Fibromyalgia is a disorder associated with chronic, wide-spread pain and tenderness in several areas of the body often with fatigue present continuously for at least three months. Fibromyalgia is characterized by widespread musculoskeletal pain along with stiffness, fatigue, sleep disturbance, cognitive difficulties and mood conditions such as anxiety or depression.
People with fibromyalgia have multiple tender points on the body affecting the neck, shoulders, trapezius muscles, buttocks, hips, arms, ankles and legs. These points are painful when pressure is applied and occur above and below the waist as well as along the axial spine. Patients present with deep constant aches arising within muscles. People with fibromyalgia often have associated disorders including thyroid dysfunction, irritable bowel syndrome, temporomandibular joint disorder, depression and anxiety. However, it is important to rule out other disorders that could be the cause of symptoms. Fibromyalgia is a diagnosis of exclusion.
The exact cause of fibromyalgia is unknown. Research projects are underway to further understand this condition; it is currently thought to be a neurosensory disorder. Patients with fibromyalgia may have a lower threshold for pain due to increased sensitivity to pain signals in the brain. There is an important genetic contribution to fibromyalgia. Women are more likely to develop fibromyalgia than men. As such, female hormones may play a role in experiencing pain. Sleep disturbance plays a role as abnormal sleep affects the stress response system. Symptoms are sometimes seen after physical trauma from tissue injury. Large bodies of data suggest that various forms of stress-related disorders cause dysregulation in the stress response system contributing to fibromyalgia.
There is no cure for fibromyalgia and treatment can be challenging, but with patient education and a multi-disciplinary treatment approach patients can see considerable improvement. Aerobic activity has been shown to improve symptoms in affected individuals, in addition to proper nutrition, sleep therapy, stress management and an overall healthy lifestyle. Psychological and behavioral therapy have shown to be helpful. Certain medications are approved for fibromyalgia, but it is important to not solely rely on these drugs. Patients with fibromyalgia often have difficulty tolerating regular doses of medications and supplements with increased sensitivity and adverse side effects. It is essential to discuss treatment options with a physician specialized in fibromyalgia.
Pain Management Series Part One: MedicationViews 13156