Fibromyalgia is one specific condition characterized by a chronic pain which is increasing with time! The most common localizations of pain include the neck, back, shoulders, pelvic girdle and hands, but any body part can be involved.
The syndrome could be described with several symptoms such as widespread musculoskeletal aches, pain and stiffness, soft tissue tenderness, general fatigue and sleep disturbances. Fibromyalgia patients experience a range of symptoms of varying intensities that wax and wane over time, which means that the condition have periods of remission and periods of exacerbation! It is especially confusing and often misunderstood condition.
Signs and symptoms of fibromyalgia
The fact is that signs and symptoms of fibromyalgia can vary, depending on the:
- weather
- stress
- physical activity
- even just the time of day
Most common symptoms are:
- Widespread pain
The most common symptom is a specific pain in different areas of body when pressure is applied. Most common areas are the back of head, upper back and neck, upper chest, elbows, hips and knees. Biggest problem is that the pain is generally present for months and is often accompanied by stiffness, which makes it very difficult to handle and find fibromyalgia pain relief.
- Fatigue and sleep disturbances
It is hard to understand but the fact is that people with fibromyalgia often wake up tired and fatigued even though they seem to get plenty of sleep. Although the exact cause is still unknown, some experts suggest that this sleep problem could be the result of a sleep disorder called alpha wave interrupted sleep pattern. This is a condition in which deep sleep is frequently interrupted by peaks of brain activity similar to wakefulness. So people with fibromyalgia miss the deep restorative stage of sleep.
- Nighttime muscle spasms
Specific muscle spasms during the nighttime sleep in patient’s legs may be associated with fibromyalgia, they are known as restless leg syndrome.
- Irritable bowel syndrome
The constipation, diarrhea, abdominal pain and bloating associated with irritable bowel syndrome are common in people with fibromyalgia.
- Headaches and facial pain
Many people diagnosed with this condition have also complained about migraines, severe headaches and facial pain that may be related to tenderness or stiffness in their neck and shoulders.
- Heightened sensitivity
Sensitive to odors, noises, bright lights and touch are also common symptoms in people with fibromyalgia!
- Other symptoms
There are several other symptoms that could occur although, rarely. Some of those are:
- Depression, anxiety and PTSD
- Numbness or tingling sensations in the hands and feet
- Difficulty concentrating
- Mood changes
- Chest pain
- Irritable bladder
- Dry eyes, skin and mouth
- Painful menstrual periods
- Dizziness
Possible causes of fibromyalgia
The specific cause of fibromyalgia is unknown. However, doctors believe a number of factors may contribute. These factors may include:
- Complex chemical changes in the brain.
Several studies have proven that people with fibromyalgia have some specific alterations in the regulation of certain brain chemicals called neurotransmitters. This may be particularly due to:
- serotonin — which is linked to depression, migraines and gastrointestinal distress
- substance P – specific brain chemical associated with pain, stress and anxiety, as well as depression
- Sleep disturbances
Some researchers suggest that disturbed sleep patterns may be a cause rather than just a symptom of fibromyalgia. There are no real proofs for these claims!
- Injury.
Fibromyalgia can start as a result of some trauma (such as a traffic accident) or illness, but there is no strong correlation between any specific type of trigger and the subsequent initiation of fibromyalgia.
- Infection.
Some researchers believe that a viral or bacterial infection may trigger fibromyalgia.
- Abnormalities of the autonomic nervous system.
Some experts claim that all the symptoms characteristic for fibromyalgia could be linked to some abnormality of autonomic nervous system. This part of nervous system controls bodily functions that you don't consciously control, such as heart rate, blood vessel contraction, sweating, salivary flow and intestinal movements.
- Changes in muscle metabolism.
It is proven that decreased blood flow may contribute to decreased strength and fatigue. Differences in metabolism and abnormalities in the hormonal substance that influences the activity of nerves may play a role.
Risk factors for developing fibromyalgia
Several studies done in the past have proven that there are several risk factors which could be linked with fibromyalgia. Some of the most common are:
- Sex
Statistic data tells that fibromyalgia occurs more often in women than in men.
