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
- Heightened sense of pain
- Sleep problems
- Joint Stiffness
- Bowel problems
- Bladder problems
- 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
- 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.
- 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.
- 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.
- 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.
- Exercise and fitness helps reduce pain, fatigue, and it improves overall sleep and health
- Strong evidence that cardiovascular exercise is effective in some patients
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
- Quality of life were improved in patients with fibromyalgia by taking something for depression
- Sleep, fatigue, depression, and other symptoms were improved.
- This medication is a long acting pain medication
- Is moderately effective in treating fibromyalgia
- 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
- 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
- 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
- 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