Fibromyalgia is a condition characterized by widespread pain in muscles, ligaments and tendons with several tender points causing pain on small pressure along with fatigue.
If there are symptoms of anxiety related disorder along with pain then it is called as fibromyalgia syndrome.
The exact cause of fibromyalgia is not known but there could be the involvement of variety of factors working together to cause the condition. These factors are genetics, infections and physical or emotional trauma.
Fibromyalgia is genetically associated. If there is a family history of fibromyalgia then it is a risk factor for causing the condition.
Some diseases can cause or aggravate the condition. There is a strong association between post traumatic stress disorder and fibromyalgia.
Sleep disturbances also can cause fibromyalgia.
The symptoms of fibromyalgia may be seen after physical or emotional trauma. But in many cases no such trigger is seen.
It is believed that people having fibromyalgia have increased sensitivity to pain signals in the brain, therefore, they have less pain bearing capacity. There is a repeated stimulation of nerves which results in inappropriate increase in pain transmitting chemicals in the brain. Also pain receptors in brain keep the memory of pain and happen to be more responsive to pain signals.
It is more prevalent in women and in people of middle and adolescent age. Being female, middle or adolescent age, having family history of fibromyalgia, rheumatoid arthritis and disturbed sleep pattern are the risk factors for fibromyalgia.
The symptoms are dependent on stress, weather conditions, physical activity or even the time of the day. Constant wide spread dull muscle pain, along the length of the spine, present above and below the waist; on both the sides of the body and pain lasts for more than three months are the symptoms of fibromyalgia.
There is pain on pressure on specific points. These points are called as tender points and the locations at which they are present are back area of the head, top of the shoulders and between the shoulder blades, front part of the neck, upper chest, outer side of the elbow, upper side of the hips, sides of the hips or inner sides of the knees.
People with fibromyalgia feel tiredness even after plenty of sleep. There may be blurred vision, sensitivity to light and fluctuating eye sight.
Patients of fibromyalgia may have other conditions associated with fibromyalgia. They are lupus, osteoarthritis, rheumatoid arthritis, headache, restless leg syndrome, post-traumatic stress disorder, irritable bowel syndrome, chronic fatigue syndrome, endometriosis and depression.
The American College of Rheumatology has the following recommendations:-
If the pain is widespread and lasts for at least three months, and
Presence of at least 11 positive tender points out of a total of 18.
The presence of above two criteria is in favors for a positive diagnosis of fibromyalgia.
Fibromyalgia is also diagnosed based on medical history, physical examination by applying pressure on tender points and blood tests.
The blood test is for complete blood count, erythrocyte sedimentation rate and thyroid function test. Blood test is done to rule out the diseases with similar symptoms.
The treatment is for symptomatic relief, patient education, exercise, behavioral therapies, in general to improve overall health.
Drugs given are analgesics, antidepressants and anti-seizures. Treatment can be long lasting, in some cases it may be life long also. Friends and family members should be involved in treatment program to help the patient to do physical exercise. Help from support groups help the patients to better cope up the condition.
Good sleep habits should be worked out.
Diet should be with low animal fat and more of fibers, fruits, vegetables and whole grains. Diet should include foods containing Omega 3 fatty acids like dark green leafy vegetables, some oils and some varieties of fishes.
Physiotherapy may be given to make the muscles strong and balanced to reduce pain and counseling to deal with the condition and stressful situations.
Relaxation techniques like biofeedback, meditation, hypnosis or even a massage may help.
The condition is not degenerative and it is also not fatal but it is persistent especially in patients with major life crisis. Many patients with fibromyalgia can not perform their routine functions. There is a risk of self medication and over use of alcohol, drugs, caffeine or sleeping pills. Children have better prognosis than adults. Prognosis is better with regular exercise.
Fibromyalgia is not a progressive disease. This does not lead to any secondary disease or condition. It can disturb sleep pattern and depression which in turn can affect daily life and relationships. The struggle to deal with the condition may be misunderstood and can lead to complications.
