Fibromyalgia is a condition that can be complex and is not well understood.

It is described as a set of conditions that circle around pain, fatigue, pressure, and other symptoms.

It appears to affect the central nervous system.

Fibromyalgia is often a condition that is also closely related or affected by other conditions such as depression, post-traumatic stress disorder, and anxiety.

Not all individuals experience the entire range of symptoms.

It is seen in women almost 9 times for every 1 times it is seen in men.

This condition remains to be elusive in defining a cause or acceptability throughout the medical world.

The belief by some health care providers is that there is a lack of abnormalities on physical exam and there are no objective diagnostic tests that show an abnormality.

It has been recognized as a diagnosable disorder by the National Institute of Health and the American College of Rheumatology.

This is a major issue of Women’s Health

 

Fibromyalgia breaks down into:

1.)  Fibro  – meaning fibrous tissues

2.)  Myo – meaning muscle

3.)  Algos – meaning pain

 

Symptoms

  • Heightened sense of pain
  • Pain
  • Pressure
  • Fatigue
  • Sleep problems
  • Joint Stiffness
  • Bowel problems
  • Bladder problems
  • Numbness
  • Tingling
  • Cognitive Dysfunction

*** Pain is often in many locations therefore the diagnosis is often made after several different complaints of body pain with normal X-ray, MRI, and blood work examinations

 

Causes

  • Currently the cause of fibromyalgia is unknown.
  • Theories range from a mental health initiated pain change.
  • To lower pain threshold because of increased brain sensitivity.
  • Stress may be a cause or at least a precipitating factor.
  • But it is unclear why it affects some people and not others.
  • Lack of sleep may also be a risk factor for this condition.

 

Diagnosis

  • No single test can help diagnosis a patient.
  • The debate about a proper diagnosis procedure is underway.
  • Lab tests are often normal.
  • Usually diagnosis occurs after many other problems have been eliminated as possibilities.
  • Consideration for age, gender, symptoms, location, medical history, and other factors should be given.

 

Additional consideration:

  • Widespread pain lasting for more than 3 months affecting both sides of the body and above and below the waist.
  • Tender points – patient must feel pain in 11 of the 18 tender points.

 

Treatment

  • There is no universally accepted treatment.
  • Symptoms can be different in many cases.
  • Behavioral therapies are designed to help with mental health, fatigue, and inactivity
  • Exercise if often helpful, though this is light exercise such as walking or pool use for many patients.

Physical Treatment

  • Exercise and fitness helps reduce pain, fatigue, and it improves overall sleep and health
  • Strong evidence that cardiovascular exercise is effective in some patients

Medications

1.) Pregabalin  –  approved for use in Fibromyalgia in June 2007
2.) Duloxetine  –  approved in 2008
3.) Milnacipran  –  approved in 2009

Pregabalin and Duloxetine can help reduce pain in some patients

Antidepressants

  • Quality of life were improved in patients with fibromyalgia by taking something for depression
  • Sleep, fatigue, depression, and other symptoms were improved.

Tramadol

  • This medication is a long acting pain medication
  • Is moderately effective in treating fibromyalgia

Neurontin (gabapentin)

  • An atypical seizure medication that is also used to help tingling and nerve problems.
  • Is also used in some diabetics to help with Neuropathy
  • Is approved for neuropathic pain but is not approved for fibromyalgia
  • Is occasionally used for fibromyalgia

Lyrica  (pregabalin)

  • Is used for treatment of nerve pain in Diabetics
  • Some benefit is seen in a small population of patients with fibromyalgia
  • Is not approved for fibromyalgia
  • Is occasionally used for fibromyalgia

Mirapex and Requip

  • Has some improvement
  • Many side effects make these medications more of a concern than a treatment option

Muscle Relaxers

  • Flexeril (Cyclobenzaprine) is occasionally used to help muscle pains felt by those with fibromyalgia.
  • It has been studied for this use
  • Has mild improvement overall
  • Tizanidine is another muscle relaxer
  • Is typically used less often than Flexeril

Opioids

  • These are stronger pain medications called Narcotics
  • This medication should be the last tried medication for pain
  • It is not often a good option unless all other avenues have been evaluated
  • The risk for abuse often outweighs the benefits gained.
  • Addiction is another concern
  • No actual studies have shown benefit of opioids and fibromyalgia
  • Symptoms may actually worsen when taking
VN:F [1.9.22_1171]
Rating: 9.3/10 (4 votes cast)
VN:F [1.9.22_1171]
Rating: +5 (from 5 votes)
Fibromyalgia, 9.3 out of 10 based on 4 ratings