FIBROMYALGIA

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.

  • Chronic widespread pain;100% The pain is constant day and night and it hurts all over. No one can understand it only the sufferers. Neurological complaints such as numbness, tingling and burning are often present too. Aggravating factors that affect pain include non-restorative sleep, cold/humid weather, physical and mental fatigue, excessive physical activity, anxiety, stress, and physical inactivity.
  • Fatigue;80% The fatigue of FM cannot be compared to normal fatigue of people, it is much more severe and can interfere with ones work, social or educational activities. It causes lack of energy.
  • Sleep;95% Many fibromyalgiacs have a sleep disorder that prevents them from getting restorative and restful sleep. They wake up, wander around their homes at night. They also loose sleep worrying about not sleeping and feel so bad when another person is dead asleep yet they cannot sleep.
  • Other signs, symptoms and overlapping conditions include:
  • Stiffness;35% Fibromyalgiacs wake up every day in the morning feeling so stiff that sometimes leaving the bed becomes a problem.
  • Dysesthesia of hands;46% Fibromyalgiacs experience tingling and numbness in their hands and some may end up dropping things .The fingers also feel swollen but they look normal.
  • Memory dysfunction;40% FMs patients have trouble focusing on one thing, they also get distracted easily and feel mentally sluggish. It is called fibro fog, it is very annoying since it makes multitasking very hard.
  • Migraine headache;47% The headache is concentrated at the back of the head and worsens if the head is bent down or moved around. It also makes one to be sensitive to bright lights, loud sounds and sometimes strong scents. It may also make one feel nauseated.
  • Backaches, chest pains, irritable bowel syndrome and bladder, anxiety,depression,ringing in the ears, dry eyes and mouth, vision problems, dizziness and some neurological symptoms.
  • 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

    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]