Fibromyalgia

Fibromyalgia is a chronic pain disorder, the cause of which is unknown. It affects 2% of the population. Women are more likely to be diagnosed than men, and incidence increase with age. It is more common in close relatives of those with fibromyalgia, but no gene has been identified. Infections, such as viral illnesses or Lyme disease, or physical or emotional trauma may trigger or aggravate the condition. However, there is no evidence that fibromyalgia is related to persistent infection. Currently, fibromyalgia is considered to be a disorder of pain regulation. Affected individuals show increased pain sense and sensitivity to other stimuli.

Signs and Symptoms

• generalized aches and pains
• muscle and joint stiffness
• sleep disturbances
• chronic fatigue
• dizziness
• anxiety
• irritable bowel syndrome
• fluid retention
• headache

Diagnosis

The American College of Rheumatology diagnostic criteria identifies fibromyalgia as a widespread pain (occurring both above and below the waist, and on both right and left sides). This pain has been described as soreness, stiffness, burning, or throbbing. Some patients may experience an unusual “crawling” sensation, numbness and/or tingling in the arms and legs. According to the American college of Rheumatology, the diagnosis is confirmed if, upon examination, a provider finds muscle tenderness in at least 11 of 18 specific points. Laboratory tests and x-rays are usually normal and are needed only to eliminate another diagnosis.

Treatment

• Develop a regular sleep routine with adequate amounts of sleep.
• Ask your provider about medication to improve sleep quality and to decrease pain and stiffness. Medications may include tricyclic antidepressants, cyclobenzaprine, selective serotonin reuptake inhibitors, dual reuptake inhibitors, anticonvulsants, and pain medication. Adequate sleep is critical.
• Perform daily or regular low-impact aerobic exercise (walking, deep-water exercise, etc.) and stretching. Start with only a few minutes and gradually increase tolerance. Fibromyalgia patients note that water exercise is more beneficial in warm water than in cold water.
• Reduce your physical and emotional stress.
• Try massage, hot baths, or relaxation techniques.
• Enlist the support of your family and friends.
• Educate yourself. Learn more about fibromyalgia and seek out support groups.
• Stick to a daily routine.
• Seek evaluation and treatment of an associated mood disorder, if present.
• Practice good time management.

Most persons with fibromyalgia can get to the point where they feel good most of the time. However, even with successful treatment, brief relapses are common and can be caused by staying up one hour later than normal, skipping exercise, exercising too vigorously, increasing stress,change in weather conditions, or for no obvious reason. When this happens it's best to get extra rest, take medication as prescribed, and relax in a warm bath. Try not to stop exercising, although you may want to limit the amount and intensity. Also, return to your daily routine as soon as possible.

Resources:

• National Library of Medicine (www.nlm.nih.gov/medlineplus/healthtopics.html)
• National Fibromyalgia Association (www.fmaware.org)
• The Arthritis Foundation (www.arthritis.org)

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