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Description:

Is a chronic syndrome in which an individual has long-term, body-wide pain and tenderness of the joints, muscles, tendons and other soft tissues. Fibromyalgia is also referred to as fibromyalgia syndrome (abbreviated FMS) and is characterized by pain, fatigue, sleep, memory and mood problems. Fibromyalgia is also commonly referred to by physicians as a “mysterious” and debilitating disease. Fibromyalgia affects predominantly women (over 80% of those affected are women) and most women seen with the disease are between 35-55 years of age. Fibromyalgia can also affect men, children, and the elderly, and is also normally seen with complications like headaches, anxiety and irritable bowel syndrome. It can occur independently or can be associated with another disease, such as systemic lupus or rheumatoid arthritis and others. There are "tender points," or "pressure points," which are areas of the body that are tender to light touches. These tender points are found in the neck, shoulders, hips, back of the head and side of the breastbone, and are especially sensitive to those with Fibromyalgia. It is not uncommon to see a presenting case of Fibromyalgia following physical trauma or even severe psychological stress.


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Diagnosis:

Diagnosing fibromyalgia can be tricky, and is normally one of a clinical nature, as there is no definitive test for fibromyalgia. On average, it takes five years for a person with fibromyalgia to get an accurate diagnosis due to its complicated and non-specific nature. There is a blood test that is used to help diagnose fibromyalgia; this test is called FM/a. FM/a identifies markers produced by the immune system blood cells in people with fibromyalgia. Fibromyalgia is also diagnosed by a physical exam, doctor will ask about your symptoms, tender points and history. Other test that you may be asked to take is CBC-complete blood count, Kidney and Liver tests and possibly a thyroid test to see it’s overactive or under-active. These are all routine tests to determine and rule out certain pathologies; but they also give insight to a fibromyalgia diagnosis. To make sure the patient gets the right diagnosis, your doctor will do the following eight things to diagnose Fibromyalgia:

  • 1. Examine patient history
  • 2. check for the whole body for pain
  • 3. evaluate trigger points & tenderness
  • 4. ask about fatigue
  • 5. inquire about sleep patterns and possible disturbances
  • 6. evaluate current stress levels
  • 7. test for depression
  • 8. Run specific labs (CBC, TSH, F/MA…)

Once diagnosed you will be put on a treatment program that includes medications, exercise, stress reduction, sleep strategies and much more.

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Cause:

The cause of fibromyalgia is unknown, but most likely fibromyalgia is the result of many factors working together. Genetics are thought to play a factor in the cause of fibromyalgia. There may be certain genetic mutations that account for fibromyalgia in patients. Patients experiencing fibromyalgia most likely have genes that are more susceptible to this disorder.

Possible triggers are:
  • Physical or emotional trauma
  • Abnormal pain response-areas in the that are responsible for pain may react differently in fibromyalgia patients
  • Sleep disturbances
  • Infections, such as a virus
  • Depression
  • Major Life Changes
  • High Levels of Stress


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Symptoms:

  • Chronic muscle pain, muscle spasms, or tightness
  • Fatigue with decreased energy
  • Insomnia or waking up feeling just as tired as when you went to sleep
  • Stiffness
  • Difficulty remembering, concentrating, and performing mental tasks ("fibro fog")
  • Abdominal pain, bloating, nausea, and constipation alternating with diarrhea (irritable bowel syndrome)
  • Tension or migraine headaches
  • Jaw and facial tenderness
  • Sensitivity to odors, noise, bright lights, medications, certain foods, and cold
  • Feeling anxious or depressed & other mood issues like increased irritability
  • Numbness or tingling in the face, arms, hands, legs, or feet
  • Increase in urinary urgency or frequency (irritable bladder)/ Irritable bowel
  • Reduced tolerance for exercise and muscle pain after exercise
  • A feeling of swelling (without actual swelling) in the hands and feet
  • Dizziness
  • Dry mouth, skin, and eyes



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Treatment:

The treatment program that includes medications, exercise, stress reduction, sleep strategies. Some of the medications that are used for treating fibromyalgia are Cymbalta (use to manage the unique symptoms), Lyrica (calms over excited nerves that causes pain/first approved drug to treat FMS), and Savella (relieves pain and improves how the patient functions physically). Although not very common, some physicians will prescribe a small course of antibiotics to fibromyalgia patients. Stress Reduction varies from person to person. There is no one "pill" that treats or cures fibromyalgia. Patients respond differently to each type of treatment, so treating Fibromyalgia effectively can be a complicated task for even the most seasoned physician. A multidisciplinary approach that uses both medication and alternative or lifestyle strategies seems to work best to treat fibromyalgia symptoms. The multidisciplinary approach does not cure fibromyalgia; it is implemented to manage the symptoms of the disease. Sometimes, changes in environmental factors (such as noise, temperature, and weather exposure) can worsen the symptoms of fibromyalgia, and these factors need to be modified accordingly. Optimal sleep is encouraged, patients need to aim for eight hours a night. Exercise regimens are most beneficial when performed on an every-other-day basis, in the morning. Exercising keeps the muscles conditioned and healthy by exercising three times a week will decrease the amount of discomfort. Low-impact aerobic exercises, such as swimming, cycling, walking, yoga, and stationary cross-country ski machines, can be effective fibromyalgia treatments. Many patients report a decrease in symptoms from a change in diet geared away from processed foods. Physical Therapy can also used as treatment for fibromyalgia. Physical therapist may use different types of tools with fibromyalgia patients including:

  • deep tissue massage
  • low-impact aerobic conditioning (water aerobics)
  • pain relief exercise
  • stretching and strengthening exercises
  • TENS units (transcutaneous electrical nerve stimulation)
  • Ultrasound


Web Resources:

Tips on Coping with Fibromyalgia
National Fibromyalgia Association
Fibromyalgia News
Fibromyalgia Clinical Trials

Related Terminology:


Citations/References:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001463/
http://www.webmd.com/fibromyalgia/guide/what-is-fibromyalgia
http://flplahore.blogspot.com/2012/08/fibromyalgiacauses-diagnosis-symptoms.html
http://www.nytimes.com/2008/01/14/health/14pain.html?pagewanted=all
Diagnosis
Treatment

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