What Is Fibromyalgia? What Causes Fibromyalgia?

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What Is Fibromyalgia? What Causes Fibromyalgia?

http://www.medicalnewstoday.com/articles/147083.php

Article Date: 22 Apr 2009 - 4:00 PDT

The word fibromyalgia comes from the Greek myos meaning " muscle " , Greek

algos meaning " pain " , and New Latin fibro meaning " fibrous tissue " .

According to MediLexicon's medical dictionary, fibromyalgia is " A common

syndrome of chronic widespread soft-tissue pain accompanied by weakness,

fatigue, and sleep disturbances; the cause is unknown. " Fibromyalgia is a

common and chronic disorder. When a health illness or condition is chronic

it means it is long-lasting.

Even though fibromyalgia is frequently referred to as an arthritis-related

condition, it does not cause joint damage or inflammation, as arthritis

does. Neither does fibromyalgia cause damage to muscle and other tissues.

However, it is similar to arthritis because it causes severe pain and

tiredness, and can undermine the patient's ability to go about his daily

activities. Fibromyalgia is seen as a rheumatic condition. A rheumatic

condition is one that causes joint and soft tissue pain.

What are the signs and symptoms of fibromyalgia?

Morning stiffness

Headaches

Irregular sleep patterns

IBS (irritable bowel syndrome)

Painful menstrual periods (Dysmenorrhea)

Hands and feet tingle and can feel numb

Restless leg syndrome

Sensitivity to cold or heat

Fibro fog (memory problems, cognitive problems)

The following signs and symptoms are also possible

Widespread pain

Problems with vision

Nausea

Pelvic and urinary problems

Weight gain

Dizziness

Cold/flu like symptoms

Jaw pain and stiffness

Skin problems

Chest symptoms

Depression

Anxiety

Myofascial pain syndrome (pain/tiredness in muscles and adjacent fibrous

tissues)

Breathing problems

Fibromyalgia is a syndrome

A syndrome is a collection of signs, symptoms and medical problems. A

disease is a medical condition with defined causes and clear signs and

symptoms.

How common is Fibromyalgia? Who gets Fibromyalgia?

According to reported cases in the USA, approximately 1 in every 73 American

adults suffers from fibromyalgia. The American College of Rheumatology says

that between 3 and 6 million Americans have fibromyalgia.

The NIH (National Institutes of Health, USA) says 90% of fibromyalgia

patients are women. Men and children may also be affected.

Although symptoms may become present at any time during a person's life,

they are most commonly reported when the patient is middle-aged.

People who suffer from rheumatoid arthritis, lupus (systemic lupus

erythematosus), or spinal arthritis (ankylosing spondylitis) have a higher

risk of developing fibromyalgia, as well as patients with some other

rheumatic diseases.

Studies indicate fibromyalgia may also be hereditary. Females who have a

close relative with fibromyalgia have a significantly higher risk of

suffering from it themselves. Experts are not certain whether the link is

genetic, circumstantial, or both.

What Causes Fibromyalgia?

Experts say there are probably a number of factors. However, nobody is

really sure what causes fibromyalgia. Factors such as a traumatic,

stressful, or emotional event may be linked to developing fibromyalgia.

Possible causal factors currently include:

A stressful, traumatic physical or emotional event (e.g. Post-traumatic

stress disorder, a car accident)

Repetitive injuries

Rheumatoid arthritis

Lupus

CNS (central nervous system) problems

The way our genes regulate how we process painful stimuli

How Is Fibromyalgia Diagnosed?

A patient with fibromyalgia will usually keep going back to the doctor many

times before a proper diagnosis is made. This is because the symptoms are

similar to other conditions. Before diagnosing fibromyalgia the doctor needs

to rule out other conditions and illnesses.

As laboratory tests do not show a physical reason for the pain that goes

with fibromyalgia, there are not any diagnostic laboratory tests for it.

This can be frustrating for the patient and the doctor as well.

Unfortunately, the patient still runs the risk of being told by an untrained

doctor that his pain is not real and that there is therefore no treatment.

The American College of Rheumatology has established two criteria for

diagnosing fibromyalgia:

A history of widespread pain that has lasted over three months. Widespread

means the pain affects the four parts (quadrants) of your body - the left,

right, top and bottom sides.

The presence of tender points in 18 sites of the body. These sites are

located at the back and front of the neck, between the neck and chest, just

below the neck on the back, the knees, the inside of the elbows, just above

the buttocks (where two dimples are usually located), just below the

buttocks at the top of the back thighs at their furthest point from the

crotch. At least 11 of these points need to be tender for a fibromyalgia

diagnosis to be confirmed. For a point to be tender the patient should feel

pain if 4gk of pressure is applied to it. It is possible that a fibromyalgia

patient feels pain at other points - however, for a diagnosis to be

confirmed tenderness needs to be limited to those 18 points (at least 11 of

them).

What is the treatment for Fibromyalgia?

It is important that the patient's doctor is trained in treating

fibromyalgia, as it is not an easy condition to treat. Fortunately, more and

more doctors, including GPs (general practitioners) know what to do. For

best results the patient should be treated by the doctor, a physical

therapist, and possibly some other health care professionals simultaneously.

Patient compliance is crucial for good results. Patient compliance means

that the patient is actively involved and does not forget to follow

instructions.

Each patient is different and will require individualized treatment.

Treatment will usually include some or all of the following:

An active exercise program

Low-dose anti-depressants

Acupuncture

Psychotherapy

Behavior modification therapy

Chiropractic care

Massage

Physical therapy (UK term is called physiotherapy)

Drugs

Various studies have indicated that pharmacologic treatment (drugs) for

fibromyalgia helped between one-third and one-half of all patients. However,

some of them experienced worsening symptoms.

One study demonstrated that taking a tricyclic antidepressant, 25 mg of

amitriptyline (Elavil), with a selective serotonin reuptake inhibitor, 20 mg

of fluoxetine (Prozac), all in combination was twice as effective as either

one taken alone.

Exercise

Aerobic exercise combined with resistance training (strength-training) have

been linked to a significant improvement in pain, tender point counts, and

sleep disturbance. Unfortunately, a large percentage of patients do not keep

up the exercises. Studies have shown that working out with a partner or

personal trainer helps to keep the program active.

Acupuncture

Many patients have experienced improvements in their quality of life after

starting acupuncture therapy. How often sessions should be depends on the

individual.

Painkillers

If the pain is severe, and other therapies have not been effective or cannot

be utilized, chronic opioid analgesic therapy - oral painkillers - may be an

option. Aspirin and ibuprofen are generally not very effective.

Behavior modification therapy

This includes learning new coping skills, relaxation exercises and

self-hypnosis. Patients have commented that pain perception, which is a very

complicated phenomenon, may be altered with experience.

Growth hormone therapy

Growth hormone therapy has been shown in one study to be effective in

reducing symptoms, without serious side-effects. However, the treatment is

extremely expensive.

Will I get better? Will I get worse? What is the prognosis?

There is no definitive cure for fibromyalgia. However, treatment is a lot

better today than it used to be. Clinical studies have shown that your

symptoms can improve significantly if you follow all your treatment to the

letter. Keep working with trained health care professionals, as well as

informed and motivated patients and you will experience significant

improvements in your symptoms and quality of life.