You hurt all over and you frequently feel exhausted. Even after numerous tests, your doctor can’t seem to find anything specifically wrong with you. Are you experiencing a set of symptoms that sound familiar? You might be affected by fibromyalgia – it’s estimated that between 3 – 8 million people in the US are living with this condition. Approximately 80-90% of cases are in females.
Fibromyalgia is an ongoing health issue that causes severe fatigue and widespread pain in the muscles, tendons, and ligaments. In the past, conditions like Fibrositis, psychogenic rheumatism, muscle pain syndrome, and tension myalgias were all called by different names.
In the year 1990, ACR (American College of Rheumatology) defined a clear set of criteria for diagnosing fibromyalgia. To diagnose a patient with fibromyalgia, the ACR stipulates that at least 11 out of 18 different body areas must be painful when pressure is applied. Additionally, you must have been experiencing a generalized state of discomfort for at least 3 months.
Signs and symptoms of fibromyalgia can vary, depending on weather, stress, physical activity, or even just the time of day. Different people experience different signs and symptoms, but common signs and symptoms include:
Fibromyalgia is characterized by pain in specific areas of your body when pressure is applied. These areas include the back of your head, upper back, neck, upper chest, elbows, hips, and knees. Chronic pain can be quite debilitating, lasting for prolonged periods. This is usually accompanied with a feeling of stiffness in the body.
People suffering from fibromyalgia commonly experience fatigue and an unrefreshed feeling even if they have had enough sleep. Some studies suggest that this problem is the result of a sleep disorder called alpha wave interrupted sleep pattern, a medical condition in which deep sleep is frequently interrupted by bursts of brain activity similar to wakefulness. Due to fibromyalgia, individuals don’t experience the restorative benefits of sleep (stage 4). Nighttime muscle spasms in your legs (periodic limb movement disorder or nocturnal myoclonus) and restless legs syndrome also may be associated with fibromyalgia.
Fibromyalgia sufferers often experience the unpleasant symptoms of constipation, diarrhea, abdominal pain and bloating which are associated with (IBS).
Many people who have fibromyalgia also have recurrent tension-type headaches that may be related to tenderness in the neck and shoulders. Facial pain is common, and as many as one-third experience jaw pain — temporomandibular joint (TMJ) dysfunction.
It’s common for people with fibromyalgia to report being sensitive to odors, noises, bright lights, touch, and changes in weather.
As many as one-third of people with fibromyalgia also experience depression.
Doctors believe that there isn’t one single cause of fibromyalgia. Rather, a number of factors may contribute. These factors may include:
Some people with fibromyalgia appear to have alterations in the regulation of certain brain chemicals called neurotransmitters. This may be particularly true of serotonin — which is linked to depression, migraines, and gastrointestinal distress — and substance P, a brain chemical associated with pain, stress, and anxiety, as well as depression.
It has been suggested by some scientists that irregular sleeping habits may be triggering fibromyalgia, rather than being just a symptom of it. Studies have shown abnormally low levels of a hormone called somatomedin C in the blood of people with fibromyalgia. Somatomedin C is thought to be essential for the body to rebuild itself and is secreted only during stage 4 sleep.
Fibromyalgia can be triggered in some individuals due to a traumatic event or injury, mainly in the upper spinal region. An injury may affect your central nervous system, which might trigger fibromyalgia.
Fibromyalgia may be triggered by a viral or bacterial infection, which is what some studies suggest.
Your autonomic nervous system is divided into the sympathetic and parasympathetic systems. Your sympathetic nervous system releases norepinephrine and influences the release of epinephrine from the adrenal gland. The sympathetic nervous system also controls bodily functions that you don’t consciously control, such as heart rate, blood vessel contraction, sweating, salivary flow, and intestinal movements.
Several studies have looked at the responses of the sympathetic nervous system in people with fibromyalgia. Recent studies have suggested that people may experience fewer adrenaline responses to low blood sugar and exercise.
