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Fibromyalgia
Overview

Fibromyalgia can be a debilitating disorder. The aches and pains, along with fatigue affect over 12 million people in the United States. It is most common in women, but men can suffer from it too. Fibromyalgia is responsible for missed work and school and can severely impact the quality of life. The exact cause is still unknown and research is ongoing.
New developments in the treatment of fibromyalgia along with lifestyle changes can significantly improve how sufferers feel. This article will explain the disorder in detail and gives helpful tips on living with and managing the disorder.

Fibromyalgia Symptoms

The Symptoms of fibromyalgia include:
Pain in the joints, muscles, and pressure points. This is one of the ways fibromyalgia is diagnosed. There is chronic and widespread pain in one or many areas of the muscles and joints.

Doctors also look at pain in one or more pressure points that are significant to FMS sufferers.
Fatigue and lack of energy. FMS causes chronic and severe fatigue that can be disabling and leave you feeling like you cannot get out of bed or perform usual tasks.
Lack of restful sleep. It is common in disorders like fibromyalgia to wake up feeling unrefreshed.
Joint and muscle Stiffness
Trouble focusing or concentrating
Memory issues (Brain Fog, trouble with word recall)
Abdominal pain or bloating
Constipation
Migraine headaches
Jaw pain
Chemical Sensitivity. You may notice increased symptoms with certain fragrances, chemical household cleaners, lights and noises, medications, and some foods.
Anxiety
Depression
Irritated bladder
Inability to tolerate exercise
Feeling swollen or puffy
Fibromyalgia symptoms tend to be worse in the late evening or first thing in the morning. You may also feel worse when it is really hot outside or really cold. If you do too much activity, it may take longer to rest and recover (often days). You may also feel worse around the time of your period or during times of stress. Symptoms tend to come in “flares” where they are very severe for a while, then may lessen or even disappear completely for months to years.

What is Fibromyalgia?

Fibromyalgia is a disorder that causes joint and muscle pain. There are other symptoms but one of the most common symptoms is severe fatigue. Many sufferers become homebound and suffer depression. It is actually a syndrome known as, “Fibromyalgia Syndrome” or FMS.
FMS is a group of symptoms that affects people between 25 and 60 years of age. It is more common in women who are at least 10 more commonly affected than males. Diagnosis is based on certain criteria that is symptom related.

Fibromyalgia Causes and Risk Factors

The causes of fibromyalgia aren’t clear, but here are a few factors that may increase the chances of getting it. These include:
Trauma. Trauma leading to a form of Post-Traumatic Stress Disorder
Genes. Fibromyalgia is often seen in close family members
Infection. Infections may trigger flares such as; Epstein-Barr, Lyme
Hormones and Brain Chemical Disruption. Serotonin, Cortisol, thyroid hormones and norepinephrine

Something happens that changes the way the brain perceives pain in fibromyalgia sufferers. There are higher levels of pain transmitters in the brain and people with the disorder have a lower pain tolerance than others.
There are certain risk factors for fibromyalgia including:
Female gender
History of rheumatic or autoimmune disease. Arthritis, lupus, MS, etc.
Family History of Fibromyalgia or Autoimmune Disease
History of physical or emotional trauma
Exposure to chemicals or other environmental factors

Having one risk factor does not necessarily mean you are going to get fibromyalgia, but having multiple risk factors may increase the chances. Also, if the doctor is unable to find a physical cause for your symptoms in tests you may be diagnosed with fibromyalgia by diagnosis of exclusion.

How is Fibromyalgia Diagnosed?

Fibromyalgia can be hard to diagnose and for some takes up to 5 years to make an accurate diagnosis. If you have the symptoms of fibromyalgia, your doctor will most likely test you for other causes first. These tests may include things that can cause the symptoms like; thyroid function, Sedimentation rate for inflammation, and a complete blood count.
If everything checks out okay with lab and other tests, your doctor will then look at your symptoms according to a set of criteria. This includes:
Pain that is Widespread for 3 months or longer. For pain to be considered widespread, it has to occur on; both sides of your body, all along your spine, and below/above the waist area.
Tenderness to touch at 11 out of 18 pressure points on the body. This system is somewhat outdated but used in conjunction sometimes with the above. The doctor will press on 18 different pressure points and if pain is experienced with pressure on at least 11 then a diagnosis of fibromyalgia can be given.
Tender Pressure Points
The pressure points that are noted as tender to touch are as follows:

Elbows
Knees
Hips
Back of the Head
Breastbone
Lower back below the waist area
The neck
Shoulder blades
Upper back