- Age
Fibromyalgia tends to develop in people during early and middle adulthood, but there is no rules because it can also occur in children.
- Disturbed sleep patterns
It is proven that people with sleep disorders, such as nighttime muscle spasms in the legs, restless legs syndrome or sleep apnea, are in higher risk to develop fibromyalgia.
- Family history
The part of this disease is definitely inherited because it tends to run in families!
- Rheumatic disease
People with rheumatic diseases may be more likely to have fibromyalgia.
Diagnosis of fibromyalgia
Unfortunately, currently there are no laboratory tests available for diagnosing fibromyalgia, which means that doctors must rely on:
- patient histories,
- self-reported symptoms,
- a physical examination and
- an accurate manual tender point examination
Good thing is that, via several tests such as blood tests and X-rays, some other condition could be ruled out such as rheumatoid arthritis, lupus and multiple sclerosis.
Fibromyalgia is not a diagnosis of exclusion and must be diagnosed by its own characteristic features.
To receive a diagnosis of FM, the patient must meet the following diagnostic criteria:
- Widespread pain in all four quadrants of the body for a minimum duration of three months
- Tenderness or pain in at least 11 of the 18 specified tender points when pressure is applied
Complications if left untreated
Although the fact is that fibromyalgia isn't progressive and generally doesn't lead to other conditions or diseases- it is proven that it can cause pain, depression and lack of sleep. These problems can then interfere with your ability to work at home or on the job, or maintain close family or personal relationships.
Treatment of fibromyalgia
Medications
Medications can help reduce the pain of fibromyalgia and improve sleep. The ones most commonly recommended by doctors include:
- Analgesics
Analgesics may ease the pain and stiffness caused by fibromyalgia but their effectiveness varies with individuals. Sometimes doctors may also prescribe non-steroidal anti-inflammatory drugs such as Aspirin, ibuprofen or naproxen sodium in conjunction with other medications. The fact is that NSAIDs haven't proven to be effective in managing the pain in fibromyalgia.
- Antidepressants
Sometimes antidepressant medications are being prescribed simply to help promote sleep. Fluoxetine (Prozac) in combination with amitriptyline has also been found effective. Sertraline (Zoloft) and paroxetine (Paxil) also are effective if you're suffering from depression.
- Muscle relaxants
It is proven that taking the muscle relaxant medications at bedtime may help treat those muscle pain and spasms characteristic for fibromyalgia.
- Benzodiazepines
These drugs may also help relax muscles and promote sleep, but doctors usually avoid benzodiazepines in treating fibromyalgia because they haven't been shown to have long-term benefit and have the potential drug dependence risk!
- Sleeping pills
These sleeping pills may provide short-term benefits for some people with fibromyalgia, but doctors usually advise against long-term use of these drugs. These medications tend to work for only a short time, after which your body becomes resistant to their effects.
Cognitive-behavioral therapy
Cognitive-behavioral therapy seeks to increase your belief in your own abilities and teaches you methods for dealing with stressful situations.
Exercises
Exercise programs that stretch muscles and improve cardiovascular (aerobic) fitness are also showed very helpful! Many patients find temporary relief by applying heat to painful areas.
Living with fibromyalgia
Fibromyalgia can affect every aspect of a person's life- there is no doubt about it. This condition can severely curtail social activity and recreation, and as many as 30% of those diagnosed with fibromyalgia are unable to maintain full-time employment. Individuals with fibromyalgia often need accommodations to fully participate in their education or remain active in their careers.
Fibromyalgia is often referred to as an "invisible illness" or disability due to the fact that generally there are no outward indications of the illness or its resulting disabilities. The invisible nature of the illness, as well as its relative rarity and the lack of understanding about its pathology, often has psychosocial complications for those that have the syndrome.
Self-care
Self-care is critical in the management of fibromyalgia. Important aspects of self-care include taking several actions:
- Reduce stress
- Get enough sleep
- Exercise regularly
- Pace yourself
- Maintain a healthy lifestyle
- Use eye drops as needed.