arthritis_fibromyalgia_fibromyalgia

Fibromyalgia is somewhat of a mystery and difficult to identify. The condition does have a set of general symptoms but they often mirror other medical issues such as a viral flu, including musculoskeletal pain and fatigue. So how do you know if you have fibromyalgia?

Meaning of Fibromyalgia

The condition called “fibromyalgia” is a myofascial pain syndrome (a muscular pain syndrome) that can result in generalized back pain and muscle pain, a feeling of general fatigue, and specific tender areas. The patient will have a normal neurological exam, but may have multiple spots that are tender to palpation, called “tender points”. These tender points are specific places on the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them.

Fibromyalgia most commonly affects middle-age women who are otherwise healthy. However, the condition can affect women of all ages, as well as men and children.

While there is no known anatomical reason for the syndrome, it is suspected that there are underlying biochemical causes.

Fibromyalgia_tender_points_chart-2-359x334

Fibromyalgia Symptoms

People with fibromyalgia often have other symptoms in addition to specific tender points, and common symptoms may include one or some combination of the following:

  • Difficulty sleeping
  • Feeling tired after waking from sleep, instead of feeling refreshed
  • Stiff joints in the morning that usually feel better as the day goes on
  • Headaches
  • Tingling or numbness
  • Depression

Fibromyalgia Treatment

Physicians who treat fibromyalgia typically include family physicians, general internists, or rheumatologists (who specialize in treating painful conditions that involve the joints, muscles, tendons and ligaments). Often a team of healthcare professionals is the best option to treat the diverse symptoms of fibromyalgia.

For example, treatment for fibromyalgia may include one or a combination of the following options:

  • Massage or injections of lidocaine may be used to help relieve the pain in tender spots
  • Non-narcotic pain medications (e.g. acetaminophen)
  • Low-impact aerobic conditioning
  • Antidepressants (e.g. Amytriptiline), both for help with sleeping and to alleviate the pain

On June 21, 2007, the FDA approved Lyrica (pregabalin) as the first medication specifically indicated to treat fibromyalgia pain. Lyrica is an analgesic (pain relief medication) and anticonvulsant medication that is also approved to treat neuropathic pain.

In the clinical trial submitted to the FDA, 30% to 60% of study participants with fibromyalgia experienced significant pain relief while taking Lyrica. The mechanism of action of how Lyrica works to reduce pain in patients with fibromyalgia is not exactly known; it is thought that the drug may impact how chemicals in the brain transmit signals to communicate between neurons.

There are a number of potential risks and side effects with Lyrica, including but not limited to:

  • Weight gain
  • Dizziness, sleepiness
  • Blurry vision
  • Impaired motor function
  • Swelling of the hands and feet

Patient Education

The foundation of an effective fibromyalgia management program is perhaps patient education. A patient who is well educated about fibromyalgia can have a sense of control and improved ability to manage the condition, which in turn can substantially alleviate symptoms of fibromyalgia.

First, patients should know that fibromyalgia is a common, non-progressive, non-deforming, and non-life threatening condition. Patients should be reassured that physical activity will not harm them and in fact can be helpful. Also, remissions can be expected from time to time

Modulating factors that may exacerbate or alleviate fibromyalgia patient symptoms should be identified and discussed. These may include:

  • Offending habits such as excessive caffeine, alcohol or nicotine intake should be addressed.
  • Facilitation of stress management techniques and counseling should be incorporated as appropriate.
  • Energy conservation techniques and work simplification principles should be employed under the direction of an occupational therapist, as appropriate.
  • Adjustments in the work or home environment (such as use of lumbar support in a chair) can facilitate maximum social and vocational abilities.

Source: spine-health web

 

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