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Fibromyalgia
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Fibromyalgia is a condition of chronic, all-over pain and fatigue. It is an insidious disease that has no obvious test for the disease, making it a diagnosis of exclusion. The pain is mostly located in the tendons, ligaments and muscles and there is fatigue that is not improved by rest. The entire body aches and it inhibits movement and activities. It occurs in 2 percent of the population of the US. It is much more common in women and is something that increases with age. It happens after a psychological or physical trauma most often but can have no trigger.
The signs and symptoms of fibromyalgia can be different depending on the individual, the level of physical activity, stress and the weather. The pain is a continuous dull aching pain that comes from the muscles primarily. It is usually present on both sides of the body and should occur both above and below the waist in order for the condition to be fibromyalgia.
Fibromyalgia has the following symptoms: tender points that hurt when pressure is applied to them, chronic fatigue not improved by rest. Tender locations include the following areas:
- Between the shoulder blades
- Back of the head
- Shoulders
- Front or sides of neck
- Outer aspect of elbows
- Upper chest
- Upper hips
- Sides of hips
- Inner aspect of knees
There are also co-existing conditions that seem to go along with fibromyalgia. They include depression, headaches, endometriosis, chronic fatigue syndrome, lupus, post traumatic stress disorder, irritable bowel, osteoarthritis, rheumatoid arthritis and restless legs syndrome.
The cause of fibromyalgia is unknown. It is believed to be caused by a combination of genetics, in which several family members are involved, infections, and physical or emotional trauma. It is believed that the brain has a decreased level of pain threshold and is more sensitive to pain signals. Chemicals in the brain that cause the pain signals are believed to be increased so that small amounts of pain cause a great perception of pain.
Risk factors for fibromyalgia include advancing age, especially middle and early adulthood, gender, being more frequent in women than in men. Sleep difficulties are common as is family history. If you have rheumatic disease, you have an increased likelihood of developing fibromyalgia.
The diagnostic criteria include: pain that lasts at least three months and having at least eleven out of 18 trigger points of pain.
The doctor will do an examination to diagnose fibromyalgia and this can include a test for trigger points. A blood test for white blood cell count can show if there are other diseases that can be the cause of the pain, an erythrocyte sedimentation rate can show if there is inflammation and thyroid function testing can determine if the thyroid is responsible for the fatigue and pain. There are tests for lupus and rheumatoid factor that can be done to see if the pain is due to an inflammatory disease.
In treating fibromyalgia, there are anti-inflammatory medications or medications like Ultram that can control the pain. Tylenol can help some people. Antidepressants such as amitriptyline or fluoxetine (Prozac) seem to help the pain of fibromyalgia. Cymbalta is also known to control fibromyalgia pain. Anti-seizure drugs seem to reduce certain types of pain. Lyrica is a newer medication that is specifically designed to control fibromyalgia pain.
There is always physical therapy as a way to control fibromyalgia pain. There are exercises that can reduce the pain of fibromyalgia, including stretching exercises and regular exercises. Local ice and heat make a difference to the pain as well.
Some people improve with psychological counseling. This includes therapy to help you improve your ability to cope with stress so the pain doesn't get out of control. Yoga and meditation also seem to help control the pain.