Other reported abnormalities include decreased responses to cold and altered heart rate and blood pressure responses during tilt-table testing — a noninvasive procedure normally used to help diagnose a common form of fainting (syncope).
During the test, you lie on a bed that moves from a horizontal to a vertical position while your blood pressure and heart rate are monitored.
Decreased strength and fatigue can be attributed to deconditioning and the reduction in blood flow. Variations in metabolic processes as well as irregularities in neuroendocrine hormones that affect nerve activity may contribute to the occurrence of the issue.
Fibromyalgia could be linked to mental distress and fluctuations in hormones.
Risk factors for fibromyalgia include:
It’s estimated that fibromyalgia occurs much more often in women than in men.
Fibromyalgia tends to develop in people between the ages of 20 and 60. But it can occur in children.
It is still not known whether fibromyalgia is triggered by sleeping troubles or if sleeping troubles are a consequence of living with fibromyalgia. Still, people with sleep disorders such as nighttime muscle spasms in the legs, restless legs syndrome, or sleep apnea can also develop fibromyalgia.
According to research, the chances of developing fibromyalgia are higher if a relative is already suffering from it.
Diagnosing fibromyalgia is difficult because there isn’t a single, specific diagnostic laboratory test. It may take a while before you can get confirmation of fibromyalgia since medical tests like blood work and X-rays typically come back with normal results. It is only after this that fibromyalgia can be diagnosed. Although these tests may rule out other conditions, such as rheumatoid arthritis, lupus, and multiple sclerosis, they can’t confirm fibromyalgia.
The American College of Rheumatology has put together a comprehensive set of guidelines on classifying fibromyalgia, to facilitate the evaluation and research surrounding this disorder. According to the regulations, in order to be eligible, you must have been experiencing widespread pain for 3 or more months, as well as having 11 or more spots on your body that are sensitive when lightly touched. In addition to taking your medical history, a doctor checking for fibromyalgia will press firmly on specific points on your head, upper body, and certain joints so that you can confirm which causes pain.
However, not all doctors agree with the guidelines. Some believe that the criteria are too rigid and that you can have fibromyalgia even if you don’t meet the required number of tender points. Doubts have been raised about the accuracy and usefulness of tender points as a tool for diagnosis.
Fibromyalgia is usually treated through a combination of medications and self-care measures. The focus is on minimizing any signs or indications of disease and enhancing overall well-being.
People with fibromyalgia can find relief from their pains with the use of prescribed medications. The ones most commonly recommended by doctors include:
These over-the-counter pain relievers may ease the pain and stiffness caused by fibromyalgia. However, their effectiveness varies with individuals. In addition, frequent or long-term use of aspirin and ibuprofen, also known as nonsteroidal anti-inflammatory drugs (NSAIDs), can cause serious side effects, including stomach pain, bleeding, or ulcers. Prolonged use of acetaminophen can potentially cause harm to your kidney or liver.
Your doctor may prescribe antidepressant medications, such as amitriptyline (Elavil), nortriptyline (Pamelor), trazodone (Desyrel), or doxepin (Sinequan) to help promote sleep. Fluoxetine (Prozac) in combination with amitriptyline has also been found effective. Sertraline (Zoloft) and paroxetine (Paxil) also are effective if you’re suffering from depression. Elevating serotonin levels in the brain could be a potential benefit of taking these medications. Taking antidepressants can bring on a range of side effects, such as dry eyes and mouth, constipation, and increased appetite.
In the early to mid-1990s, there were a few short-term studies with a small number of fibromyalgia patients using benzodiazepines, some in combination with NSAIDs, and the results were variable. Usually, doctors avoid benzodiazepines in treating fibromyalgia since they haven’t been shown to have long-term benefits and have the potential for drug dependence.
Prescription sleeping pills, such as zolpidem tartrate (Ambien), may provide short-term benefits for some people with fibromyalgia, but doctors usually advise against long-term use of these drugs. These medications tend to work for only a short time, after which your body becomes resistant to their effects. Sleeping pills may provide temporary relief from fibromyalgia insomnia, however, in the long run it can exacerbate sleeping difficulties.
