Marion Pellicano Ambrose
Fibromyalgia is adisorder characterized by widespread musculoskeletal pain accompanied byfatigue, sleep, memory and mood issues. Researchers believe that fibromyalgiaamplifies painful sensations by affecting the way your brain processes pain signals.
Symptoms sometimesbegin after a physical trauma, surgery, infection or significant psychologicalstress. In other cases, symptoms gradually accumulate over time with no singletriggering event.
The pain and fatigueassociated with this disease can be crippling. Constant pain and lack ofsleep,along with this fatigue often leads to depression. The fact that this isan invisible disease also causes much distress. Family members, coworkers, andsometimes even medical personnel tend to ignore or downplay the effects of thisdisease. Unless one has experienced the horrific effects of Fibromyalgia, theyshould not judge. This goes for scoffing at people using handicapped parking ordevices that “look perfectly healthy”.
Women are much morelikely to develop fibromyalgia than are men. Many people who have fibromyalgiaalso have tension headaches, temporomandibular joint (TMJ) disorders, irritablebowel syndrome, anxiety and depression.
While there is nocure for fibromyalgia, a variety of medications can help control symptoms.Exercise, relaxation and stress-reduction measures also may help.
The pain associatedwith fibromyalgia often is described as a constant dull ache, typically arisingfrom muscles. To be considered widespread, the pain must occur on both sides ofyour body and above and below your waist.
Fibromyalgia ischaracterized by additional pain when firm pressure is applied to specificareas of your body, called tender points. Tender point locations include:
· Back of the head
· Between shoulderblades
· Top of shoulders
· Front sides ofneck
· Upper chest
· Outer elbows
· Upper hips
· Sides of hips
· Inner knees
Fatigue andsleep disturbances
People with fibromyalgia often awakentired, even though they report sleeping for long periods of time. Sleep isfrequently disrupted by pain, and many patients with fibromyalgia have othersleep disorders, such as restless legs syndrome and sleep apnea, that furtherworsen symptoms.
Coexistingconditions
Many people who have fibromyalgiaalso may have:
· Fatigue
· Anxiety
· Depression
· Endometriosis
· Headaches
· Irritable bowelsyndrome
Doctors don't knowwhat causes fibromyalgia, but it most likely involves a variety of factorsworking together. These may include:
· Genetics. Because fibromyalgia tends to run in families, theremay be certain genetic mutations that may make you more susceptible todeveloping the disorder.
· Infections. Some illnesses appear to trigger or aggravatefibromyalgia.
· Physicalor emotional trauma.Post-traumatic stress disorder has been linked to fibromyalgia.
Why does ithurt?
Current thinking centers around a theorycalled central sensitization. This theory states that people with fibromyalgiahave a lower threshold for pain because of increased sensitivity in the brainto pain signals.
Researchers believerepeated nerve stimulation causes the brains of people with fibromyalgia tochange. This change involves an abnormal increase in levels of certainchemicals in the brain that signal pain (neurotransmitters). In addition, thebrain's pain receptors seem to develop a sort of memory of the pain and becomemore sensitive, meaning they can overreact to pain signals.
Risk factors forfibromyalgia include:
· Your sex. Fibromyalgia is diagnosed more often in women than inmen. Female reproductive hormones may play a part in how women experience pain.
· Familyhistory. You may be more likelyto develop fibromyalgia if a relative also has the condition.
· Rheumaticdisease. If you have a rheumaticdisease, such as rheumatoid arthritis or lupus, you may be more likely todevelop fibromyalgia.
Fibromyalgiagenerally doesn't lead to other conditions or diseases. But the pain and lackof sleep associated with fibromyalgia can interfere with your ability tofunction at home or on the job. The frustration of dealing with anoften-misunderstood condition also can result in depression and health-relatedanxiety.
Because many of thesigns and symptoms of fibromyalgia are similar to various other disorders, youmay see several doctors before receiving a diagnosis. Your family physician mayrefer you to a rheumatologist, a doctor who specializes in the treatment ofarthritis and other inflammatory conditions.
