Fibromyalgia

What is Fibromyalgia?

Fibromyalgia is a chronic state which results in stiffness and soreness of muscles, tendons and joints. Fibromyalgia causes pain and is portrayed by sleep disturbances, tiredness, fatigue, bowel disturbances, depression and anxiety. It is also known as fibromyalgia syndrome and may be abbreviated as FMS. Fibromyalgia was referred to as fibrositis formerly.

Fibromyalgia is one of the common conditions that affect muscles resulting in chronic pain and disability. The causes of fibromyalgia are still not known. An important characteristic of fibromyalgia are the tissues involved in generating pain have nothing to do with inflammation. Thus, patients do not develop any deformity or severe damage to the body. The condition does not cause any damage to internal organs which makes it quite different from other rheumatic disorders. In these diseases and disorders, pain , stiffness and tenderness which results from inflammation which can lead to deformity and damage to joints, muscles and  internal organs.

fibro

Statistics

Women have a higher incidence rate of fibromyalgia when compared to men. More than 80% of fibromyalgia cases presented are women aged between 35 and 55. Although less common, fibromyalgia can affect children, men and the aged.  Fibromyalgia can occur by itself or maybe related to other diseases like rheumatoid arthritis or systemic lupus. The incidence rate also differs from one country to another. In countries like Sweden and Britain, 1% of the total population are estimated to be afflicted with fibromyalgia. In the United States, around 4% of the total population are affected by fibromyalgia.

Causes of Fibromyalgia

As previously mentioned, the exact cause of fibromyalgia is still not known. Patients afflicted with this condition experience pain as a result of a stimuli, which in normal situations would not be regarded as painful. Researchers have discovered that there are high levels of substance P, a nerve chemical signal, and nerve growth factor. These are found in the spinal fluid of affected patients. In addition, serotonin, a brain chemical or neurotransmitter, is comparatively low in fibromyalgia patients. Research and studies conducted on pain of fibromyalgia patients have concluded that the brain (central nervous system) is by some means ‘supersensitive’. This phenomenon lead to a disturbance in the perception of pain. Additionally, fibromyalgia patients have impaired non-REM or non rapid eye movement, sleep phase. The commencement of this condition is often linked to psychological trauma, infection and stress.

Signs and Symptoms of Fibromyalgia

The major symptom associated with fibromyalgia is pain which is not caused by inflammation of tissue. Fibromyalgia patients have an increased  sensitivity to the many different sensory stimulants they might encounter. In addition, they have an uncommon low threshold to pain. Therefore, certain pain stimuli, considered as minor sensory stimuli, which would not cause excruciating pain in a normal person can become a very severe condition in fibromyalgia patients. Moreover, the body pain can worsen by noise, changes of weather and mental stress and trauma. The pain felt by fibromyalgia patients are often prevalent and widespread which generally affects both sides of the body. Pain can be felt in the neck, arms, shoulder areas, rear end, back (upper) and the chest areas. Tender points are areas in the body that are tender to touch, even if it is just light touch. Tender points or pressure points  of fibromyalgia patients can arise and are often found near and around elbows, knees, back of head, hips, shoulders, sides of sternum,etc. These are the common signs of fibromyalgia. Another common sign, felt almost by 90% of the fibromyalgia patients, is fatigue. Fatigue can be linked to the abnormal and irregular sleep patterns seen in patients who have this condition. Several degrees of the depth of sleep has been observed. In order to be refreshed, a person should have enough deep sleep. This is considered more important than the number of hours a person may sleep for. Alas, patients with this condition do not have deep sleeps which can be restorative and therapeutic. This is called ‘non-rapid eye movement’ or non-REM sleep. As a result, patients who wake up in the morning do not feel completely relaxed or rested although they would have slept for a number of hours which would seem adequate. Some patients wake up with muscle ache and muscle fatigue, like they have working all night long rather than being asleep. Emotion and/or mental stress and disturbance have been reported in more than half of the patients who suffer from fibromyalgia. These mental symptoms may include, lack of concentration and the ability to remember and recall, absentmindedness, mood swings, touchiness, apprehension and depression. Doctors are unable to confirm fibromyalgia as it is rather difficult and no appropriate laboratory tests are available, thus fibromyalgia patients are frequently misdiagnosed. Doctors may misdiagnose them as having depression and not fibromyalgia. Patients afflicted with this condition may also have other symptoms like tension headaches and migraines, numbness or tingling sensation in certain areas of the body, pain in the abdominal region which may be linked to irritable bowel syndrome, bladder problems causing polyuria and painful urination.

Diagnosis of Fibromyalgia

There are no available blood tests or any other laboratory test that can accurately diagnose fibromyalgia. These tests, if performed  will let the medical doctors rule out the possibilities of the patient being afflicted with other medical conditions. Consequently, the diagnosis of fibromyalgia is dependent on clinical grounds. Therefore, a doctor will make his diagnosis based on medical history and a thorough physical examination. Some patients have a widespread body pain. In this case, doctors will diagnose fibromyalgia by identifying tender points. Typically, but not always the case, fibromyalgia patients may present at least 11 out of the 18 tender points of the condition. In addition, doctors will diagnose the condition based on finding pain which is not a result of any inflammation of tissues. He/she may also rule out all other possible medical conditions that have similar features to this illness.Some of these conditions include:-