Doctors don’t usually recommend narcotics for treating fibromyalgia because of the potential for dependence and addiction. Corticosteroids, such as prednisone, haven’t been shown to be effective in treating fibromyalgia.
Complementary and alternative therapies for pain and stress management aren’t new. Meditation and yoga are two ancient forms of practice that have been around for millennia. Nevertheless, their use has been on the rise lately, predominantly among people suffering from chronic illnesses like fibromyalgia.
Several of these treatments do appear to safely relieve stress and reduce pain, and some are gaining acceptance in mainstream medicine. But many practices remain unproved because they haven’t been adequately studied.
Some of the more common complementary and alternative treatments promoted for pain management, and the current thinking about their effectiveness and safety, include:
This treatment is based on the belief that if movement in the spine is limited, then it could lead to lowered performance and aches. Spinal adjustment (manipulation) is one form of therapy chiropractors use to treat restricted spinal mobility. The goal is to restore spinal movement and, as a result, improve function and decrease pain. Chiropractors manipulate the spine from different positions using varying degrees of force. Manipulation doesn’t need to be forceful to be effective. Chiropractors can use massage and stretching to ease contracted muscles or those in spasms. This helps them to provide relief from pain, tension, and stiffness. Because manipulation has risks, always use properly trained and licensed practitioners.
Traditional healthcare methods have been around for centuries and are still being used today. It involves the use of different manipulative techniques to move your body’s muscles and soft tissues. The therapy aims to improve circulation in the muscle, increasing the flow of nutrients and eliminating waste products. Massage can reduce your heart rate, relax your muscles, improve the range of motion in your joints and increase the production of your body’s natural painkillers. It often helps relieve stress and anxiety. Although massage is usually considered a safe practice if you have any open sores, acute inflammation, or circulatory problems.
Doctors of osteopathy go through rigorous and lengthy training in academic and clinical settings. They’re licensed to perform many of the same therapies and procedures as traditional doctors. Osteopathic medicine departs from the traditional forms of healing in one key aspect: the use of manipulation to resolve spinal and joint issues, similar to what chiropractic medicine does. Again, this is an area of controversy, but many studies support osteopathic techniques for many joint and muscle conditions.
Both acupressure and acupuncture stem from the Chinese belief that 14 invisible pathways, called meridians, lie beneath your skin. In this belief, when the life force that runs through these meridians is interrupted, you become ill. Practitioners restore the flow of energy by applying pressure with their fingers (acupressure) or by inserting very fine needles (acupuncture) into the skin. There has not been definitive research to explore the potential advantages of acupressure. But according to the National Institutes of Health, acupuncture to help control pain associated with fibromyalgia may be effective.
Besides dealing with the pain and fatigue of fibromyalgia, you may also have to deal with the frustration of having a condition that’s often misunderstood. Becoming more knowledgeable on fibromyalgia can help you cope with the disease, but it’s also beneficial to give your loved ones, colleagues and associates an understanding of the condition.
It’s also helpful to know that you’re not alone. Organizations like the Arthritis Foundation and the American Chronic Pain Association offer educational classes and support groups to aid patients. With the help of these groups, you can gain unique and invaluable insights and access to useful advice that you can’t find anywhere else. They can also help put you in touch with others who have had similar experiences and can understand what you’re going through.
Cognitive-behavioral therapy teaches you how to manage and control your thoughts, feelings, and behaviors in order to cope with stress. Therapy can be provided via individual counseling, audiotapes, or classes, and may help you manage your fibromyalgia.
Interdisciplinary treatment programs may be effective in improving your symptoms, including relieving pain and depression. These programs can combine a variety of treatments, such as relaxation techniques, biofeedback, and receiving information about chronic pain. There isn’t one combination that works best for everybody. Your physician can tailor a treatment plan that is best suited to your needs and condition.
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