What you cando
Before your appointment, you may wantto write a list that includes:
· Detaileddescriptions of your symptoms
· Information aboutmedical problems you've had in the past
· Information aboutthe medical problems of your parents or siblings
· All themedications and dietary supplements you take
· Questions youwant to ask the doctor
What toexpect from your doctor
In addition to a physical exam, yourdoctor will probably ask you if you have problems sleeping, and if you've beenfeeling depressed or anxious
In 1990, the
· Widespread painlasting at least three months
· At least 11positive tender points — out of a total possible of 18
But fibromyalgiasymptoms can come and go. And many doctors were uncertain about how muchpressure to apply during a tender point exam. While the 1990 guidelines maystill be used by researchers studying fibromyalgia, less stringent guidelineshave been developed for doctors to use in general practice. These newerdiagnostic criteria include:
· Widespread painlasting at least three months
· No otherunderlying condition that might be causing the pain
Blood tests
While there is no lab test to confirma diagnosis of fibromyalgia, your doctor may want to rule out other conditionsthat may have similar symptoms. Blood tests may include:
· Complete bloodcount
· Erythrocytesedimentation rate
· Thyroid functiontests
In general,treatments for fibromyalgia include both medication and self-care. The emphasisis on minimizing symptoms and improving general health.
Medications
Medications can help reduce the painof fibromyalgia and improve sleep. Common choices include:
· Analgesics. Acetaminophen (Tylenol, others) may ease the pain andstiffness caused by fibromyalgia. However, its effectiveness varies. Tramadol(Ultram) is a prescription pain reliever that may be taken with or withoutacetaminophen. Your doctor may recommend nonsteroidal anti-inflammatory drugs(NSAIDs) — such as ibuprofen (Advil, Motrin, others) or naproxen sodium (Aleve,others) — in conjunction with other medications.
· Antidepressants. Duloxetine (Cymbalta) and milnacipran (Savella) mayhelp ease the pain and fatigue associated with fibromyalgia. Your doctor mayprescribe amitriptyline or fluoxetine (Prozac) to help promote sleep.
· Anti-seizuredrugs. Medications designed totreat epilepsy are often useful in reducing certain types of pain. Gabapentin(Neurontin) is sometimes helpful in reducing fibromyalgia symptoms, whilepregabalin (Lyrica) was the first drug approved by the Food and DrugAdministration to treat fibromyalgia.
Therapy
Talking with a counselor can helpstrengthen your belief in your abilities and teach you strategies for dealingwith stressful situations. Many have found acupuncture and massage therapy helpful in controllingthe pain and fatigue of Fibromyalgia.
Besides dealing with the pain and fatigue offibromyalgia, you may also have to deal with the frustration of having acondition that's often misunderstood. In addition to educating yourself aboutfibromyalgia, you may find it helpful to provide your family, friends andco-workers with information.
Living with fibromyalgia
Even withthe many treatment options, patient self-care is vital to improving symptomsand daily function. In concert with medical treatment, healthy lifestylebehaviors can reduce pain, increase sleep quality, lessen fatigue and help youcope better with fibromyalgia.
Here aresome self-care tips.
· Make time torelax each day. Deep-breathingexercises and meditation will help reduce the stress that can bring onsymptoms.
· Set a regularsleep pattern. Go to bed and wake upat the same time each day. Getting enough sleep lets your body repair itself,physically and mentally. Also, avoid daytime napping and limit caffeine intake,which can disrupt sleep. Nicotine is a stimulant, so those with sleep problemsshould stop smoking.
· Exerciseoften. This is a very important partof fibromyalgia treatment. While difficult at first, regular exercise oftenreduces pain symptoms and fatigue. Patients should follow the saying,"Start low, go slow." Slowly add daily fitness into your routine. Forinstance, take the stairs instead of the elevator, or park further away fromthe store. After awhile, do more physical activity. Add in some walking,swimming, water aerobics and/or stretching exercises. It takes time to create acomfortable routine. Just get moving, stay active and don't give up!
· Educateyourself. Nationally recognizedorganizations like the Arthritis Foundation and the National FibromyalgiaAssociation are great resources for information. Share this information withfamily, friends and co-workers.
Points to remember
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