What is fibromyalgia?
Fibromyalgia is a condition characterized by aching and pain
in muscles, tendons and joints all over the body, especially along the spine.
There are measurable changes in body chemistry and function
in some people with fibromyalgia. These changes may be responsible for certain
symptoms.
However, fibromyalgia is not associated with muscle, nerve
or joint injury; inadequate muscle repair; or any serious bodily damage or
disease. Also, people who have fibromyalgia are not at greater risk for any
other musculoskeletal disease.
What are the symptoms of fibromyalgia?
The pain of fibromyalgia usually seems worse when a person
is trying to relax and is less noticeable during busy activities or exercise.
Other symptoms are often associated with the pain, including
the following:
·
Sleep disturbance
·
Depression
·
Daytime tiredness
·
Headaches
·
Alternating diarrhea and constipation
·
Numbness and tingling in the hands and feet
·
Feelings of weakness
·
Memory difficulties
·
Dizziness
What causes fibromyalgia?
The exact cause of fibromyalgia is unknown. There are,
however, many theories about why people get fibromyalgia.
One theory suggests that stress contributes to the onset of
fibromyalgia.
Other possible causes are:
Distress (stress related to finances, work, marriage or
recent loss such as the death of a close family member)
Conscious or subconscious tension, disordered sleep
Abnormal production of pain-related chemicals in the nervous
system
Lower pain threshold, heightened perception of pain
Tenderness in certain areas, such as the upper back and
forearms
When fibromyalgia begins, stresses in a person's life are
prominent. Stress often results in disturbed sleep patterns and a lack of
restful sleep. When you don't get enough sleep, your body does not produce the
chemicals necessary to control or regulate pain. A lack of these
pain-regulating chemicals results in tenderness in the upper back and forearms,
leading to the symptoms of fibromyalgia.
Physical and emotional factors may also contribute to the
onset of fibromyalgia. For example, a physical illness (such as an infection)
could cause changes in your body chemistry that lead to pain and sleeplessness.
When you are sick, you may worry about your health and
become anxious, depressed or inactive. These emotional factors could make your
symptoms worse and aggravate fibromyalgia.
Women tend to have fibromyalgia more often than men. In
Europe, some studies suggest that as many as 14 percent of women may have
fibromyalgia symptoms. In the United States, the fibromyalgia estimate is much
lower - 2 to 4 percent of women and men.
The diagnosis of fibromyalgia is based on a combination of
factors, including the following:
Complete medical history and physical exam (to exclude other
illnesses that may have similar symptoms such as rheumatoid arthritis, muscle
inflammation, bursitis or tendinitis).
Presence of widespread pain together with some of the other
symptoms of fibromyalgia.
Presence of very tender areas ("tender points") at
specific locations. People who have fibromyalgia experience abnormal
sensitivity when light pressure is applied to many of the locations shown here.
People with fibromyalgia receive individual treatment based
on several factors, including their overall health, medical history, number of
tender points, severity of pain and presence of other symptoms. Treatment for
fibromyalgia includes the following:
·
Medications that decrease pain and improve sleep
·
Lifestyle changes, including stress reduction
·
Exercise to improve cardiovascular (heart and lung) health
·
Relaxation techniques to relieve muscle tension
Medications that increase restful sleep may help, such as
low doses of antidepressant medication taken before bedtime. Other kinds of
sleeping pills are not very helpful for people who have fibromyalgia.
Nonsteroidal anti-inflammatory drugs including aspirin and
ibuprofen (such as Motrin) may help decrease pain, but should be used
sparingly. These drugs have many side effects such as stomach upset and fluid
retention. They may also interact unfavorably with other drugs, such as
medications for high blood pressure.
No currently existing medications completely relieve
fibromyalgia pain. However, acetaminophen (such as Tylenol) is both helpful and
safer than other analgesics (pain-relieving medications).
Anti-inflammatory medications (such as cortisone
derivatives) used to treat other rheumatic conditions have been tested in
people with fibromyalgia and did not improve symptoms in tests.
Brisk walking, biking, swimming and water aerobics are good
activities to choose when starting your exercise program. Your physician can
help you choose an exercise program that's right for you.
Participating in aerobic exercise for 30 minutes three times
each week is an important step to improve fibromyalgia symptoms. Exercise
increases heart and lung function and stretches tight, sore muscles.
Certain stress factors in life (financial burdens, or
difficulties with a boss, coworkers or your spouse) may not be easily
eliminated. Evaluating the causes of stress and learning new ways to handle or
cope may improve fibromyalgia.
Anxiety and depression are major contributors to stress and
must be treated to enable fibromyalgia to improve.
Relaxation techniques can help relieve muscle tension and
reduce stress. Professionals trained in stress management can teach you these
techniques.
Often, if the situations that caused the initial stress are
resolved, fibromyalgia may spontaneously improve and medications may not be
necessary.
Many people with fibromyalgia will continue to have symptoms
despite treatment, especially when life
is stressful. However, medications that can alter the balance of pain-producing
chemicals, such as anti-depressant drugs, should improve symptoms by 30
percent.
When other forms of therapy such as acetominophen (Tylenol) and
aerobic exercise are combined to treat fibromyalgia, even more improvement can
be expected.
Those who are able to continue working and fulfilling their
social obligations - despite their pain - do best.