Fibromyalgia

Overview of fibromyalgia – Fibromyalgia is a syndrome characterized by widespread musculoskeletal pain and is accompanied by fatigue, sleep disturbances, cognitive disturbances.

There is repeated nerve stimulation caused by an increase in levels of certain chemicals in the brain that signal pain (neurotransmitters).

 

Symptoms of fibromyalgia –

  • Musculoskeletal pain – There is widespread musculoskeletal pain. Typically, at least six sites are involved in people with fibromyalgia, which may include the head, the chest, each arm, the abdomen, each leg, the upper back and spine, and the lower back and spine (including the buttocks).
  • Sleep disturbances – People with fibromyalgia have difficulty getting enough sleep. People with fibromyalgia wake up frequently during the early morning and have difficulty getting back to sleep.
  • Fatigue
  • cognitive disturbances – The cognitive disturbances in fibromyalgia are often referred to as “fibro fog.” The ability to focus, pay attention and concentrate on mental tasks may be impaired.
  • Headache – Migraine and muscular type of headaches are common in people with fibromyalgia.
  • There may be tingling, burning, numbness or creeping or crawling sensations, especially in both arms and both legs.

 

Causes of fibromyalgia –

  • Fibromyalgia tends to run in families.
  • Physical trauma or psychological stress may trigger fibromyalgia.
  • Infections may trigger or aggravate fibromyalgia.

 

Complications of fibromyalgia –

  • Depression
  • Anxiety

 

Diagnostic criteria for fibromyalgia –

According to the 2010 American College of Rheumatology (ACR) preliminary diagnostic criteria for fibromyalgia, if the following three conditions are met:

  • Widespread pain index (WPI) >7 and symptom severity (SS) scale >5 or WPI 3 to 6 and SS scale >9
  • Symptoms have been present for at least three months
  • There is no other disorder that would explain the patient’s symptoms

 

The WPI is a measure of the number of painful body regions from a defined list of 19 areas.

The SS score includes an estimate of the degree of fatigue, cognitive symptoms, waking unrefreshed, and the number of somatic symptoms (symptoms experienced in the body) in general.

 

Diagnosis of fibromyalgia –

The diagnosis is based on the subjective symptoms and ruling out other conditions that could have caused these symptoms.

The tests that may be done are complete blood count, erythrocyte sedimentation rate, C reactive protein levels. In selected people, muscle enzymes and thyroid testing are done.

 

Management of fibromyalgia –

Lifestyle management –

  • Reduce stress by stress management techniques, such as deep-breathing exercises or meditation.
  • Practice good sleeping habits such as going to bed and getting up at the same time each day.
  • Follow an exercise program such as biking, swimming, walking. A physical therapist or your doctor can develop a pain exercise program for you.
  • Eat healthy food and limit your caffeine intake.
  • Engage in activities that you find enjoyable and fulfilling.
  • Talk to your doctor about complementary and alternative therapies for pain and stress management such as acupuncture, massage therapy, yoga, and tai chi.
  • Physical therapy, occupational therapy, counseling are different therapies that can help reduce the effect fibromyalgia has on your body. Talk to your doctor about these therapies.

 

Medications- Medications that are used are pain killers such as acetaminophen, ibuprofen, naproxen; antidepressants such as duloxetine, milnacipran, amitriptyline; anti-seizure medications such as gabapentin, pregabalin.

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