Fibromyalgia Causes, Symptoms, Diagnosis, Treatment

Fibromyalgia Causes, Symptoms, Diagnosis, Treatment


What Is Fibromyalgia Syndrome?


Fibromyalgia Causes, Symptoms, Diagnosis, Treatment
Fibromyalgia

Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and multiple tender points. "Tender points" refers to tenderness that occurs in precise, localized areas, particularly in the neck, spine, shoulders, and hips. People with this syndrome may also experience sleep disturbances, morning stiffness, irritable bowel syndrome, anxiety, and other symptoms.

How Many People Have Fibromyalgia Syndrome?


According to the American College of Rheumatology, fibromyalgia affects 3 to 6 million Americans. It primarily occurs in women of childbearing age, but children, the elderly, and men can also be affected.

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What Causes Fibromyalgia Syndrome?


Although the cause of fibromyalgia syndrome is unknown, researchers have several theories about causes or triggers of the disorder. Some scientists believe that the syndrome may be caused by an injury or trauma. This injury may affect the central nervous system. Fibromyalgia may be associated with changes in muscle metabolism, such as decreased blood flow, causing fatigue and decreased strength. Others believe the syndrome may be triggered by an infectious agent such as a virus in susceptible people, but no such agent has been identified.

What are fibromyalgia symptoms and signs?


The universal symptom of fibromyalgia is pain. As described earlier, the pain in fibromyalgia is not caused by tissue inflammation. Instead, those affected seem to have an increased sensitivity to many different sensory stimuli and an unusually low pain threshold. Minor sensory stimuli that ordinarily would not cause pain in normal individuals can cause disabling, sometimes severe pain in people with fibromyalgia. The body pain of fibromyalgia can be aggravated by noise, weather change, and emotional stress.

Fibromyalgia Causes, Symptoms, Diagnosis, Treatment
Fibromyalgia Symptoms

The pain of fibromyalgia is generally widespread, involving both sides of the body. Pain usually affects the neck, buttocks, shoulders, arms, the upper back, and the chest. "Tender points" are localized areas of the body that are tender to light touch. Fibromyalgia tender points, or pressure points, are commonly found around the elbows, shoulders, knees, hips, back of the head, and the sides of the breastbone and are typical signs of fibromyalgia.

Fatigue occurs in nearly all people with fibromyalgia. Fatigue may be related to abnormal sleep patterns commonly observed in these patients. Normally, there are several levels of depth of sleep. Getting enough of the deeper levels of sleep may be more important in refreshing a person than the total number of hours of sleep. People with fibromyalgia lack the deep, restorative level of sleep, called "non-rapid eye movement" (non-REM) sleep. Consequently, those with fibromyalgia often awaken in the morning without feeling fully rested, even though they seem to have had an adequate number of hours of sleep time. Some patients awaken with muscle aches or a sensation of muscle fatigue as if they had been "working out" all night!

Mental and/or emotional disturbances occur in over half of people with fibromyalgia. These symptoms include poor concentration, forgetfulness, and memory problems, as well as mood changes, irritability, depression, and anxiety. Since a firm diagnosis of fibromyalgia is difficult and no confirmatory laboratory tests are available, patients with fibromyalgia are often misdiagnosed as having depression as their primary underlying problem.

Other symptoms of fibromyalgia include migraine and tension headaches, numbness or tingling of different parts of the body, abdominal pain related to irritable bowel syndrome ("spastic colon"), and irritable bladder, causing painful and frequent urination. Like fibromyalgia, irritable bowel syndrome can cause chronic abdominal pain and other bowel disturbances without detectable inflammation of the stomach or the intestines.

Each patient with fibromyalgia is unique. Any of the above symptoms can occur intermittently and in different combinations.

How Is Fibromyalgia Syndrome Diagnosed?


Fibromyalgia syndrome is difficult to diagnose because many of the symptoms mimic those of other disorders. The physician reviews the patient's medical history and makes a diagnosis of fibromyalgia based on a history of chronic widespread pain that persists for more than 3 months. The American College of Rheumatology (ACR) has developed criteria for fibromyalgia that physicians can use in diagnosing the disorder. According to ACR criteria, a person is considered to have fibromyalgia if he or she has widespread pain in combination with tenderness in at least 11 of 18 specific tender point sites.

Fibromyalgia Treatment


Fibromyalgia Causes, Symptoms, Diagnosis, Treatment
Fibromyalgia

Fibromyalgia treatment requires a comprehensive approach. The physician, physical therapist, and patient may all play an active role in the treatment of fibromyalgia. Studies have shown that aerobic exercise, such as swimming and walking, improves muscle fitness and reduces muscle pain and tenderness. Heat and massage may also give short-term relief. Antidepressant medications may help elevate mood, improve quality of sleep, and relax muscles. Patients with fibromyalgia may benefit from a combination of exercise, medication, physical therapy, and relaxation.

Keeping in tune with your disease or condition not only makes treatment less intimidating but also increases its chance of success, and has been shown to lower a patients risk of complications. As well, as an informed patient, you are better able to discuss your condition and treatment options with your physician.

Are exercise, stress reduction, or changes in diet helpful in the treatment of fibromyalgia?


Since the symptoms of fibromyalgia are diverse and vary among patients, treatment programs must be individualized for each patient. Fibromyalgia treatment programs are most effective when they combine patient education, stress reduction, regular exercise, and medications. Recent studies have verified that the best outcome for each patient results from a combination of approaches that involves the patient in customization of the treatment plan.

Patient education


Patient education is a key first step in helping patients understand and cope with the many symptoms. Unfortunately, not all physicians are intimately acquainted with the vagaries of this illness. Therefore, community hospital support groups and the local chapters of the Arthritis Foundation have become important educational resources for patients and their doctors. The Arthritis Foundation is a national voluntary health organization that provides community education through their many local chapters. Community hospital support groups also provide an arena for patients to share their experiences and treatment successes and failures.
Fibromyalgia Causes, Symptoms, Diagnosis, Treatment
Fibromyalgia

Exercise


Low-impact aerobic exercises, such as swimming, cycling, walking, and stationary cross-country ski machines, can be effective fibromyalgia treatments. Exercise regimens are most beneficial when performed on an every-other-day basis, in the morning. How exercise benefits fibromyalgia is unknown. Exercise may exert its beneficial effect by promoting a deep level of sleep (non-REM sleep). Sometimes physical therapy can be helpful to optimally guide the exercise plan.

Fibromyalgia diet


Similarly, avoiding alcohol and caffeine before bedtime can also help promote a more restful sleep. Foods that lead to comfortable sleep should be favored. While these dietary changes may not apply to everyone, they can be very helpful for some. There is no specific fibromyalgia diet or food supplements that are recommended for all patients. When patients have accompanying irritable bowel syndrome, the diet should be adjusted to not aggravate the bowels. Likewise, when patients have accompanying interstitial cystitis, foods that irritate the bladder should be avoided.

Stress reduction


The perception of stress varies from one individual to another. For some people, spilling milk on the table can represent a significant tragedy. For others, a tank rolling into the living room might represent just another day! Therefore, stress reduction in the treatment of fibromyalgia must be individualized. Stress reduction might include simple stress modification at home or work, biofeedback, relaxation tapes, psychological counseling, and/or support among family members, friends, and doctors. Sometimes, changes in environmental factors (such as noise, temperature, and weather exposure) can exacerbate the symptoms of fibromyalgia, and these factors need to be modified. Optimal sleep is encouraged.