Fibromyalgia

What is Fibromyalgia?
Fibromyalgia is a complex chronic pain syndrome that can affect a person physically, socially, and mentally. It is characterized by chronic widespread pain, multiple tender points, abnormal pain processing, sleep disturbances, fatigue, or even psychological distress. The underlying cause of fibromyalgia remains a mystery, but may be different for each patient. While there may be some genetic component, it is believed that most often there is a triggering factor (some sort of physical or emotional stressor) that activates fibromyalgia. There is a current agreement that fibromyalgia is a disorder of processing of the central nervous system. A fibromyalgia patient feels an abnormal amplification of pain due to irregular sensory processing in the central nervous system.

Syndrome – A group of symptoms that consistently occur together or a condition characterized by a set of associated symptoms. (No relation to a specific, identifiable cause)

Who gets Fibromyalgia?
It is estimated that fibromyalgia affects nearly 10 million people in the United States, and approximately 3-6% of the world population. Fibromyalgia can occur in people of all ages, even children. However, fibromyalgia is more common in women. The diagnosis is usually made between the ages of 20 to 50 years of age.

What are the symptoms of fibromyalgia?

• The primary symptom of fibromyalgia is chronic widespread body pain.
  • Fibromyalgia pain has been described as stabbing or shooting pain and deep muscular aching and throbbing. Additional complaints include numbness, tingling, and burning which can all intensify the discomfort for the patient.
  • Severity is typically worse in the morning.
  • Factors that can worsen the pain include cold/humid weather, irregular sleeping, physical and mental fatigue, physical inactivity, anxiety, and stress.

• Other common signs and symptoms include fatigue, sleep disturbances, sensitivity to touch, light, and sound, and impaired memory and concentration.

• There are other conditions that are frequently seen in patients with fibromyalgia. These can include irritable bowel and bladder, headaches and migraines, mitral valve prolapse, periodic limb movement disorders (Restless leg syndrome), skin sensitivities and rashes, dry eyes and mouth, anxiety, depression, ringing in the ears, dizziness, vision problems, neurological symptoms, and impaired coordination.

Top Ten Most Common Fibromyalgia Symptoms
1. Chronic widespread pain
2. Fatigue
3. Sleep difficulties
4. Brain fog
5. Morning stiffness
6. Muscle knots, cramping, weakness
7. Digestive disorders
8. Headaches/migraines
9. Balance problems
10. Itchy/burning skin

What else could these symptoms mean?
These symptoms could be associated with other disorders like osteoarthritis, inflammatory arthritis, chronic fatigue syndrome, or even structural skeletal abnormalities. In order to be properly diagnosed, see your primary care physician.

How is fibromyalgia diagnosed?
To receive a diagnosis of FM, the patient must meet the following diagnostic criteria: (based on the American College of Rheumatology, 2010 Fibromyalgia classification criteria)

• Pain and symptoms over the past week, based on the total of: Number of painful areas out of 18 parts of the body (as identified on Figure 1). Plus level of severity of these symptoms: Fatigue, waking unrefreshed, cognitive (memory or thought) problems. (Other symptoms are also taken into account)

• Symptoms lasting at least three months at a similar level.

• No other health problem that would explain the pain and other symptoms.

Figure 1
http://fmaware.org/site/PageServer.html

How is fibromyalgia treated?

• Are there any prescription medications that I should ask my physician about?
  • There are a few prescription medications that are approved by the U.S. Food and Drug Administration (FDA) specifically for the treatment of fibromyalgia pain. In addition to these medications, there are a multitude of other medications that can be used depending on the patient and the symptoms they are experiencing. If you would like more information on the medications approved by the FDA, or other general questions regarding medication therapy of fibromyalgia, please come in and ask the pharmacist.

• What else can I do to relieve the symptoms?
  • There are other things you can try than just medications to relieve symptoms of fibromyalgia. These depend on exactly what symptoms the patient is trying to relieve.
  • Common symptoms and recommendations:
    • Sleep disturbances/Fatigue
      • Proper sleep discipline – establish routine bedtimes and wake times, avoid naps during the day, avoid alcohol, caffeine, or nicotine close to bedtime, provide a pleasant and relaxing environment (bed should be comfortable, the room should not be too hot or cold, or too bright).
    • Pain
      • Exercise (low-impact aerobics and strength training if able. Ideas include water aerobics, yoga, or Tai Chi), Acupuncture, Massage therapy, Physical/Occupational therapy.
    • Mood Disorders
      • Psychological, spiritual, and/or group counseling

Resources

Fibromyalgia Network – http://www.fmnetnews.com/

National Fibromyalgia Association – http://fmaware.org/site/PageServer.html

American Fibromyalgia Syndrome Association – http://www.afsafund.org/

American College of Rheumatology – http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/fibromyalgia.asp