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Fibromyalgia: It Hurts & Puzzles

Frequently, chipur presents a medical piece on Tuesdays. I’d like to do just that today, bringing you some helpful information on fibromyalgia. Let’s learn together.

Fibromyalgia is a mysterious and troubling condition featuring ongoing and widespread muscle, ligament, and tendon pain (described as a dull ache). Multiple tender points and fatigue are also primary symptoms.

But a diagnosis of fibromyalgia syndrome ups the ante. In addition to the symptoms I just mentioned, presenting may be overwhelming fatigue, poor sleep, joint stiffness, bowel and bladder abnormalities, cognitive dysfunction, muscle spams and twitching, tingling of the skin, heart palpitations, weakness in the limbs, nerve pain – and more.

Fibromyalgia commonly coexists with depression, anxiety, and stress-related disorders. Interestingly, symptoms often commence after an emotional or physical trauma.

The risk of fibromyalgia increases with age. And, sorry ladies, you’re nine times more likely to have to endure it than us guys.

Fibromyalgia is not a progressive condition, and does not lead to more serious physical diagnoses.

Tender Points?

Allodynia is an increased pain response to tactile (touch) pressure. There are specific areas of the body – tender points – that are especially vulnerable.

Included are the back of head, between the shoulder blades, top of the shoulders, front sides of the neck, upper chest, outer elbows, upper hips, sides of hips, and inner knees.

Sleep Issues, Fatigue, and More

It’s not uncommon for someone enduring fibromyalgia to awaken exhausted, in spite of believing they got plenty of sleep. It could well be about not reaching the deep level of sleep that refreshes us. It’s thought that conditions such as restless leg syndrome and sleep apnea are close friends to fibromyalgia.

Speaking of which, common co-existing conditions include…

Headaches, lupus, osteoarthritis, chronic fatigue syndrome, irritable bowel syndrome, depression, endometriosis, posttraumatic stress disorder, and rheumatoid arthritis.

Cause?

Well, that’s a good question. No one knows for sure, but it’s likely a matter of a combination of factors. Certainly, genetics is involved because fibromyalgia tends to run in families. Any number of illnesses may trigger fibromyalgia, as well. And just as its onset can be linked to some sort of physical trauma, emotional and mental traumas may also cause problems.

It’s also been hypothesized that fibromyalgia may be caused by a lower threshold for pain, due to increased sensitivity in the brain to pain signals. This is known as central sensitization.

Finally, it’s believed that repeated nerve stimulation results in actual changes in the brain. One of these may be abnormal increases in neurotransmitters involved in pain. It’s also thought that the brain’s pain receptors develop, shall we say, a memory of the pain. And that causes them to become more sensitive – “overreactive.”

How Is It Diagnosed?

The American College of Rheumatology offers two criteria for a diagnosis of fibromyalgia…

  • Widespread pain lasting at least three months
  • At least 11 positive tender points — out of a total possible of 18

Blood tests are also used to diagnose fibromyalgia. But physicians aren’t looking for proof of fibromyalgia, as much as they’re looking for rule-outs. “What it isn’t.”

How Is It Treated?

The keystones of treatment for fibromyalgia are medications and self-care/management.

Frequently prescribed medications…

  • Pain relievers – acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and the prescription opioid, tramadol (Ultram)
  • Antidepressants – amitriptyline (Elavil), fluoxetine (Prozac), duloxetine (Cymbalta), milnacipran (Savella)
  • Anti-seizure meds – gabapentin (Neurontin), pregabalin (Lyrica)

Within the non-med treatment realm…

  • Exercise, stretching, applications of hot or cold
  • Psychotherapy, particularly cognitive behavioral therapy (CBT)
  • Stress reduction work
  • Sleep enhancement strategies and techniques
  • Maintaining a healthy lifestyle
  • Meditation and yoga
  • Acupuncture
  • Chiropractic care
  • Massage

So there’s a nice thumbnail on fibromyalgia. One of chipur’s responsibilities is to provide objective information on that which may be ailing us. Consider it information to get us started (or stay) on the road to wellness.

Need more information on fibromyalgia? Here’s a link to the National Fibromyalgia Association’s website. And how ’bout this? Here’s a site that provides resources for new moms with autoimmune conditions.

image credit midwestfibromyalgiareliefcenter.com Thanks to mayoclinic.com for the info.

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