It is a disease characterized by chronic pain, stiffness and tenderness of muscles, soft tissues, tendons and joints without detectable inflammation. Fibromyalgia does not cause body damage or deformity. However, undue fatigue and chronic pain plagues 90 percent of patients with fibromyalgia and interferes with school, work and activities. Fibromyalgia can be associated with other rheumatic conditions and irritable bowel syndrome. There is no definitive medical test to diagnose fibromyalgia though health professionals use a combination of symptoms to make diagnosis.
Fibromyalgia occurs in people of all ages including children though it is more common in women in adults but in children/teens it affects equal number of boys and girls. There is no cure for fibromyalgia but management approaches and relief of symptoms are always recommended. Medications, cognitive behavioral therapies, massage therapies and gentle exercises are some of the ways to manage it.
It is very challenging to make a diagnosis of fibromyalgia, healthcare providers rely on patient histories, physical examination and an accurate tender point examination.
Laboratory tests for other illness often prove negative since many FM symptoms overlap those of other conditions.This has led to extensive investigative costs and frustration for both the doctor and patient.
One should note that the presence of other diseases such as rheumatoid arthritis and lupus does not rule out an FM diagnosis.FM is not a diagnosis of exclusion and must be diagnosed by its own characteristic features.This diagnostic criteria include a history of chronic and widespread body pain and the presence of at-least 11 of 18 tender points that are revealed through a physical examination of the patient lasting for at least 3 months.
Although there is no specific cure for fibromyalgia there are some ways in which it can be managed with the help of physicians such as rheumatologist,neurologist,psychologist/psychiatrist,sleep physiologist,physiotherapist and rehabilitation physician.
Also aerobic exercises,patient education,cognitive behavioural therapy,physical therapies,application of heat or cold,nutritional supplements, relaxation exercises and pharmacologic therapies,they have been proved to improve symptoms in patients with fibromyalgia.One should try and identify which combination of these therapies helps them and make impact on the quality of their life.
There is also a need for lifestyle adaptation alongside medical care ,this needs effort and causes discomfort but it really does improve one’s life.
The pharmacological treatments for fibromyalgia are pregabalin(lyrica),duloxetine(Cymbalta) and milnacipran(savella),other painkillers also may help eg tramadol.Other FM medication are currently on development.Good sleep can also be improved by developing a good sleeping regimen and sleeping in a conducive environment i.e quiet,comfortable bed,going to bed and waking up at the same time everyday.Avoiding caffeine,sugar,alcohol before bed and practicing relaxation exercises as you fall to sleep.
The causes of FMs still remain a mystery but the scientists with their research bring them closer to understanding the basic mechanisms of fibromyalgia.Most researchers agree that fms patients experience pain amplification due to abnormal sensory processing in the central nervous system.
Recent studies show that genetic factors may predispose individuals to a genetic susceptibility to FM,however in large percentage of patients the onset is triggered by an illness or injury that causes trauma to the body .More research is still on to untangle the truths about this autoimmune disease.
The cost of fibromyalgia to both the individual and to society is very extensive .The long diagnosis process has its own costs i.e the hospital visits, prescriptions and drugs. The prevalence of disability in schools, places of work among fibromyalgia is very high compared to other normal people. Managing fibromyalgia is very expensive and abit stressful.
Lifestyle Education for Fibromyalgia
Body: Physical exercise such as walking, yoga, strength, Pilates, postural Exercises.
Lifestyle: Good sleep and diet reduces pain and dysfunction.
Social: Social support, positive relationships, helping others.
Emotions: Avoid triggers for negative moods, boost positive emotions with activity (e.g.creativity, exercise, sleep, helping).
Spirit: Finding purpose, insight, hope, self-compassion, mindfulness meditation as a tool.
Mind: Build resilience, understanding, realistic expectations.
Environment: Stimulating and non-threatening environment.
FMS Management Acronym.
Six steps to ADEPT Living
• Attitude- Patient/Family/Others
• Diagnosis- Differential Diagnosis
• Education- Psychosocial/Biomedical/CBT
• Physical- Home [pace, heat,exercise]
• Treatments- Medications/Alternative (surg)
• Living- Follow-up[Assessment/support]