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Fibromyalgia is a very common condition that affects a multitude of people. In the United States alone it is estimated that nearly three percent of the population is affected by Fibromyalgia. Compared to other autoimmune diseases, that’s a pretty significant number.
Fibromyalgia is known as a soft tissue disorder that is widespread, which means it effects multiple parts of the body. While it effects muscles, ligaments and tendons, it does not cause muscle inflammation. It is just a chronic pain condition.
Although fibromyalgia has been around for a while under different name, The American College of Rheumatology only adopted the term fibromyalgia in 1993 due to the lack of muscle inflammation. At that time they also set diagnostic criteria so people could accurately be diagnosed with fibromyalgia.
We classify fibromyalgia with tender points. There are 18 areas of the body that are tender points or trigger points. Everyone has these trigger points, but they are hyperactive in those with fibromyalgia. The trigger points range from the base of the skull and neck to the arms hips and knees. To be diagnosed with fibromyalgia you need 11 of the 18 trigger points to be positive.
In addition, you will also need to have a history of severe chronic pain for more than three months, pain that is on both sides of the body, pain above and below the waist and an exclusion of other diseases or ailments. Conditions that can be mistaken for fibromyalgia include hormonal imbalances, infections, autoimmune disorders, neurologic conditions, psychiatric conditions, malignancies, hypercalcemia.
Unfortunately, there is no lab test to diagnose fibromyalgia. The diagnosis is clinical and purely based on the exclusion of other diseases and conditions.
Some of the symptoms of fibromyalgia include widespread body aches/pain, fatigue, poor sleep habits, cognitive impairment (also known as fibro-fog), morning stiffness that lasts more than an hour, depression and anxiety, subjective numbness and burning functional bowel disease, periodic limb movement syndrome and impaired social and occupational functioning.
We definitely see more cases of fibromyalgia among the female population. In fact, 85-90% of all cases are in females and though it is seen at any age it seems to peak in reproductive years and during the peri-menopausal years. The reason fibromyalgia affects more women than men may be due in part to hormones.
There is a belief that genetics could play a part in fibromyalgia. We are seeing a cluster of this disease in families so it’s important if you suspect you have fibromyalgia to ask your family if they ever suffer from widespread pain.
Treatment for fibromyalgia includes a variety of both over-the-counter and presecription medications, physical therapy and exercise as tolerated. The medications used most commonly to treat fibromyalgia are Lyrica, Cymbalta, Savella.
Lyrica was initially indicated for diabetic neuropathy and it works by inhibiting the release of neurotransmitters associated with pain. Cymbalta was also initially used to treat symptoms associated with depression and it works by helping the seratonin to circulate, which helps with chronic pain. The last medication used to treat fibromyalgia is Savella, a drug used to treat depression in Europe. Savella works by increases norepinephrine to give you more energy. Like all medications, the drugs used to treat fibromyalgia have side effects.
Non-pharmalogic therapies also work very well to treat fibromyalgia. This includes cardiovascular fitness (especially water therapy), muscle training, hypnotherapy, cognitive therapy, acupuncture and acupressure.
When it comes to exercise, people with fibromyalgia benefit the most from stretching based exercises like yoga and pilates as well as low impact aerobics.
While there is no cure for fibromyalgia, people who have the condition can lead perfectly full lives and can find relief for their symptoms. A comprehensive approach is used to treat fibromyalgia that includes medications, education, counseling, exercise and herbal/supplementary medications.