Fibromyalgia-Solution.com

The online solution guide for fibromyalgia

Fibromyalgia Frequently Asked Questions

1. What is fibromyalgia?

Fibromyalgia syndrome (FMS) is a widespread musculoskeletal pain and fatigue disorder. Fibromyalgia means pain in the muscles, ligaments, and tendons—the soft fibrous tissues in the body. Most patients say that they ache all over. Their muscles may feel like they were pulled or overworked. Sometimes the muscles twitch and other times they burn. More women than men are afflicted with fibromyalgia (75% versus 25%) and it shows up in people of all ages.

2. What causes fibromyalgia?

Although the cause is not known, there appear to be many triggering events that often precipitate its onset. Examples include: infections (bacterial or viral), physical trauma (such as an automobile accident), or the development of another disorder, such as rheumatoid arthritis, lupus, or hypothyroidism. These triggering events probably do not cause fibromyalgia, but rather, they may awaken an underlying physiological abnormality that is already present.  Abnormalities that may be related to your symptoms include the following:

• alterations in pain-related chemical transmitters (particularly substance P, nerve growth factor, serotonin, and norepinephrine)

• immune system dysfunction (e.g., abnormally elevated levels of cytokines that form the communications link between your immunologic and neurologic systems)

• sleep disturbances

• hormonal irregularities

• differences in brain function that are being explored with the help of modern brain imaging techniques

• the body’s response to exercise and stress

• dysregulation of the autonomic nervous system (the one that operates in your peripheral tissues)

• elevated substance P and nerve growth factor are increased threefold and fourfold (respectively) in the spinal fluid of people with fibromyalgia, but researchers are still working to figure out how these elevations are related to the symptoms

3. How is fibromyalgia diagnosed?

For the most part, routine laboratory testing reveals nothing. However, upon physical examination, patients will be sensitive to pressure in certain areas of the body, called tender points. To meet the diagnostic criteria (set forth for research purposes), patients must have widespread pain in all four quadrants of their body for a minimum duration of three months and at least 11 of the 18 specified tender points. The 18 sites used for diagnosis cluster around the neck, shoulder, chest, hip, knee, and elbow regions. However, if a person has widespread pain, at least six or more tender points and many of the commonly associated symptoms of fibromyalgia (such as disturbed sleep, irritable bowel syndrome, frequent headaches, fatigue, and memory problems), they should still be diagnosed and treated for fibromyalgia. Roughly 75% of chronic fatigue syndrome (CFS)-diagnosed patients will meet the fibromyalgia criteria. If you have been diagnosed with fibromyalgia or chronic fatigue syndrome but you are unsure about the diagnosis, or you are concerned you have something else that mimics these conditions, click here for more details.

4. How is fibromyalgia treated?

Traditional treatments are geared toward reducing pain and improving the quality of sleep, meaning that a sleep study may aid with individualizing your therapy. Deep level (stage 4) sleep is crucial for many body functions (such as tissue repair, antibody production, and the regulation of various neurotransmitters, hormones, and immune system chemicals). Therefore, the sleep disorders that frequently occur in fibromyalgia patients should probably be treated first because they may aggravate the symptoms of this condition. Ambien, Lunesta, clonazepam, and trazodone are just a few of the medications that may be used to aid sleep. For addressing the pain and the symptoms in general, medications that boost serotonin and norepinephrine (neurotransmitters that modulate sleep, pain, and immune system function) are commonly prescribed in low doses, such as amitriptyline, cyclobenzaprine and Cymbalta. Ultram may help with the pain, although stronger opioids may be needed. Muscle relaxants, anti-epileptics (such as Neurontin and Lyrica) and other drug categories may be prescribed as well.

In addition to medications, most patients will need to use other treatment methods, such as trigger point injections with lidocaine, physical therapy, occupational therapy, acupuncture, acupressure, relaxation/biofeedback techniques, osteopathic manipulation, chiropractic care, therapeutic.

5. What can I do to help myself?

Lifestyle modifications may help you conserve energy and minimize pain. Learn what factors aggravate your symptoms and avoid them when possible. Many patients find warm water (hot tub or shower) to be soothing. Hot wraps for particularly painful areas are also beneficial. Maintaining a rigid sleep schedule (e.g., ensuring that you receive at least eight hours of sleep per night and that you have a routine for easing you into sleep) is one method endorsed by patients to help minimize daytime fatigue and reduce nighttime sleep difficulties. Gentle movement and stretching exercises will help you maintain your function, which is essential when the body is tired and the muscles hurt.

6. Is there a cure?

No, but there are researched treatments that have been shown to be helpful for reducing the symptoms. Patients need to beware of the many bogus cures that are being promoted on the Internet and in the media. Many businesses count on people who are desperate to get rid of chronic, unrelenting pain (such as that produced by fibromyalgia). If a remedy sounds too good to be true, it probably is.

7. What is fibromyalgia pain like?

The pain of fibromyalgia has no boundaries. People describe the pain as deep muscular aching, throbbing, shooting, and stabbing. Intense burning may also be present. Quite often, the pain and stiffness are worse in the morning, and you may hurt more in muscle groups that are used repetitively.

8. What factors aggravate the symptoms of fibromyalgia?

Changes in weather, cold or drafty environments, hormonal fluctuations (premenstrual and menopausal states), stress, depression, anxiety, infections (flu or a cold), and over-exertion can all contribute to symptom flare-ups. Repetitive use of the same muscle group can strain the muscles and lead to more pain.

9. Is fibromyalgia genetic (i.e., does it run in families)?

Fibromyalgia does run in families, but the exact genetic nature of this hereditary linkage is not yet known. Many research studies are under way to look at the genetic abnormalities that might be linked to various neurotransmitters involved in both pain and sleep regulation.

10. Does fibromyalgia get worse over time?

Studies show that roughly 25% of patients get worse over time, but another 25% get better. Some patients may be likely to improve because they have a good doctor willing to work with them to find which therapies they respond to. Also, as people age, other medical conditions can aggravate the symptoms of fibromyalgia, so it is imperative that patients seek aggressive treatment for age-related conditions, such as arthritis. A preventive medicine program with maintenance exercises and a healthy diet may prove worth while.

11. Can I still work with fibromyalgia?

Balancing work and chronic illness is always a challenge, but most patients with fibromyalgia are able to remain employed. The answer to this question really depends upon one’s job and whether job accommodations can be made to ease the symptoms. Also, the development of other medical conditions may make fibromyalgia symptoms more severe and lead to the need to consider early retirement or disability. Studies show that roughly 25% of fibromyalgia patients receive some form of disability compensation at any given time.