Fibromyalgia
What
is it?
Fibromyalgia is an inflammation of the fibrous or
connective tissues of the body that causes chronic
widespread muscle pain and stiffness, fatigue and
multiple tender points.
Who
gets it?
As many
as six percent of people in the United States are
affected by fibromyalgia. It is more prevalent in
adults than children, and older women are seven
times more likely to have the condition than men.
Sometimes it occurs in families, suggesting that
it may be an inherited disorder.
What
causes it?
The
exact cause of fibromyalgia is not known. Some
researchers believe fibromyalgia may be the
extreme end of a continuous spectrum of chronic
pain due to abnormal levels of various hormones.
Fibromyalgia coincides with many other conditions
such as lupus, Lyme disease and rheumatoid
arthritis. In addition, many patients with
fibromyalgia are also diagnosed with chronic
fatigue syndrome, irritable bowel syndrome,
migraine headaches, or depression. Some experts
suggest that these conditions might be different
manifestations of the same root condition.
Another
theory is that a powerful nerve impulse
(particularly a pain impulse) from the body sent
over and over again physically changes the central
nervous system, especially the nerves and nerve
connections in the dorsal horn of the spinal cord.
Genes are switched on, and nerve cells become
physically altered so they are more easily excited
by pain signals or process normal touching
sensations as if they were pain impulses.
What
are the symptoms?
The
most common symptoms of fibromyalgia are muscle
and joint pain, stiffness and fatigue. The pain
may move from one part of the body to another, and
is most common in the neck, shoulders, chest,
arms, legs, hips, and back. The pain may last for
years, though the severity of it may change over
time. Other symptoms include tension headaches,
difficulty swallowing, recurrent abdominal pain,
diarrhea, and numbness or tingling of the
extremities. Stress, anxiety, depression, or lack
of sleep can increase symptoms.
How is
it diagnosed?
Diagnosis of fibromyalgia is difficult and it is
often misdiagnosed because symptoms can be
mistaken for another condition. Coexisting nerve
and muscle disorders such as rheumatoid arthritis,
spinal arthritis, or Lyme disease may further
complicate diagnosis.
Currently, there are no specific tests available
to diagnose fibromyalgia, so the doctor may make a
diagnosis by ruling out other conditions with
similar symptoms. The doctor may be able to
diagnose fibromyalgia if the patient has
widespread pain in combination with tenderness in
at least 11 of 18 sites known as trigger points.
These include areas such as the base of the neck,
along the backbone, at the elbow, hip, the back of
the knee, and shoulder.
What
is the treatment?
Patients with fibromyalgia may be referred to a
rheumatologist (a doctor who specializes in
disorders of the joints, muscles, and soft tissue)
to determine the cause of various rheumatic
symptoms, to be educated about fibromyalgia and
its treatment, and to exclude other rheumatic
diseases.
The
doctor may prescribe applying heat and occasional
cold compresses to affected areas, and advise a
stretching program to help alleviate symptoms of
fibromyalgia. The doctor may also advise the
patient to follow any exercise program that
elevates the heart rate, and to avoid any
exercises that cause joint pain. The patient may
also need to follow a special diet including a
large variety of fruits and vegetables to maintain
healthy muscles.
If
diet, exercise, and adequate rest do not relieve
the symptoms of fibromyalgia, medications may be
prescribed. Possible medications that may provide
relief include antidepressant drugs, muscle
relaxants, and anti-inflammatory drugs.
Counseling may also provide some people with
relief. Cognitive-behavior therapy is used widely
for patients with other chronic pain conditions,
and doctors believe this kind of therapy may help
some fibromyalgia patients as well.
Self-care tips
While
there is no known or specific way to prevent
fibromyalgia, remaining as healthy as possible
with a good diet, safe exercise, and adequate rest
is the best prevention.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
|
