...........................................................................................................................................................
Fibromyalgia
Medically reviewed by
Drugs.com.
Overview
Fibromyalgia
is a disorder characterized by widespread musculoskeletal pain accompanied by
fatigue, sleep, memory and mood issues.
Researchers
believe that fibromyalgia amplifies painful sensations by affecting the way
your brain processes pain signals.
Symptoms
sometimes begin after a physical trauma, surgery, infection or significant
psychological stress.
Women are more
likely to develop fibromyalgia than are men.
Many people
who have fibromyalgia also have tension headaches, temporomandibular joint
(TMJ) disorders, irritable bowel syndrome, anxiety and depression.
While there is
no cure for fibromyalgia, a variety of medications can help control symptoms.
Exercise, relaxation and stress-reduction measures also may help.
Symptoms
Symptoms of
fibromyalgia include:
· Widespread pain. The pain associated with
fibromyalgia often is described as a constant dull ache that has lasted for at
least three months. To be considered widespread, the pain must occur on both
sides of your body and above and below your waist.
· Fatigue. People with fibromyalgia
often awaken tired, even though they report sleeping for long periods of time.
Sleep is often disrupted by pain, and many patients with fibromyalgia have
other sleep disorders, such as restless legs syndrome and sleep apnea.
· Cognitive difficulties. A
symptom commonly referred to as "fibro fog" impairs the ability to
focus, pay attention and concentrate on mental tasks.
Fibromyalgia
often co-exists with other painful conditions, such as:
· Irritable bowel syndrome
· Migraine and other types of headaches
· Interstitial cystitis or painful bladder syndrome
· Temporomandibular joint disorders
Causes
Doctors don't
know what causes fibromyalgia, but it most likely involves a variety of factors
working together. These may include:
· Genetics. Because fibromyalgia tends
to run in families, there may be certain genetic mutations that may make you
more susceptible to developing the disorder.
· Infections. Some illnesses appear to
trigger or aggravate fibromyalgia.
· Physical or emotional trauma. Fibromyalgia
can sometimes be triggered by a physical trauma, such as a car accident.
Psychological stress may also trigger the condition.
Why does it hurt?
Researchers
believe repeated nerve stimulation causes the brains of people with
fibromyalgia to change.
This change
involves an abnormal increase in levels of certain chemicals in the brain that
signal pain (neurotransmitters).
In addition,
the brain's pain receptors seem to develop a sort of memory of the pain and
become more sensitive, meaning they can overreact to pain signals.
Risk factors
Risk factors
for fibromyalgia include:
· Your sex. Fibromyalgia is diagnosed
more often in women than in men.
· Family history. You may be more likely to
develop fibromyalgia if a relative also has the condition.
· Other disorders. If you have
osteoarthritis, rheumatoid arthritis or lupus, you may be more likely to
develop fibromyalgia.
Complications
The pain and
lack of sleep associated with fibromyalgia can interfere with your ability to
function at home or on the job.
The frustration
of dealing with an often-misunderstood condition also can result in depression
and health-related anxiety.
Diagnosis
In the past,
doctors would check 18 specific points on a person's body to see how many of
them were painful when pressed firmly.
Newer
guidelines don't require a tender point exam.
Instead, a
fibromyalgia diagnosis can be made if a person has had widespread pain for more
than three months — with no underlying medical condition that could cause the
pain.
Blood tests
While there is
no lab test to confirm a diagnosis of fibromyalgia, your doctor may want to
rule out other conditions that may have similar symptoms.
Blood tests
may include:
·
Complete blood count
·
Erythrocyte sedimentation rate
·
Cyclic citrullinated peptide test
·
Rheumatoid factor
·
Thyroid function tests
Treatment
In general,
treatments for fibromyalgia include both medication and self-care.
The emphasis
is on minimizing symptoms and improving general health. No one treatment works
for all symptoms.
Medications
Medications
can help reduce the pain of fibromyalgia and improve sleep. Common choices
include:
· Pain relievers. Over-the-counter pain
relievers such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB,
others) or naproxen sodium (Aleve, others) may be helpful.
Your doctor
might suggest a prescription pain reliever such as tramadol (Ultram).
Narcotics are
not advised, because they can lead to dependence and may even worsen the pain
over time.
· Antidepressants. Duloxetine (Cymbalta) and
milnacipran (Savella) may help ease the pain and fatigue associated with
fibromyalgia.
