of the symptoms must be ruled out before making a diagnosis of fibromyalgia.

Still, a physician familiar with fibromyalgia will be able to make a proper diagnosis. The first step is a thorough medical examination. Your physician will evaluate you based on the criteria established by the ACR in 1990. You must have had at least three months of widespread pain, and pain must be present in both the right and left sides of your body as well as above and below the waist. You will be examined to see if you have tenderness in at least 11 of 18 “tender points” on your body. (If you have fibromyalgia, you may have pain at other sites, too, but these 18 sites identified by the ACR are the ones used for diagnosis.)

A variety of other tests may be conducted to rule out other conditions that commonly present with fatigue, (such as anemia chronic fatigue syndrome, hypothyroidism and arthritis). These tests include electro-diagnostic testing, neuroradiological imaging, sleep studies, urine tests and blood tests (to check blood count, antibodies, thyroid and liver function, etc.).

Be forewarned that testing for fibromyalgia can be time consuming and take many months. It’s very important to stay informed throughout the process. If you don’t understand the test results or why certain tests are being conducted, ask your doctor.

Treatment

Fibromyalgia can last a long time—possibly your entire life. Unfortunately there is no cure for this abnormality. However, there are ways to manage the pain.

Treatment of fibromyalgia includes medication (fibromyalgia drugs such as duloxetine, pregabalin and milnacipran, along with pain relievers, muscle relaxants and antidepressants) and physical therapy, acupuncture and acupressure to control the body’s response to pain.

Lifestyle modifications, such as regular exercise, dietary changes (eating a high-fiber, low-fat diet and limiting caffeine), good sleep hygiene, and stress management (i.e., hypnosis, meditation, massage therapy and biofeedback) may also help relieve some of the symptoms.

The bottom-line is you don’t have to let the pain of fibromyalgia prevent you from living your life and doing the things you want to do. If you suffer from chronic, widespread pain, contact Advanced Pain Consultants to schedule an examination with Dr. Pasi. We offer a full range of medication and treatment options that target fibromyalgia pain and fatigue, and help you get your life back.