A Guide To Fibromyalgia


Fibromyalgia is one of the more common musculoskeletal conditions.  However, it is still frequently misunderstood and misdiagnosed.  Its symptoms include fatigue, joint pain and muscle pain.  Fibromyalgia also sometimes leads to social isolation and depression.

What Does Fibromyalgia Syndrome Mean?

A syndrome refers to a set of symptoms.  Whenever they exist at the same time, it implies either the presence of a certain disease or the changes of developing the disease are greater.  It is common for the following symptoms to occur together with fibromyalgia syndrome:

  • Widespread pain
  • Incapacitating fatigue
  • Tender points or decreased pain threshold
  • Depression or Anxiety

Fibromyalgia Symptoms

When you have fibromyalgia, you ache all over.  Another symptom you might have is crippling fatigue, even when you wake up in the morning.  You might have specific tender points that are painful to touch on your body.  You might also experience depression, mood disturbances and also disturbances to your restful or deep-level sleep.  Your muscles might feel like they’ve been pulled or overworked.  Even without exercise they might feel that way.  Your muscles sometimes have deep stabbing pain, burn or twitch.  Some fibromyalgia patients have achiness and pain around their joints in the hips, back, shoulders and neck.  This makes it very hard to exercise or sleep.  There are other fibromyalgia symptoms, including:

  • Stiffness
  • Tingling or numbness in the feet and fingers
  • Irritable bowel syndrome
  • Incontinence
  • Inability to concentrate (referred to as “fibro fog”)
  • Hypersensitivity to heat and/or cold
  • Dryness in eyes, nose and mouth
  • Chronic headaches
  • Abdominal pain

Sometimes fibromyalgia causes feelings and signs that are similar to tendinitis, bursitis and osteoarthritis.  Some experts include fibromyalgia in the arthritis and related group of disorders.  However, the pain from tendinitis or bursitis is localized in a specific area, whereas fibromyalgia stiffness and pain is widespread.

How Is Fibromyalgia Diagnosed?

In order to accurately diagnose your condition, the doctor relies on your medical history and a comprehensive physical exam.  A blood test called FM/a helps to diagnose fibromyalgia.  The test identifies markers that the immune system’s blood cells produce in individuals that have fibromyalgia.  Discuss whether or not the FM/a test is a good option for you with your doctor.

Your doctor might run other specific blood tests in order to rule other serious illnesses out.  Your doctor, for example, might ask to have a complete blood count done.  He might also ask for chemical tests, like glucose, that may create problems that are similar to those caused by fibromyalgia.  There could also be a thyroid test performed.  Underactive thyroids may sometimes cause problems that are similar to the ones caused by fibromyalgia.  This includes depression, weakness, muscle aches and fatigue.

Other laboratory tests that might be used for ruling out other serious illness can include vitamin D level, calcium level, prolactin level, erythrocyte sedimentation rate, rheumatoid factor, antinuclear antibodies and Lyme titers.

Your doctor might want to know whether or not your symptoms satisfy the American College of Rheumatolgy’s fibromyalgia syndrome diagnostic criteria.  Included in the criteria is widespread pain persisting for three months at least.  Widespread pain is occurring in the left and right sides of one’s body, both below and above the waist as well as in the lower or mid back, neck and chest.  Another criteria is tender points being present at different parts of the body.  Your doctor will also evaluate how severe related symptoms are like mood disorders, sleep disturbances and fatigue.  This helps to measure what impact fibromyalgia  has had on your emotional and physical functioning in addition to your overall health and quality of life.

Is There A Standard Fibromyalgia Treatment?

There is no such thing as a fibromyalgia cure.  There is also not one standard treatment that addresses every fibromyalgia symptom.  There are instead a wide variety of both alternative and traditional treatments that have proven to be effective as treatments for this very difficult syndrome.  A fibromyalgia treatment program might include a combination of behavioral techniques, exercises (both aerobic and strength conditioning) and medications.

What Drugs Are Effective In Treating Fibromyalgia?

Fibromyalgia drug therapy mainly treats the symptoms.  Three drugs have been approved by the FDA to treat fibromyalgia: Savella, Cymbalta and Lyrica.  The FDA states that Lyrica (also used for treating nerve pain from spinal cord injuries, diabetes and shingles) can help ease pain form fibromyalgia for some patients.  Savella and Cymbalta are in the serotonin and norepinephrine reuptake inhibitor (SNRIs) drug class.

Trycyclic drugs in low doses are also sometimes effective in treating fibromyalgia pain.  These include amitriptyline and Flexeril.  Dual reuptake inhibitor antidepressants such as Effexor have also shown positive results.  Another pain-relieving medication that might be helpful is Ultram.

An antidepressant like Zoloft, Paxil or Prozac might also be prescribed by your doctor.  These drug can help with relieving feelings of pain, sleep disorders and depression.  Researchers recently have discovered that Neurontin, which is an antiepileptic, also shows promising signs for treating fibromyalgia.

Anti-inflammatory nonsteroidal drugs such as Cox-2 inhibitors haven’t proven to be very effective in the treatment of fibromyalgia pain.  Avoiding opioid pain medications is usually best.  They have a tendency to not work very well over the long run and there could also be dependency problems.

Are There Any Alternative Fibromyalgia Treatments?

Although alternative therapies haven’t been well-tested, they can help with managing fibromyalgia symptoms.  For example, the the body’s soft tissues and muscles are manipulated when therapeutic massage is used.  This helps with easing deep muscle pain.  This also helps with relieving pain from tense muscles, muscle spasms and tender points.  Myofascial release therapy works on a wider range of muscles.  It can also realign, lengthen, soften and gently stretch connective tissues to help ease pain or discomfort.

Moderate aerobic exercise is recommended by the American Pain Society two to three times per week.  Clinician-assisted treatments are also endorsed, including chiropractic manipulation, therapeutic massage, acupuncture and hypnosis for pain relief.

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