What is
Fibromyalgia?
Fibromyalgia is a condition characterised by pain in joints,
muscles, tendons, and other soft tissues. The pain occurs in areas
called ‘tender points’. Common tender points are the front of the
knees, the elbows, hip joints and around the neck.
What are the causes?
The cause of this disorder is unknown. Physical or emotional
trauma may play a role in development of this syndrome.
Fibromyalgia patients have abnormal pain transmission responses.
It can develop on its own, or secondary to other musculoskeletal
conditions, such as rheumatoid arthritis, or systemic lupus.
It has been suggested that sleep disturbances, which are common in
fibromyalgia patients, may actually cause the condition. The
disorder may be associated with changes in skeletal muscle
metabolism, possibly caused by decreased blood flow, which could
cause chronic fatigue and weakness. Others have suggested that an
infectious microbe, such as a virus, triggers the illness. No such
virus or microbe has yet been identified. Studies have shown a
possible inherited tendency toward the disease, though evidence is
very preliminary.
What are the symptoms?
Increased sensitivity to pain is the main symptom of fibromyalgia.
Symptoms may come and go. One may have some degree of constant
pain, but the pain may get worse in response to activity, stress,
weather changes and other factors. One may also have a deep ache
or a burning pain, muscle tightening or spasms. Many people have
migratory pain (pain that moves around the body). Most people with
fibromyalgia feel tired or fatigued (out of energy). This fatigue
may be mild or very severe. They may also have trouble sleeping,
which may add to the fatigue. One has feelings of numbness or
tingling in parts of the body, or a feeling of poor blood flow in
some areas. Many people are very sensitive to odours, bright
lights, loud noises and even medicines. Headaches and jaw pain are
also common.
In addition, one may have dry eyes or difficulty focusing on
nearby objects. Problems with dizziness and balance may also
occur. Some people have chest pain, a rapid or irregular
heartbeat, or shortness of breath. Digestive symptoms are also
common in fibromyalgia and include difficulty swallowing,
heartburn, gas, cramping abdominal pain, and alternating diarrhoea
and constipation. Some people have urinary complaints, including
frequent urination, a strong urge to urinate and pain in the
bladder area. Women with fibromyalgia often have pelvic symptoms,
including pelvic pain, painful menstrual periods and painful
sexual intercourse.
* Multiple tender areas (muscle and joint pain) on the back of the
neck, shoulders, sternum, lower back, hip, shin, elbows, knees.
* Fatigue
* Sleep disturbances
* Body aches
* Reduced exercise tolerance
* Chronic facial muscle pain or aching
How is it diagnosed?
Diagnosis of fibromyalgia requires a history of a least three
months of widespread pain, and pain and tenderness in at least 11
of 18 tender-point sites. Number of tests may be done to rule out
other disorders. An examination reveals multiple tender areas on
the back of the neck, shoulders, sternum, lower back, hip, shin,
elbows, or knees.
Sometimes, laboratory and X-ray tests are done to help confirm the
diagnosis. The tests will also rule out other conditions that may
have similar symptoms. Other underlying ailments, such as chronic
fatigue syndrome, irritable bowel syndrome, and rheumatoid
arthritis, can also be present. New patients should be checked for
these underlying conditions as well as fibromyalgia.
What is the treatment?
In mild cases, symptoms may go away when stress is decreased or
lifestyle changes are implemented. A combination of treatments
including medications, patient education, physical therapy, and
counselling are usually recommended. Many fibromyalgia sufferers
have found support groups helpful. Certain classes of
antidepressant medications are sometimes prescribed for the
disorder. Antidepressants in low doses can decrease depression,
relax craniofacial and skeletal muscles, improve sleep quality,
and release pain-killing endorphins. Other medications that are
used include anti-inflammatory pain medications and medications
that work on pain transmission pathways. Eating a well-balanced
diet, and avoiding caffeine may help with problems of sleeping,
and may help reduce the severity of the symptoms. Lifestyle
measures to improve the quality of sleep can be effective for
fibromyalgia.
Improved fitness through exercise is recommended. Fibromyalgia
symptoms can be relieved by aerobic exercise. The best way to
begin a fitness programme is to start with low impact exercises,
like walking and swimming. Starting slowly helps stretch and
mobilise tight, sore muscles. High-impact aerobics and weight
lifting could cause increased discomfort. Gentle stretching and
light massage may help relieve symptoms, as do relaxation
techniques. Severe cases of fibromyalgia may require a referral to
a pain clinic.
What is the prognosis?
Fibromyalgia is a common and chronic problem. The symptoms
sometimes improve. At other times, the symptoms may worsen and
continue for months or years. The key is seeking professional help
which includes a multi-faceted approach to the management and
treatment of the disease. There is no proof that fibromyalgia
syndrome results in an increased death rate.
Fibromyalgia is
a chronic condition characterized by widespread pain in your
muscles, ligaments and tendons, as well as fatigue and multiple
tender points
People, suffer from one
or
more chronic diseases
Healthcare Provider
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