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Fibromyalgia

What is fibromyalgia?

Fibromyalgia is a chronic (ongoing) condition of widespread pain, tenderness and fatigue. The word fibromyalgia comes from “fibro” – meaning fibers (connective tissue or muscle); “my” – muscle; “al” – pain; and “gia” – meaning the condition of. Thus, fibromyalgia literally means a condition of pain in the muscles and connective tissue fibers. However, individuals with fibromyalgia can and frequently do have pain anywhere in their body.

Fibromyalgia is a common syndrome that affects 2-4% of the U.S. population. It is more commonly diagnosed in women but teens and men may develop this condition as well.. It occurs more frequently during early and middle adulthood or during a woman’s childbearing years. People who have a rhematic disease such as lupus or rheumatoid arthritis are at higher risk for developing fibromyalgia and genetics may play a role as well because fibromyaligia is often found in family members.

How does it occur?

The cause of fibromyalgia is not known, but there are many pieces of evidence that point to a fundamental problem in the way the spinal cord and brain are processing pain signals. Simplistically, it is as if the “volume control” in the nerves throughout the body is turned up too high. Possible triggers of fibromyalgia include infections, physical trauma, psychological stress, hormonal alterations (e.g., hypothyroidism), drugs, vaccines and certain catastrophic events (such as war).

What are the symptoms?

Fibromyalgia is a chronic illness typically characterized by its cardinal symptoms: widespread pain; and fatigue. Some people who have fibromyalgia may complain only of pain. Most people, however, will experience a variety of symptoms and syndromes that fall outside the definition of fibromyalgia, yet frequently accompany it.

The symptoms most often associated with fibromyalgia include:

Regional or organ-specific symptoms and syndromes, such as tension/migraine headache, temporomandibular joint disorder, irritable bowel syndrome, interstitial cystitis, and many other conditions are related to fibromyalgia and fall under the umbrella of Chronic Multisymptom Illnesses.

How is it diagnosed?

There is no diagnostic test for fibromyalgia – x-rays, blood tests, and muscle biopsies are normal in people with fibromyalgia. Your health care provider will take your medical history and will ask about your patterns of symptoms. He or she will want to focus on your features of pain and tenderness to distinguish it from other rheumatic disorders. Your health care provider may test your TSH (thyroid stimulating hormone) and your ESR (erythrocyte sedimentation rate) values to rule out other conditions.

How is it treated?

The treatment for fibromyalgia is primarily for the management of its symptoms and should include education, medication and exercise. Alternative therapies may also be helpful.

Patient education is one of the most important aspects of living with fibromyalgia as the person with this condition should understand the nature of this illness. Support groups and educational workshops or programs on fibromyalgia will be helpful not only for the patient but for family members and friends. By working toward improved health and feeling better, you can be an active participant in the daily routine of living well with fibromyalgia.

Medications can be used to treat the symptoms of fibromyalgia and over-the-counter analgesics may work for some individuals. Tricyclic compounds are currently the best pharmacologic treatment for fibromyalgia as they not only treat pain but also improve sleep patterns. Antidepressants may also be prescribed and have shown positive results, regardless of whether individuals are depressed or not. Muscle relaxants and anti-inflammatory drugs may also be prescribed.

Regular exercise is extremely important in helping to relieve symptoms. Exercise affects the levels of many biochemicals in the body, particularly in the nervous system. This may be why symptoms of fibromyalgia often improve when people exercise regularly. Because much of the pain of fibromyalgia is in the muscles, you should begin an exercise program very gradually, as recommended by your health care provider. Start by slowly adding physical activity in your daily lifestyle – take the stairs or park further away from the store. Include good warm-ups and cool-downs and slowly add daily fitness into your life. Walking, water aerobics, swimming and gentle stretching exercises are examples of physical activity that can be added to your daily routine.

Getting enough rest is important the treatment of fibromyalgia. Make sure you get enough restful sleep. In the evening, avoid stimulating foods and drinks (such as coffee) and certain medicines (for example, decongestants) and avoid daytime napping. Try to go to bed and wake up at the same time each day to establish good sleep habits. Your body needs sleep to repair itself physically and your mind needs rest to prepare for the next day. Get enough sleep.

Relaxation and reducing stress in your life is key to maintaining good health. Set aside time to relax, pace yourself in your daily activities and include deep-breathing exercises or meditation. To stop all activity will make you feel worse, but finding the right balance between relaxation and activity will provide both physical and mental benefits.

Your health care provider can also help to find other ways to reduce your pain and fatigue. For example, you may benefit from heat or massage therapy or a home exercise program recommended by a physical therapist. Acupuncture and acupressure are additional examples of alternative therapies that may be helpful. Therapeutic massage can alleviate pain and muscle spasms while myofascial release therapy works on connective tissue to soften, lengthen and realign the fasica (connective tissue).

How long will the effects last?

Fibromyalgia is a chronic problem. The symptoms sometimes improve and at other times worsen, but they will probably continue for months to years. Although the illness can produce much discomfort, it does not shorten your life.

How can I prevent fibromyalgia?

There is no known way to prevent fibromyalgia. However, as with many medical problems, staying as healthy as possible with a good diet, regular exercise, and enough rest may be the best way to live well with fibromyalgia.

Information provided by UMHS Chronic Pain and Fatigue Research Center, May, 2007