Fibromyalgia
A Little About Fibromyalgia
Fibromyalgia is believed to be suffered by roughly 3 to 6 million American's. This is anywhere from 2 to 4 percent of the population, with women being the primary suffers having this condition 9 to 1 in comparison to men. There is actually alot of controversy over whether Fibromyalgia is actually considered to be a disease, overall it is considered to be a controversial diganosis. This is because it lacks any scientific evidence as to its cause. Historically it is considered to be either a musculoskeletal disease or neuropsychiatric condition, evidence over the last 3 decades has come to show that it could possibly be caused by central nervous system abnormalities. These abnormalities may be linked to both the clinical symptoms and research phenomena affecting particular regions of the brain. Some research shows this condition may be linked to childhood stress, or prolonged or severe stress.
What is Fibromyalgia?
Fibromyalgia is a greek/latin word meaning, fibro - fibrous tissue, myo - muscle, algos - pain related to muscle and connective tissue. It is a chronic condition that causes stiffness, tenderness of the muscles, joints, and tendons, and severe pain for the people that suffer from it. It's cause is relatively unknown even though it is one of the most common known diseases/syndromes that affect the muscles. It does not cause any internal damamge to the organs of the body, nor will it cause the patient to suffer from any physical deformities. It will however cause widespread pain throughout the body, meaning the nervous system is unable to control what it feels. This causes the nerves, spinal cord, and brain to send pain signals rather than the normal feelings a person would likely feel. People suffering from fibromyalgia feel pain even when there is no injury, this makes it difficult for a person who has this condition to find proper treatment.
Some people may have to change their overall lifestyle if the condition is or becomes severe enough. Some of the symptoms caused by fibromyalgia can cause interference in a person daily life. This may cause you to feel depressed, lack the energy to perform normal duties, or even have difficulty sleeping if the symptoms are not kept under control. This is not a likely situation as most fibromyalgia patients are able to continue working and paticipate in daily activities once the proper treatment is found.
What Causes Fibromyalgia?
The exact cause of fibromyalgia is unknown, however there are believed to be a number of factors involved. Some believe the people who have this condition have neurotransmitters that are out of balance, while some think it may have to do with nerve cells that are to sensitive. There is not enough evidence to prove it is caused one single condition or event. It is also beieved that people who have certain rheumatic diseases are more susceptible to have fibromyalgia.
There are several different studies being conducted to determine the causes of fibromyalgia, there is speculation that a persons genes can regulate the way a person perceives pain. It has been identified that there are genes that occur more often in fibromyalgia patients. NIAMS supported research is also looking into other possibilities such as tramatic events and severe stress, repetitive injuries, and illness. There are even studies being conducted in relation to it being linked to the central nervous system.
What are Fibromyalgia's Symptoms?
There are symptoms that can help identify wether or not you are/or could be suffering from fibromyalgia. One of the primary indicators is wide spread chronic pain in the neck, back, muscles, and soft tissues. There may also be pain throughout the body at certain locations called pressure points, they may not always hurt but will when pressed upon. This is no always the case but these pressure points are a pretty good indicator that your pain could be related fibromyalgia. Fibromyalgia is also believed to be associated with depression or anxiety. Below are some of the symptoms that are known to be associated with identifying fibromyalgia, there are many others but these are the most common.
* Headaches
* Restless Leg Syndrome
* Memory Problems
* Irritable Bowel Syndrome
* Morning Stiffness
* Numb or Tingling Extremities
* Sleep Disturbance
* Sensitivity to Temperature
* Bright Light/Loud Noise Sensitivity
* Prolonged Muscle Spasms
* Nerve Pain
* Inability to Multi-Task
* Fatigue
A recent internet survey for fibromyalgia patients was conducted to help identify the most common factors believed to worsen fibromyalgia pain, out of 2,596 the following were the results of the test; emotional distress (83%), weather changes (80%), sleeping problems (79%), strenuous activity (70%), mental stress (68%), worrying (60%), car travel (57%), family issues (52%), physical injuries (50%), and physical inactivity (50%). Other factors that were included in the test were chemical exposure, medication side effects, lack of support, infections, and allergies. Also, even though fibromyalgia is often associated with wide spread pain, it may also be localized in areas such as the lower back, hips, shoulders, neck, and other areas throughout the body.
How is Fibromyalgia Diagnosed?
Research has shown that many people suffering from fibromyalgia have to see several doctors before determining that fibromyalgia is the diagnosis. The most likely cause for this is the fact that the most common symptoms, pain and fatigue are associated with so many other conditions. This results in most doctors eliminating the presence of other conditions before a diagnosis of fibromyalgia can be made. At this time there is currently not a diagnostic test to determine if a patient is indeed suffering from fibromyalgia. For this reason a doctor may determine a patients pain may not be real, or they may also tell them there is little or nothing that can be done to offer relief.
A doctor that is familiar with fibromyalgia on the other hand may be able to make a clear diagnosis of this condition. He/She will most likely be able to identify the condition by conducting a pressure point test where atleast 11 of 18 of these points present pain when pressed. Widespread pain is also another indicator of fibromyalgia, usually presenting pain on both sides of the body above and below the waist. This pain as determined by the American College of Rheumatology, will have been present for a duration of more than 3 months, and present a significant amount of tenderness. Widespread pain is determined when it has been known to affect all 4 quadrants of the body. Meaning that it is felt on both the right and left sides, and in the upper and lower regions of the body. The ACR is also the organization who has helped determine the 18 points throughout the body used to perform the pressure point examination.
