Fibromyalgia

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Fibromyalgia is a condition characterized by chronic, widespread pain affecting the muscles, ligaments, tendons and bones.

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Fibromyalgia Defined

This pain may be accompanied by the following symptoms: fatigue, cognitive impairment, depression, headaches and pain or cramping in the lower abdomen. To be considered chronic and widespread, the pain experienced must have lasted at least three months, must affect both sides of the body and must be present both above and below the waist.

The cause of fibromyalgia is currently unknown, though according to Mayo Clinic it may be associated with various factors such as genetic mutations, infections, physical trauma or emotional trauma. It is believed that the pain experienced by fibromyalgia patients is linked to increased chemical levels in the brain's neurotransmitters, which are responsible for signaling pain. The pain receptors in the brain may also develop a "memory" of the chronic pain, causing hypersensitivity to pain signals.

Fibromyalgia may be considered a "subjective" medical disorder because there is no specific laboratory test that can confirm its presence. Doctors must rely on a patient to indicate when and where pain is felt. In the past, doctors would test for fibromyalgia by applying a specific amount of pressure to 18 points on the body to see how many were painful. Today, a fibromyalgia diagnosis may be based on a patient's report of widespread pain for at least three months along with an absence of other medical conditions that could cause such pain.

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The physician makes a diagnosis of fibromyalgia based on his judgment and about the truth and accuracy of the patient's reports, his knowledge of the illness, his judgment on the patient's character, the patient's prior medical records, and how well the patient's reports and actual lifestyle match the known characteristics of fibromyalgia.

Scientists have confirmed that patients with fibromyalgia do perceive the pain they report. They also prove that these patients perceive the pain they report at much lower levels of stimulus than do healthy individuals. This is caused by neural sensitization may reflect an increase in the size of pain transmitting nerve cells.

When mild stimulation is given to fibromyalgia suffers, the pain continues as long as the mild stimulus is applied. For healthy people, the mild stimulation does not maintain the pain level.

Fibromyalgia suffers have fairly normal muscle strength, no swelling of joints, normal range of motion, normal peripheral nerve examination, and normal interaction on the king of "light" mental status evaluation.

Some patients who suffer from fibromyalgia also suffer from "brain fog" which is the decreased ability to concentrate of think quickly, especially with complex or multi-tasked problems. These people typically appear normal on standard office examination. This brain fog may be the result of the greater effort these people require in order to concentrate.

The pain associated with fibromyalgia varies from day to day and changes locations in the body. The pain is usually most severe in parts of the body that are used the most, such as the neck, shoulders, and feet.

Fibromyalgia also causes fatigue. The fatigue varies from person to person ranging from mild to exhaustion to the point of severe flu-like illness.

Fibromyalgia patients normally suffer from one or more of the following:

  • Stiffness
  • Sleep disturbances
  • Gastrointestinal complaints
  • Paresthesia
  • Chest symptoms
  • Depression and anxiety
  • Pain in 11 of 18 tender point sites on digital palpitation
  • Increased headaches or facial pain
  • Cognitive disorders (brain fog)
  • Genito-Urinary problems
  • Myofascial trigger points
  • Skin complaints
  • History of widespread pain

TREATMENTS AND DRUGS

In general, treatments for fibromyalgia include both medication and self-care. The emphasis is on minimizing symptoms and improving general health.

MEDICATIONS

Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices include:

  1. Analgesics. Acetaminophen (Tylenol, others) may ease the pain and stiffness caused by fibromyalgia. However, its effectiveness varies. Tramadol (Ultram) is a prescription pain reliever that may be taken with or without acetaminophen. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs) - such as ibuprofen (Advil, Motrin, others) or naproxen sodium (Aleve, others) - in conjunction with other medications.
  2. Antidepressants. Duloxetine (Cymbalta) and milnacipran (Savella) may help ease the pain and fatigue associated with fibromyalgia. Your doctor may prescribe amitriptyline or fluoxetine (Prozac) to help promote sleep.
  3. Anti-seizure drugs. Medications designed to treat epilepsy are often useful in reducing certain types of pain. Gabapentin (Neurontin) is sometimes helpful in reducing fibromyalgia symptoms, while pregabalin (Lyrica) was the first drug approved by the Food and Drug Administration to treat fibromyalgia.

THERAPY

Talking with a counselor can help strengthen your belief in your abilities and teach you strategies for dealing with stressful situations.