Fibromyalgia: Symptoms, Causes and Treatment

Fibromyalgia is a disorder that is characterized by widespread musculoskeletal pain accompanied by sleep, memory, fatigue, and mood issues. Researchers now believe that fibromyalgia amplifies painful sensations by affecting the way pain signals are processed by your brain.

 

The symptoms sometimes start after physical trauma, infection, surgery, or significant psychological stress. In other cases, symptoms accumulate over time with no single triggering event.

Women are much more likely to develop fibromyalgia than men are. While there is no cure for this condition, a variety of medications are available that can help to manage the symptoms. Exercise, stress-reduction, and relaxation measures can also help.

 

Symptoms of fibromyalgia include:

• Fatigue – People who suffer from fibromyalgia often wake up tired, even though they have slept for a long period of time. Their sleep is often disrupted by pain, and many patients with fibromyalgia also have other sleep disorders, such as sleep apnea and restless leg syndrome.
• Cognitive difficulties – A symptom, commonly known as “fibro fog” impairs the ability to pay attention and concentrate on mental tasks.
• Widespread pain – The pain that is associated with this condition is often described as a constant dull ache that has lasted for at least three months. To be considered widespread, the pain has to occur on both sides of the body and above and below your waist. 

Many people who have fibromyalgia also suffer from tension headaches, irritable bowel syndrome, depression, anxiety, and temporomandibular joint disorders.
Causes
Doctors still don’t know what causes this condition, but it most likely involves a variety of factors working together. These may include:
• Genetics – Since fibromyalgia tends to run in families, there may be certain genetic mutations that may make you more susceptible to developing this condition.
• Infections – Some illnesses seem to trigger or aggravate fibromyalgia.
• Physical or emotional trauma – This disorder can sometimes be triggered by physical trauma, such as a bad car accident. Psychological stress might also trigger fibromyalgia. 

Why Does It Hurt?

Researchers think that repeated nerve stimulation causes the brains of people with fibromyalgia to change. This change involves an abnormal increase in levels of certain chemicals in the brain that signal pain. Furthermore, the brain’s pain receptors seem to develop a memory of the pain and become more sensitive, meaning they can overreact to pain signals.
Risk Factors
Risk factors for this condition include:
• Your sex – Fibromyalgia is diagnosed more often in women than in men.
• Family history – You might be more likely to develop this painful disorder if a relative also has it.
• Other disorders – If you happen to have rheumatoid arthritis, osteoarthritis, or lupus, you could be more likely to develop fibromyalgia. 
Complications
The pain and lack of sleep that arises due to fibromyalgia can interfere with your ability to function at home or at work. The frustration of dealing with this often-misunderstood condition can also result in depression and other health-related anxiety issues.
Diagnosis
In the past, doctors would have to check 18 specific points on a person’s body to see how many of them were painful when pressed. However, new guidelines mean that a tender point exam is no longer required.
Instead, a fibromyalgia diagnosis can be made if a person has had widespread pain for more than three months – with no other underlying condition that could cause the pain.

Blood Tests

While there is currently no lab test to confirm a diagnosis of fibromyalgia, your doctor might want to rule out other conditions that may have similar symptoms. Blood tests may include:

• Complete blood count
• Rheumatoid factor
• Thyroid function test
• Erythrocyte sedimentation rate
• Cyclic citrulinated peptide test

Treatment
In general, treatments for this condition include both medication and self-care. The emphasis is on minimizing symptoms and improving general health. No one treatment will work for all symptoms.
Medications
Medications can help to decrease the pain of fibromyalgia and improve sleep. Common choices include:
• Pain relievers – Over-the-counter pain relievers such as acetaminophen, ibuprofen or naproxen sodium may be helpful. Your doctor might even suggest a prescription pain reliever such as tramadol. Narcotics are not advised as they can lead to dependence and may even worsen the pain over time.
• Antidepressants – Duloxetine and milnacipran may help to reduce the pain and fatigue associated with fibromyalgia. Your doctor might also prescribe amitriptyline or the muscle relaxant cyclobenzaprine to help you sleep.
• Anti-seizure drugs – Medications designed to treat epilepsy are often useful when it comes to reducing certain types of pain. Gabapentin is sometimes helpful in reducing fibromyalgia symptoms, while pregabalin was the first drug approved by the Food and Drug Administration to treat this condition. 
Therapy
A number of different therapies can help to decrease the effect that fibromyalgia has on your body and life. Examples include:
• Physical therapy – A physical therapist can teach you exercises that will help to improve your flexibility, strength, and stamina. Water-based exercises might be particularly useful.
• Occupational therapy – An occupational therapist can help you to make adjustments to your work area or the way you perform certain tasks that will cause less stress on your body.
• Counseling – Talking with a counselor can help to strengthen your belief in your abilities and teach you strategies for dealing with stressful situations. 

Lifestyle and Home Remedies

Self-care is absolutely critical in the management of fibromyalgia.

• Reduce stress – Develop a plan to avoid or limit overexertion and emotional stress. Allow yourself time to relax each day. This may mean learning how to say no without feeling guilty. However, try not to change your routine completely. Those who quit work or drop all activities tend to do worse than those who remain active. You can try stress-reducing techniques, such as deep-breathing exercises or meditation.
• Get enough sleep – Since fatigue is one of the main characteristics of fibromyalgia, getting sufficient sleep is vital. In addition to allotting enough time for sleep, you should practice good sleep habits, such as going to bed and getting up at the same time each day to limit daytime napping.
• Exercise regularly – In the beginning, exercising may increase your pain, but doing it regularly will help to decrease your symptoms. Appropriate exercises may include swimming, walking, biking, and aerobic exercises. A physical therapist can help you develop a home exercise program.
• Maintain a healthy lifestyle – Eat healthy foods and limit your caffeine intake. Do something that you find enjoyable and fulfilling each day. 

Alternative Medicine
Complementary and alternative therapies for pain and stress management aren’t new. Some, such as yoga and meditation, have been practiced for thousands of years. However, they have become more popular in recent years, especially with people who have chronic illnesses, such as fibromyalgia.
The treatments below do appear to safely relieve stress and reduce pain, and some are gaining acceptance in mainstream medicine.
• Acupuncture – This is a Chinese medical system based on restoring normal balance of life forces by inserting very fine needles through the skin to various depths. According to Western theories of acupuncture, the needles cause changes in blood flow and levels of neurotransmitters in the brain and spinal cord.
• Massage Therapy – This is one of the oldest methods of healthcare still in practice. It involves the use of different manipulative techniques to move your body’s soft tissues and muscles. Massage can decrease your heart rate, improve the range of motion in your joints, relax your muscles, and increase the production of your body’s natural painkillers. It can also help to relieve anxiety and stress.
• Yoga and tai chi – These practices combine meditation, deep breathing, slow movements, and relaxation. Both have been found to be useful in controlling the symptoms of fibromyalgia. 
Preparing for Your Appointment
Since many of the signs and symptoms of fibromyalgia are similar to other disorders, you might have to see several doctors before receiving a diagnosis. Your family physician might refer you to a doctor that specializes in the treatment of arthritis and other similar conditions.
What You Can Do
Before your appointment, you might want to write a list that includes:
• A detailed description of your symptoms
• Information about medical problems that you have had in the past
• Information about the medical problems of your parents and siblings
• All the medications and dietary supplements that you take
• Questions you want to ask the doctor 
 

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