· Your doctor may prescribe amitriptyline or the muscle relaxant
cyclobenzaprine to help promote sleep.
· Anti-seizure drugs. Medications designed to
treat epilepsy are often useful in reducing certain types of pain.
Gabapentin
(Neurontin) is sometimes helpful in reducing fibromyalgia symptoms, while
pregabalin (Lyrica) was the first drug approved by the Food and Drug
Administration to treat fibromyalgia.
Therapy
A variety of
different therapies can help reduce the effect that fibromyalgia has on your
body and your life. Examples include:
· Physical therapy. A physical therapist can
teach you exercises that will improve your strength, flexibility and stamina.
Water-based exercises might be particularly helpful.
· Occupational therapy. An
occupational therapist can help you make adjustments to your work area or the
way you perform certain tasks that will cause less stress on your body.
· Counseling. Talking with a counselor
can help strengthen your belief in your abilities and teach you strategies for
dealing with stressful situations.
Lifestyle and home remedies
Self-care is
critical in the management of fibromyalgia.
· Reduce stress. Develop a plan to avoid or
limit overexertion and emotional stress. Allow yourself time each day to relax.
That may mean
learning how to say no without guilt. But try not to change your routine
completely.
People who
quit work or drop all activity tend to do worse than do those who remain
active.
Try stress
management techniques, such as deep-breathing exercises or meditation.
· Get enough sleep. Because fatigue is one of
the main characteristics of fibromyalgia, getting sufficient sleep is
essential.
In addition to
allotting enough time for sleep, practice good sleep habits, such as going to
bed and getting up at the same time each day and limiting daytime napping.
· Exercise regularly. At first, exercise may
increase your pain. But doing it gradually and regularly often decreases symptoms.
Appropriate
exercises may include walking, swimming, biking and water aerobics. A physical
therapist can help you develop a home exercise program.
Stretching,
good posture and relaxation exercises also are helpful.
· Pace yourself. Keep your activity on an
even level. If you do too much on your good days, you may have more bad days.
Moderation
means not overdoing it on your good days, but likewise it means not
self-limiting or doing too little on the days when symptoms flare.
· Maintain a healthy lifestyle. Eat
healthy foods. Limit your caffeine intake. Do something that you find enjoyable
and fulfilling every day.
Alternative medicine
Complementary
and alternative therapies for pain and stress management aren't new. Some, such
as meditation and yoga, have been practiced for thousands of years.
But their use
has become more popular in recent years, especially with people who have
chronic illnesses, such as fibromyalgia.
Several of
these treatments do appear to safely relieve stress and reduce pain, and some are
gaining acceptance in mainstream medicine.
But many
practices remain unproved because they haven't been adequately studied.
· Acupuncture. Acupuncture is a Chinese
medical system based on restoring normal balance of life forces by inserting
very fine needles through the skin to various depths.
According to
Western theories of acupuncture, the needles cause changes in blood flow and
levels of neurotransmitters in the brain and spinal cord.
Some studies
indicate that acupuncture helps relieve fibromyalgia symptoms, while others
show no benefit.
· Massage therapy. This is one of the oldest
methods of health care still in practice. It involves use of different
manipulative techniques to move your body's muscles and soft tissues.
Massage can
reduce your heart rate, relax your muscles, improve range of motion in your joints
and increase production of your body's natural painkillers. It often helps
relieve stress and anxiety.
· Yoga and tai chi. These practices combine
meditation, slow movements, deep breathing and relaxation. Both have been found
to be helpful in controlling fibromyalgia symptoms.
Preparing for an appointment
Because many
of the signs and symptoms of fibromyalgia are similar to various other
disorders, you may see several doctors before receiving a diagnosis.
Your family
physician may refer you to a doctor who specializes in the treatment of
arthritis and other similar conditions (rheumatologist).
What you can do
Before your
appointment, you may want to write a list that includes:
· Detailed descriptions of your symptoms
· Information about medical problems you've had in the past
· Information about the medical problems of your parents or
siblings
· All the medications and dietary supplements you take
· Questions you want to ask the doctor
What to expect from your doctor
In addition to
a physical exam, your doctor will probably ask you if you have problems
sleeping and if you've been feeling depressed or anxious.
Mayo Foundation for Medical Education and Research
No comments:
Post a Comment