Fibromyalgia

Fibromyalgia


Definition:
Fibromyalgia is described as inflammation of the fibrous or connective tissue of the body. Widespread muscle pain, fatigue, and multiple tender points characterize these conditions. Many individuals with fibromyalgia describe the symptoms as similar to the aches and pains of a severe case of the flu. Fibrositis, fibromyalgia, and fibromyositis are names given to a set of symptoms believed to be caused by the same general problem.

Description:
Fibromyalgia is more common than previously thought, with as many as 3-6% of the population affected by the disorder. Fibromyalgia is more prevalent in adults than children, with more women affected than men, particularly women of childbearing age.

Causes & symptoms:
The exact cause of fibromyalgia is not known. Sometimes it occurs in several members of a family, suggesting
that it may be an inherited disorder. People with fibromyalgia are most likely to complain of three primary symptoms: muscle and joint pain, stiffness, and fatigue.
Pain is the major symptom with aches, tenderness, and stiffness of multiple muscles, joints, and soft tissues. The pain also tends to move from one part of the body to another. It is most common in the neck, shoulders, chest, arms, legs, hips, and back. Although the pain is present most of the time and may last for years, the severity of the pain may fluctuate.

Symptoms of fatigue may result from the individual’s chronic pain coupled with anxiety about the problem and how to find relief. The inflammatory process also produces chemicals that are known to cause fatigue. Other common symptoms are tension headaches, difficulty swallowing, recurrent abdominal pain, diarrhea, and numbness or tingling of the extremities. Stress, anxiety, depression, or lack of sleep can increase symptoms. Intensity of symptoms is variable ranging from gradual improvement to episodes of recurrent symptoms.
Diagnosis:
Diagnosis is difficult and frequently missed because symptoms of fibromyalgia are vague and generalized. Coexisting nerve and muscle disorders such as rheumatoid arthritis, spinal arthritis, or Lyme disease may further complicate the diagnostic process. Presently, there are no tests available to specifically diagnose fibromyalgia. The diagnosis is usually made after ruling out other medical conditions with similar symptoms.
Because of the emotional distress experienced by people with this condition and the influence of stress on the symptoms themselves, fibromyalgia has often been labeled a psychological problem. Recognition of the underlying inflammatory process involved in fibromyalgia has helped promote the validity of this disease.
The American College of Rheumatology has developed standards for fibromyalgia that health care practitioners can use to diagnose this condition. According to these standards, a person is thought to have fibromyalgia if he or she has widespread pain in combination with tenderness in at least 11 of the 18 sites known as trigger points. Trigger point sites include the base of the neck, along the backbone, in front of the hip and elbow, and at the rear of the knee and shoulder.
Treatment:
There is no known cure for fibromyalgia. Therefore, the goal of treatment is successful symptom management. Treatment usually requires a combination of therapies, exercise, and lifestyle adjustments. Adequate rest is essential in the treatment of fibromyalgia. The diet should include a large variety of fruits and vegetables, which provide the body with trace elements and minerals that are necessary for healthy muscles. Avoidance of stimulating foods or drinks (such as coffee) and medications like decongestants prior to bedtime is advised. A patient’s clear understanding of his or her role in the recovery process is imperative for successful management of this condition.
Treatments found to be helpful include heat and occasionally cold compress applications. A regular stretching program is often useful. Aerobic activities focusing on increasing the heart rate are the preferred forms of exercise over most other forms of exertion. Exercise programs need to include good warm-up and cool-down sessions, with special attention given to avoiding exercises causing joint pain. Hydrotherapy exercises (exercises in a pool or tub) may be useful in providing a low impact exercise environment while soothing muscle and joint pain.
Massage therapy can be helpful, especially when a family member is instructed on specific massage techniques to manage episodes of increased symptoms. Short sessions are most helpful as repetitious movement can aggravate the condition. Specific attention to mental health, including psychological consultation, may also be important, since depression may precede or accompany fibromyalgia. Relaxation exercises, yoga, aromatherapy, guided imagery, and other relaxation therapies can be useful in easing stress and promoting overall well-being. Acupuncture can be very helpful for symptom relief and in easing the general condition.
Herbalists and aromatherapists may recommend tub soaks or compresses with lavender (Lavandula an-gustifolia), chamomile (Chamaemelum nobilis), or juniper (Juniperus communis) to soothe muscle and joint pain.
Allopathic treatment:
People with fibromyalgia often need a rheumatology consultation (a meeting with a doctor who specializes in disorders of the joints, muscles, and soft tissue) to decide the cause of various rheumatic symptoms, to be educated about fibromyalgia and its treatment, and to exclude other rheumatic diseases. A treatment program must be individualized to meet the patient’s needs. The rheumatologist, as the team leader, enlists and coordinates the expertise of other health professionals in the care of the patient.
If diet, exercise, and adequate rest do not relieve the symptoms of fibromyalgia, medications may be pre-scribed. Medications prescribed and found to have some benefit include antidepressant drugs, muscle relaxants, and anti-inflammatory drugs.
KEY TERMS:
Connective tissue-Tissue that supports and binds other body tissue and parts.
Lyme disease-An acute recurrent inflammatory disease involving one or a few joints, believed to be transmitted by a tickborne virus. The condition was originally described in the community of Lyme, Connecticut, but has also been reported in other parts of the United States and other countries. Knees and other large joints are most commonly involved with local inflammation and swelling.
Rheumatology-The study of disorders characterized by inflammation, degeneration of connective tissue, and related structures of the body. These disorders are sometimes collectively referred to as rheumatism.
Expected results:
Fibromyalgia is a chronic health problem. The symptoms sometimes improve and at other times worsen, but they often continue for months to years.
Prevention:
There is no known or specific prevention for fibromyalgia. However, similar to many other medical conditions, remaining as healthy as possible with a good diet, safe exercise, and adequate rest is the best prevention.