Fibromyalgia is characterized by pain, tenderness and stiffness of muscles, joints and tendons. It is a chronic condition.
Patient also experiences restless and un-refreshing sleep, anxiety, depression, chronic fatigue and disturbance in bowel function.
Fibromyalgia is differs from other rheumatic conditions like rheumatoid arthritis, systemic lupus, and polymyositis. In these diseases the pain, stiffness, and tenderness of the joints, tendons and muscles is due to tissue inflammation and it causes joint deformity and damage to the internal organs or muscles.
When localized areas of the body get tender to light touch those points are called tender points. Tender points in fibromyalgia are found around the elbows, shoulders, knees, hips, back of the head, and the sides of the breastbone.
If physical fatigue and muscle pain are persistent for periods, that exceeds three months and without any underlying condition suggest the patient is affected with fibromyalgia
Age / Sex prevalence of Fibromyalgia
Fibromyalgia affects predominantly women (over 80% of those affected are women) between the ages of 35 and 55.
The exact cause is unknown.
• Genetic predisposition.
• Viral or bacterial infection.
• Rheumatoid arthritis, lupus, Ankylosing spondylitis or hypothyroidism.
• Exposure to cold or dampness.
• Alterations in blood flow, activity of nerves that regulate muscle action or metabolism inside muscle cells.
• Injury in the upper portion of the spine.
• Insufficient sleep.
• Abnormalities in the regulation of neurotransmitters (such as serotonin and substance P).Some people having fibromyalgia have low level of serotonin.
• Parts of the nervous system that control involuntary functions of the body functions abnormally.
Pain is the main symptom of fibromyalgia.It may be mild to severe.
• Painful areas are found in the soft tissue on the back of the neck, shoulders, chest, lower back, hips, shins, elbows, and knees. The pain then spreads.
• There may be a deep ache, or a shooting, burning pain.
• The joints are not affected but the sensation is like it is coming from the joints.
• Unrefreshing sleep.
• People wake up with bodyaches and stiffness. In some patients, pain improves during day and gets worse at night.Some patients may experience pain all day.
• Pain gets worse with activity, cold or damp weather, anxiety, and stress.
• Fatigue, depression and sleep problems.
Other symptoms of fibromyalgia may include:
• Memory and concentration problems
• Irritable bowel syndrome (IBS)
• Reduced ability to exercise
• Numbness and tingling in hands and feet
• Tension or migraine headaches
• Rheumatoid arthritis
• Systemic lupus
• Ankylosing spondylitis
• Mood disorder
• Sleep disorder
• Physical examination.
• Blood and urine tests to rule out unrelated or underlying conditions of illness.
• If the patient is having pain continuously for at least 3 months and there are at least 11 – 18 tender points, then is the diagnostic point for fibromyalgia
The goal of treatment is to relieve pain and other symptoms of the disease.
Treatment may involve:
• Physical therapy
• Stress-relief methods
• Exercise and fitness program
If any of above treatment does not work then antidepressant or muscle relaxant are prescribed. The medication helps in improving sleep and relieves pain.
Medicine should be used with exercise and behavior therapy. Duloxetine (Cymbalta), pregabalin and milnacipran are medications that are approved specifically for treating fibromyalgia.
Other drugs that are given include:
• Anti-seizure drugs
• Muscle relaxants
• Other antidepressants
• Sleeping Aids
• Pain relievers
• Severe cases of fibromyalgia may require a referral to a pain clinic.
• Low-impact aerobic exercises, such as swimming, cycling, and walking.
• Stress reduction includes relaxation tapes, psychological counseling, and/or support among family members, friends, and doctors.
Cognitive-behavioral therapy helps in learning how to:
• Deal with negative thoughts
• Recognize what makes symptoms worse
• Keep a diary of pain and symptoms
• Seek out enjoyable activities
• Avoid caffeine
• Eat a well-balanced diet
• Supplementation with the essential mineral magnesium
• Supplements of the vitamin C help protect the muscles cells against cellular damage
• Supplements of the oil of the evening primrose herb used at 2 to 4 grams daily before meals
Fibromyalgia is a chronic disorder, sometimes there is improvement in symptoms and at other times pain may get worse and continue for months or years.
• Indicated when any of body area feels bruised and sore
• Fibromyalgia pain that feels like have had a fall or hurt so badly.
• Pain after exertion, overuse of muscles or injury
• Great fear of being touched or approached
• Sprained and dislocated feeling
• A person tries to stay as still as possible
• Slightest motion aggravates the pain
• Suited to people who are extreme irritable and grumpy, not wanting to be touched or interfered with
• Complaints worse from warmth
• Better by cold applications and pressure on the painful part or lying on them .
• Severe pain in the muscles, extending from higher area to lower ones.
• Shooting pains may occur, along with stiffness, neuralgia and numbness or cold sensation
• A pain comes suddenly, and often shifts around.
• worse from motion and at night
• tearing pain in the limbs with swelling
• limbs sensitive to pressure
• white swelling of knee
• tearing in arms from shoulders to the wrist
• lacerating pain in the wrist joint
• Pains from hip to the knee. Pain in the knee
• Brain fatigue and metal fogginess that comes with fibromyalgia attack.
• People who are sensitive and intuitive.
• Tearing pains in joints, bones and periosteum
• Pains at night, as if bones were scraped.
• Stumbles easily and makes missteps.
• Itching, between fingers or in folds of joints.
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