(See Figure 1)

Figure 1: Fibromyalgia Trigger Points
Photo Courtesy of: commons.wikimedia.org

The latest diagnostic system states that if a person experiences the following symptoms for the last week prior to the doctor’s office visit, plus widespread pain for at least 3 months:

Number of places pain is felt over one week (each place is one point)
Symptom severity on a scale of 0 to 3 for; unrefreshing sleep, cognitive issues, fatigue
Three points added for; numbness, dizziness, depression, nausea, and irritable bowels

A diagnosis of fibromyalgia can be given for the following point scales:

Pain in 7 or more areas of the body/Symptom severity score 5 or higher
Pain in 3 to 6 areas of the body/Symptom severity score 9 or higher

To be conclusive, all symptoms should have been present for 3 months or longer.

Fibromyalgia Treatment

Treating fibromyalgia needs a combination of interventions to address all of the symptoms. There is no single medication that will either cure or completely remove the symptoms, but you and your doctor can come up with a treatment plan that works best for you. The following are treatments that have been shown to be helpful to fibromyalgia patients:
Antidepressants. The type used for fibromyalgia have an effect on the body’s pain responses and have been shown to reduce pain by 30%.
Anti-Seizure Drugs. Some anti-seizure medications can calm nerve pain and may improve sleep. These drugs can have side-effects including; swelling, dizziness, and drowsiness.
Cognitive Behavioral Therapy. Teaching coping skills and techniques to lessen the effects of the disorder are reported to be very helpful to patients.
Physical Therapy and Exercise. A graded exercise program can help you increase your tolerance to activity, reduce fatigue, and help you sleep better.

Pain medications and anti-anxiety medications may be used short-term, but the above treatments are the most successful for long-term. These along with lifestyle changes can improve your quality of life.

Lifestyle Changes for Fibromyalgia

The following lifestyle changes are probably the biggest and most important part of treating fibromyalgia. They greatly improve quality of life in patients with the disorder:
Proper Sleep. The following tips can help you get proper sleep which lessens pain and fatigue:
No caffeine less than four hours prior to bedtime
No alcohol less than four hours prior to bedtime
Reduce fluid intake an hour prior to sleep
Do not exercise in the evening hours
Try not to nap
Eat a light snack before sleep, but no large meals
Keep your room cool
No TV or electronics in your room
Eat The Right Diet. It has been shown that if fibromyalgia patients eat a diet high in Omega-3 fatty acids, high fiber, and plenty of fresh fruits and vegetables they feel better. East at least two servings of salmon or flaxseeds weekly for Omega-3 fatty acids.
Reduce Stress. Reducing stress has benefits to lower pain and help improve sleep. Try deep breathing, meditation, biofeedback techniques, and massages.
Pace Activities. Alternate periods of activity with periods of rest. Try not to overdo things and listen to your body. If you have pain, take it easy. If you have a good day, still take it easy and don’t push your body. Do a little, rest a little.

Fibromyalgia Natural Treatment

Some alternative medicine treatments can be helpful for fibromyalgia including:
Acupuncture
Chiropractic Care
Yoga
Melatonin for sleep
SAMe. May help with depression, inflammation and pain
5-HTP. Natural anti-depressant
Always talk to your doctor before using herbal supplements. They can have unwanted side-effects or drug interactions with your other medications. Your doctor can help you work safe herbal remedies into your treatment plan.

Prognosis for Fibromyalgia

The prognosis depends on the severity. Those with mild cases can usually perform usual tasks and work with proper treatment. Those with more severe cases may be disabled due to the condition. Around 30 to 40% of sufferers need to reduce their workload or even quit working.
People with fibromyalgia have the same life expectancy as healthy people and with treatment and good lifestyle choices can remain active and have a full life.

Bibliography for Fibromyalgia

Centers for Disease Control. (2012, November 7). Fibromyalgia. Retrieved from https://www.cdc.gov/arthritis/basics/fibromyalgia.htm
Mayo Clinic. (2014, February 20). Fibromyalgia: Causes and Risk Factors. Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/fibromyalgia/basics/causes/con-20019243
University of Maryland Medical Center. (2012, February 7). Fibromyalgia. Retrieved from University of Maryland: https://umm.edu/health/medical/reports/articles/fibromyalgia
Web MD. (2014, November 11). Fibromyalgia Treatments. Retrieved from Web MD: https://www.webmd.com/fibromyalgia/guide/fibromyalgia-treatments?page=1

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