  • Hypothyroidism- condition where there is low thyroid hormone levels in the body.
  • Vitamin D deficiency
  • Muscle and Bone diseases
  • Parathyroid disease which cause high calcium levels
  • Hypercalcemia- high levels of calcium in blood
  • Infectious diseases
  • Cancer

As mentioned before, there are no specific blood tests or any other tests that can confirm fibromyalgia in a patient. However, doctors may require a few tests to rule other medical conditions in order to diagnose the illness. Hence, thyroid and calcium levels in the blood may be needed to exclude conditions like hypothyroidism, hyperparathyroidism and hypercalcemia. In muscle diseases, like polymyositis, a muscle enzyme known as CPK is elevated. Similarly, in a bone disease, for example Paget’s disease, a bone enzyme called alkaline phosphatase is elevated. Consequently, a doctor may require the levels of these components in the blood in order for him/her to eliminate such medical conditions. In addition, doctors may ask for a complete blood count, CBC, or other liver tests to exclude hepatitis and other infectious diseases. Vitamin D deficiency is easily diagnosed by obtaining the levels of vitamin D.

 

Video of Fibromyalgia

Treatment for Fibromyalgia

Fibromyalgia treatment plans are said to be successful when they combine four components namely patient education, stress management, exercise and medications. The symptoms of fibromyalgia are quite extensive and is different from one patient to another. Therefore, treatment plans are generally personalised taking into account each individual’s needs. Studies have also shown that the most successful treatment for fibromyalgia include the combining the different approaches mentioned above.

Patient Education

Patient education is very important as it allows them to understand the illness and its symptoms in depth which will help them cope up with the condition. However, not all physicians and medical doctors out there are well acquainted with the details and particulars of the illness. Hence, one should enrol in community hospital support groups which could be of tremendous help. Branches of The Arthritis Foundation are also there to help patients. These have become very important sources of education for patients as well as doctors. The Arthritis Foundation is a nationwide health organisation which provides voluntary services in many sectors including public education. On the other hand, community hospital support groups allow patients to share their personal experiences with the illness as well as information about treatments that were successful and others which have failed. This type of information can be very advantageous to a patient.

Stress Management

It is not at all possible or extremely difficult to evaluate and measure the different levels of stress in patients. In some cases, patients may find spilling coffee a very stressful event whereas in some other cases a lorry bombarding into their living room might be just another day in their stressful lives. As a result, to manage or reduce stress in fibromyalgia patients, treatment should be personalised. Several methods may be employed in order to reduce stress. These include stress modification at workplace/home, counselling, support groups, support from family, friends, doctors, as well as relaxation tapes. Additionally, changes to certain environmental factors like noise, weather exposure, temperature,etc can be beneficial. Also, optimal number of hours of sleep is encouraged to reduce stress.

Exercise

Aerobic exercises like swimming, walking, cycling, etc can be very effective treatments for patients who are afflicted with this illness. Exercise routines is very beneficial to the patient if performed every other day. Exercises should be performed regularly and preferably in the morning hours. Although, exercise is widely accepted as a fine treatment for fibromyalgia, how exercise benefits a patient is still not known. It is believed that it may promote a more deep level of sleeping. Physical therapy when combined with regular exercises can be even more beneficial.

Diet

Avoiding caffeine and alcohol before retiring to bed can contribute to a better more peaceful sleep. Fibromyalgia diet generally consists of foods that promote restful sleep and such patients should prefer these types of food. On an important note, these changes in diet may not be helpful to everyone, only some find it useful. Additionally, there is no such thing as a fibromyalgia diet or supplements that are endorsed to all patients. For example, when patients experience irritable bowel syndrome, one should adjust his or her diet in such a way that would not worsen the condition. Similarly, when patients experience interstitial cytitis, one should adjust their diet in a way that food that would further irritate the bladder should be steered clear of.

Prognosis

The prognosis for fibromyalgia is generally good. This illness does not damage or threaten to damage any organs of the human body. Therefore, the outlook for patients with this condition is usually quite good without any serious damage. Patients who have a good understanding of the illness, combine different approaches to improve sleep, take time to follow some stress reduction techniques and those who follow regular exercise always tend to a lot better than other patients.

Prevention

It is important to understand that there is no method to prevent fibromyalgia. Symptoms of fibromyalgia can be managed and controlled with exercise, having a good night’s sleep, stress management and a good medical approach to the illness.

Future of Fibromyalgia Therapy

The causes of fibromyalgia are yet to be found. Researchers have been studying many different viruses. They suspect that viruses could be a potential cause of fibromyalgia. If an infectious organism or toxin is found to be the cause of the illness, then specific laboratory tests can be employed that will accurately diagnose the condition.

Conclusion

Fibromyalgia is a chronic state which results in stiffness and soreness of muscles, tendons and joints. Fibromyalgia causes pain and is portrayed by sleep disturbances, tiredness, fatigue, bowel disturbances, depression and anxiety without any inflammation. It does not cause any deformity or damage to the body. 90% of the patients report feeling fatigued. Additionally, irritable bowel syndrome can occur along with fibromyalgia. Sleep disturbances is very common among the patients. No tests are available that can diagnose the illness. Fibromyalgia treatment plans are said to be successful when they combine four components namely patient education, stress management, exercise and medications.     We will be expanding on this important topic in future articles. While I recommend you to register to download an e-book: “Adult Prevention Guide” for better health, a FREE

 

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The Team Manager Web Diseases

 

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