Fibromyalgia

Unexplained Aches And Pains?

Ever felt tired and achy all over, all the time, especially at the neck, shoulders, back, hips, arms or legs? These parts of your body, known as ‘tender points’ (see image), hurt even when touched. Yet, tests at the doctor’s clinic show that there is nothing wrong with your body. 

Before you start thinking that the pain is all in your mind, perhaps you should ask your doctor whether you have fibromyalgia.

WHAT IS IT?

Fibromyalgia (FM) is a chronic pain illness characterised by widespread muscular aches, pain and stiffness, soft tissue tenderness, general fatigue and sleep disturbances.

People with fibromyalgia may have other symptoms, such as headaches, tingling or numbness in hands and feet, painful menstrual periods and problems with thinking and memory, sometimes called “fibro fog.”

The pain and fatigue can be so overwhelming that it disrupts daily life such as getting out of bed and going to work. The pain gets worse with cold/humid weather, non-restorative sleep, physical and mental fatigue, excessive physical activity, physical inactivity, anxiety and stress.

Other symptoms may include irritable bowel and bladder, restless legs syndrome (periodic limb movement disorder), skin sensitivity and rashes, dry eyes and mouth, anxiety, depression, ringing in the ears, dizziness, vision problems, Raynaud’s Syndrome, neurological symptoms and impaired coordination.

All these symptoms wax and wane over time, making diagnosis even more difficult.

 

WHO GETS IT?

Muscular pains are felt particularly when the patient is doing repetitive activities. Consequently, many patients limit their activities including exercise routines. This makes them physically unfit, which aggravates their fibromyalgia symptoms.

Fibromyalgia can affect anyone, with the highest percentage found in middle-aged women. More women get fibromyalgia compared to men, with an approximate ration of 20:1.

People with rheumatoid arthritis, ankylosing spondylitis, Systemic lupus erythematosus (lupus) and other autoimmune diseases are particularly likely to develop fibromyalgia.

Although many fibromyalgia patients are aware of pain when they are resting, it is most noticeable when they use their muscles. Their discomfort can be so severe it may significantly limit their ability to perform everyday tasks.

 

WHAT CAUSES IT?

Fibromyalgia has no known causes, although scientists have found it to be linked to traumatic events such as car accidents, repetitive injuries and illness. A strong genetic link is also found to be a contributing factor.

Researchers also know that Fibromyalgia happens as a result of physiological abnormalities in the spinal cord, thalamus region of the brain and HPA axis.

Abnormal sensory processing in the central nervous system increases the experience of pain in people with fibromyalgia, making it many times worse.

 

MANAGING FIBROMYALGIA

The major challenge for patients is getting a correct diagnosis. As there are no laboratory tests to diagnosing fibromyalgia, doctors must rely on thorough clinical examination comprising the patient’s medical history, description of symptoms, a physical examination and a tender point examination.

According to the American College of Rheumatology (ACR), the criteria must include widespread pain in all four quadrants of the body for a minimum duration of three months and tenderness or pain in at least 11 of the 18 specified tender points when pressure is applied

There is no specfic cure for fibromyalgia, but you can adopt measures that make you feel better. Here are some tips:

1) Find an emphatic doctor

When blood tests and x-rays show normal results, many doctors will start telling you that you have a psychological problem. Seek second or third opinions until you find a doctor who is familiar with fibromyalgia and can emphatise with your pain.

2) Manage your pain

Pain-relief medications such asacetaminophen or ibuprofen may be effective in keeping your pain under control. Antidepressants and injections into tender points may also work well. A regular programme of gentle exercise and stretching to maintain muscle tone and reduce stiffness is also recommended.

3) Get enough sleep

A healthy sleep regimen – such as going to bed and getting up at the same time every day; making sure that the sleeping environment is conducive to sleep, avoiding caffeine, sugar, and alcohol before bed- will help relieve daytime tiredness.  Sleep medications are recommended only for chronic cases where patients cannot sleep due to restless legs syndrome or periodic limb movement disorder.

4) Social support

Psychological and emotional support is essential for fibromyalgia patients. Patients need to communicate regularly with friends and family or seek counseling services if they are beginning to withdraw from society.

5) Complementary therapies

Therapies that help to relax the mind and body can help. Try physical therapy, therapeutic massage, water therapy, light aerobics, acupressure, hot or cold application, acupuncture, yoga, relaxation exercises, breathing techniques, aromatherapy, cognitive therapy or chiropractic.

6) Have good nutrition

Maintain a well-balanced diet and check with your doctor whether you need any nutritional supplements. Eating well will improve your general well-being and help you manage your symptoms better.

7) Make lifestyle changes

Find out what makes the pain worse, such as certain repetitive movements, and avoid them or pace yourself when you are doing them to avoid over-straining yourself. You may need to consider changing jobs or slowing down your pace of work if your symptoms are severe.

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