Fibromyalgia: What is it?
Fibromyalgia is a common condition characterized by long-term, body-wide pain and tender points in joints, muscles, tendons, and other soft tissues. Fibromyalgia has also been linked to fatigue, morning stiffness, sleep problems, headaches, numbness in hands and feet, depression, and anxiety. Fibromyalgia can develop on its own or along with other musculoskeletal conditions such as rheumatoid arthritis or lupus. The cause of this disorder is unknown. Physical or emotional trauma may play a role in development of the syndrome. Some evidence suggests that fibromyalgia patients have abnormal pain transmission responses. It has been suggested that sleep disturbances, which are common in fibromyalgia patients, may actually cause the condition. Another theory suggests that the disorder may be associated with changes in skeletal muscle metabolism, possibly caused by decreased blood flow, which could cause chronic fatigue and weakness.
How is Fibro detected and diagnosed?
Diagnosis of fibromyalgia requires a history of a least 3 months of widespread pain, and pain and tenderness in at least 11 of 18 tender-point sites. These tender-point sites include fibrous tissue or muscles of the arms, buttocks, chest, knees, lower back, neck, rib cage, shoulders, thighs. Sometimes, laboratory and x-ray tests are done to help confirm the diagnosis by ruling out other conditions that may have similar symptoms.
There are several ways to distinguish to difference between RA pain and Fibro pain. First, RA does not typically involve the DIP joint (i.e. distal interphalangeal joint or end joints closest to the nails) so if there is tenderness there, this would favor fibromyalgia or possibly osteoarthritis. Secondly, fibromyalgia is not associated with joint swelling as occurs in rheumatoid arthritis, although patients often complain that their joints feel swollen. The complaint of widespread body pain associated with the typical fibromyalgia tender points would also be consistent with fibromyalgia and not RA.
For treating patients with both RA and Fibro, the RA is usually treated first, since it is associated with joint deformity and disability. Treatment for the Fibro is mostly concentrated on the sleep aspect of it, since most patients complain about the pain being so unbearable, it interferes with their sleep. It is usually treated with antidepressants or sleeping medications like Lyrica, Cymbalta, Savella or Neurotin. In mild cases, the symptoms may go away when stress is decreased, or lifestyle changes are implemented. Eating a well-balanced diet and avoiding caffeine may help with problems sleeping, and may help reduce the severity of the symptoms. Lifestyle measures to improve the quality of sleep can be effective for fibromyalgia.
There is no proven prevention for this disorder, but treatment for Fibromyalgia has come a long way over the years, so the future for this disease looks very good.