As always you should always be honest when discussing your medical history with your examining physician, this will help him/her to determine whether you are indeed catagorized as someone who may suffer from fibromyalgia. During your examination you should describe any previous conditions you feel may be contributing to why you are in pain. Go into detail about any movements or events that bring on pain, where the pain is located, how severe it is, how long the pain usually last, and any physical limitations that it may cause during your normal daily activity. A physician who is familiar with the symptoms of fibromyalgia should be able to easily indentify you as a fibromyalgia sufferer, if you feel that you have this condition and may have been misdiagnosed always ask for a second opinion. Research your physician and ask if this particular doctor is familiar with fibromyalgia before setting up an appointment. Never give up hope, if you are sure you have this condition do not take "I can't help you" as an answer.
How is Fibromyalgia Treated?
Since there is no known cause for fibromyalgia it can be a difficult condition to treat. You may be able to help control your symptoms by exercising on a regular basis and using different tactics when dealing with your stress. Maintaining a normal sleep schedule will also help to control and relieve the symptoms of fibromyalgial as well. A physician that specializes in treating rheumatology can be very affective in treating fibromyalgia.
There are currently only 3 medications that are approved by the FDA for the treatment of fibromyalgia. They are Lyrica, which is a medication designed to treat chronic neurological pain. Cymbalta, which is primarily used to treat depression, it does however have a positive affect for the treatment of pain related to fibromyalgia. Savella, this is also considered to be an anti depressant, it is approved by the FDA to only treat fibromyalgia. These medication are not the only treatment options for someone suffering from fibromyalgia pain. There are several other options for treating this condition and you should discuss what options are avaliable through your doctor.
Below are a list of the other treatment options that may be avaliable to you:
* Anti-Depressants - are medications that are used to treat people suffering from depression, these medication often help relieve neurological pain as well. They have been found to work significantly well in patients with fibromyalgia that have depression as well as those who do not. They work by raising the levels of serotonin and norepinephrine in the brain. These chemicals in the brain are thought to be associated with depression, however they are also bleieved to be associated with pain and chronic fatigue. The increase in the level of these chemicals can help to greatly reduce the pain in fibromyalgia patients. The list of medication that are most often prescribed are listed below.
* SSRI's (Selective Serotonin Reuptake Inhibitors) - these type of medications are used in lower doses than used to treat the patients who suffer depression. They are used to elevate the levels of serotonin in fibromyalgia patients, in turn reducing fatigue and other symptoms associated with fibromyalgia. The types of SSRI medications that are most often prescribed are Paxil, Zoloft, Lexapro, Celexa, and Prozac. Studies have shown these medications work well at treating the chronic pain associated with fibromyalgia.
* Tricyclic Anti-Depressants - this type of medication is also taken at a lower dosage than what is required to treat depression. It is used to increase the body's production of natural endorphins, endorphins are the body's natural pain killing chemical. They help the body to relax painful muscles and decrease pain, reducing the chance of a patient needing or becoming addicted to narcotic pain medications. The most common prescribed tricyclic medications are Elavil, Aventyl, Endep, Flexeril, Cycloflex, Adapin, Pamelor, and Sinequan. These types of medications have been in use for the last 50 years, and are ver effective in treating muscular pain and depression.
* Mixed Reuptake Inhibitors - this type of medication increases the production of both norepinephrine and serotonin, these are a relatively new form of anti-depressant. They tend to be more effective in the treatment of pain than the SSRI type of medications. They are called mixed inhibitors due to the fact they increase both the serotonin and norepinephrine levels. The most common prescribed mixed inhibitors are Effexor, Savella, and Cymbalta.
* Analgesic Medications - also refered to as painkillers, they can range from prescribed narcotics to over-the-counter medications. Doctors are often hesitant to prescribe narcotic pain medication, there is a risk of patients becoming physically or psychologically dependent with extended use. There has also been no proven evidence that they are of significant use in treatment of patients with fibromyalgia. They can however be used to relieve moderate muscle pain when used sparingly. The most commonly prescribed medicines are Vicodin, Percocet, Oxycontin, Morphine, Darvocet, Ultram, and Demerol. Over-the-counter medications that may be of use are Advil, Tylenol, Excedrine, and Ibuprofen.
* NSAID's - Nonsteroidal Anti-Inflammatory Drugs are used to treat inflammation, they also offer some relief of pain that is caused by fibromyalgia. This type of drug works by preventing a substance in the body called prostaglandins, they are known to play a vital role in development of inflammation and pain. They also help to relieve headaches, cramps, and muscle aches associated with the symptoms of fibromyalgia. Most are avaliable without a prescription, Anaprox, Naproxen, Advil, Aleve, Asprin, and Motrin can all be purchased over-the-counter. However, most of these are avaliable in prescription strength as well, if you feel there is a need for a stronger dosage please consult your treating physician be increasing any dosage of medication. Also, make sure these will no conflict with any current medication you may also be taking.
* Benzodiazepines - these help to stabalize erratic brain waves that may cause a disturbance in sleep, they also help relieve tension and relax painful muscles. .......to be continued.