WHAT IS FIBROMYALGIA?
Fibromyalgia is characterized by chronic widespread pain, increased tenderness at specific areas of the body known as “tender points,” unrefreshing sleep, fatigue and cognitive dysfunction not attributable to other disease states. Fibromyalgia affects 2–4% of the general population and of those affected, 80–90% are female. In general, symptom onset occurs between the ages of 30 and 60.
WHAT CAUSES FIBROMYALGIA?
While the etiology of fibromyalgia is not entirely clear, associated disorders include mood disturbances (ie. Depression), anxiety, cognitive dysfunction, irritable bowel syndrome, irritable bladder syndrome, dizziness, cold intolerance, subjective swelling, paresthesiae, migraine, severe menstrual pain, myofascial facial pain, sexual dysfunction and temporomandibular joint syndrome. There may also associations with trauma and adverse life events.
WHAT ARE THE SYMPTOMS OF FIBROMYALGIA?
In addition to muscle pain, the following symptoms may be experienced:
- Trouble thinking clearly
- Flu-like symptoms
- Depression and anxiety
- Stomach pain
- Too many or too few bowel movements (diarrhea or constipation)
- Pain in the bladder or the need to urinate in a hurry or often
- Problems with the jaw
- Persistent fatigue despite adequate sleep
There are approved diagnostic criteria and symptom assessment tools used to diagnose fibromyalgia but set diagnostic test. Laboratory investigations and imaging may also be considered to rule out other conditions (ie. Arthritis) but are not needed to make a diagnosis.
Your health care provider may diagnose the condition if they can find no other cause, and if a person has:
- Muscle pain all over their body with or without other symptoms such as extreme fatigue
- Severe tenderness in at least 11 of the 18 known “tender points” of fibromyalgia- “tender points” on their body that hurt when touched or pressed on. These tender points are bilateral, meaning that they are the same on both the left and right side of the body. Most people with fibromyalgia have tenderness on at least 11 of the 18 points . They usually have also had pain throughout the body for at least three months.
HOW IS FIBROMYALGIA TREATED?
There is no cure or one set treatment method that works for fibromyalgia for everyone. Some people seem to recover from fibromyalgia with little to no return of symptoms. In most cases however, symptom management and helping people carry out their activities of daily living is the focus of treatment. Fibromyalgia has times when it seems worse but it does not get worse over time, and it is not life-threatening. You and your health care provider will need to work together to find the right mix of treatments for you. In general, treatment may include:
- Medicines to relieve pain such as medications normally used for depression or seizures which seem to work well with fibromyalgia pain. Opiods (i.e. Morphine or Dilaudid have not been shown to improve fibromyalgia pain)
- Medications to help improve sleep or mood
- Physical therapy to learn exercises and stretches
- Alternative therapies: Transcutaneous electrical nerve stimulation (TENS), massage, electroaccupuncture/accupuncture for pain/stiffness
- Relaxation therapy (e. biofeedback, meditation and hypnosis)
- Working with a counselor
To get the best treatment, many people need a team that includes:
- A physical therapist
- Someone trained in mental health (such as a social worker or counselor)
- Pain specialist
HOW CAN YOU MANAGE SYMPTOMS AT HOME?
- Stay active- Exercise-aerobic exercise, biking, walking programs, pool exercises, strength training and tai chi can improve function, symptoms and well-being
- Stress management and advise knowing limits and pace your activities.
- Reduce or eliminate caffeine intake, avoid alcohol or keep to no more than 2 drinks per day, eat diet rich in fresh fruit, vegetables, fish, fiber and avoid high glycemic index carbohydrates and processed/sugary foods as may worsen symptoms. Food diary advised to monitor symptoms with intake
- Smoking Cessation
- Adequate sleep
- Vitamin D supplementation as needed however will not impact symptoms
- Stay positive: a negative outlook may seem pain feel worse. Do your best to be positive and know that this condition is one which does not need to interfere with your quality of life if managed properly.
Contact your health care provider if have chronic muscle pain with or without any of the above symptoms and would like to further discuss them.
UpToDate (2016) Fibromyalgia. Beyond the Basics. Retrieved from https://www-uptodate-com.sladenlibrary.hfhs.org/contents/fibromyalgia-beyond-the-basics?source=see_link
Boomershine, C. (2016) Fibromyalgia. Retrieved from http://emedicine.medscape.com/article/329838-overview