Fibromyalgia

Fibromyalgia: You Need To Know

What if Fibromyalgia?

Fibromyalgia is a common chronic condition that affects bones and muscles. It causes widespread symptoms of muscle and joint pain, fatigue, sleep problems, and mental distress. Frequently, the patient calls it a whole-body pain. Joint pain or arthralgia is also very common. Thus, the disease is often misdiagnosed and confused with arthritis. However, unlike arthritis, it never causes inflammation in the joints.

Fibromyalgia causes abnormal pain sensation processing in the brain, making people more sensitive to pain. There is no cure for fibromyalgia, however, a variety of medications, therapies, and healthy habits help reduce the symptoms and improve life quality.

What are the causes of Fibromyalgia?

The cause of fibromyalgia is unknown. Some people believe that the repeated nerve stimulation changes certain chemicals in the brain and spinal cord, leading to an increased sensation of pain. The disease tends to run in families, but mutations in specific genes may also lead to fibromyalgia.

The basic problem in fibromyalgia is sensitive nerves. They produce pain even without an injury. In a normal person, tissue damage or injury creates an electrical signal and this signal is called an action potential. It is carried to the brain and we feel pain. In fibromyalgia, the nerves become so sensitive that action potentials generate even without tissue damage. Even a stretching or mild pressure creates action potentials and thus pain.

In some cases, the following factors increase the risk of getting this condition

• Injury, infection, arthritis, or other physical stress
• Post-traumatic stress disorder due to physical or emotional accident or abuse
• Being a woman
• Brain and spinal cord problems
• Mood issues like anxiety or depression
• Lack of exercise and obesity

What are the signs and symptoms of Fibromyalgia?

Common fibromyalgia symptoms include:

• Widespread, dull pain occurring above and below the waist on both sides of the body.
• Irregular sleep patterns with trouble falling asleep and then sleeping for longer periods
• Extreme fatigue with tired awakening after sleep
• Memory problems and mental distress with the inability to concentrate and pay attention — called fibro fog
• Stiffness in muscles and joints
• Tenderness, tingling, or numbness in the hands and feet

Fibromyalgia often coexists with the following diseases:

• Anxiety and depression
• Migraine and other headaches
• Irritable bowel syndrome
• Temporomandibular joint (TMJ) disorders
• Painful bladder syndrome
• Insomnia or sleep apnea

How to make a diagnosis of Fibromyalgia?

Fibromyalgia resembles many diseases such as arthritis, hypothyroidism, and chronic fatigue syndrome. As a result, its diagnosis is quite difficult to make. Diagnosis is made based on widespread pain symptoms, fatigue, sleep disturbances, and cognitive impairment. These symptoms must have a presence of at least three months with no alternative explanation.

Apart from tenderness, physical examination shows normal findings. There is no laboratory test to detect fibromyalgia. Most of the diagnostic tests doctors perform are to rule out other confusing diseases. These tests include X-rays, MRIs, and blood tests.

What is the prognosis of Fibromyalgia?

Fibromyalgia is not a fatal disease. People continue to struggle with the widespread pain and other symptoms for life, though. The disease affects the quality of life but, fortunately, does not get worse with time. It also does not threaten other organs of the body.

Since people with fibromyalgia also suffer from many mental health problems, suicides among such people are very high. Recent studies have shown that medications, therapies, and healthy habits do improve the quality of life. But it may take years to show those improvements.

What are the treatments of Fibromyalgia?

Since there is no cure for the disease, treatment focuses on reducing the symptoms. A variety of treatment strategies are employed to deal with fibromyalgia symptoms.

Drug options available are as follows:

• OTC-pain relievers such as acetaminophen, ibuprofen, and naproxen may prove effective. Opioid pain relievers are not recommended due to their various side effects and dependence, which worsen the pain over time.
• Anti-depressant drugs such as duloxetine and milnacipran may help relieve the symptoms. Doctors may also prescribe muscle relaxants to promote sleep.
• Anti-seizure drugs like gabapentin and pregabalin (gabapentinoids) are often helpful in reducing fibromyalgia symptoms.

However, drugs are not the first-line treatment of fibromyalgia. Hence, specific importance is given to exercises and various therapies. These may include

• Exercise: A combination of stretching, strengthening, and aerobic exercises may help relieve fibromyalgia symptoms. A therapist can help create the combination that suits the patient.
• Acupuncture: Many people experience an improved quality of life with ancient Chinese acupuncture therapy.
• Cognitive-behavioral therapy: It aims at reducing the pain-increasing behaviors; and improving behaviors that relieve pain symptoms.
• Yoga, meditation, and other such exercises may also prove effective.
• A good sleep hygiene
• Massage
• A balanced diet
• A counselor or a support group may help ease the mental issues related to fibromyalgia.

What are interventional pain managements for Fibromyalgia?

If everything has failed, systemic desensitization is one good treatment option. Under cardiovascular monitoring, a patient with fibromyalgia receives lignocaine (a local anesthetic medicine) slowly in the intravenous route. Trigger point injections or spinal cord stimulations are other treatment options in resistant cases.

It should be noted that no one quite understands fibromyalgia. So, these alternatives may not work for everybody.