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Fibromyalgia


Fibromyalgia is a chronic condition that causes pain and tenderness all over the body. People who suffer from fibromyalgia appear to be more sensitive to pain than others who do not have it. There is no cure for this illness, but it is not life-threatening and there are medicines and strategies to help manage fibromyalgia symptoms.


Causes

The exact cause of fibromyalgia is unknown. It is thought that fibromyalgia patients have a heightened perception of pain in response to various stimuli, a phenomenon called “central sensitization.”


It’s unclear why fibromyalgia patients develop central sensitization. There may be a genetic component as people with a parent or sibling with fibromyalgia have a higher chance of developing it themselves. In some cases, various stressors appear to trigger fibromyalgia.


Triggers associated with fibromyalgia include:

  • Infections such as viral illness and Lyme disease

  • Diseases involving joint inflammation such as rheumatoid arthritis and Lupus

  • Physical or emotional trauma

  • Sleep disturbances


Symptoms

The hallmark of fibromyalgia is widespread, chronic, and persistent pain of the muscles and soft tissues. The pain can be described as deep muscular aching, burning, throbbing, or soreness but there are no visible abnormalities in any of the involved areas. In some areas, there may be tenderness even with mild to moderate pressure.


In addition to pain and tenderness, other symptoms include:

  • Fatigue

  • Trouble sleeping

  • Headaches

  • Thinking and memory problems

  • Morning stiffness

  • Tingling or numbness in the hands and feet

  • Depression and anxiety


Diagnosis

The diagnosis is based on symptoms and physical exam. Doctors may make the diagnosis of fibromyalgia if the widespread body pain and symptoms can not be explained by another cause. Lab tests and imaging studies may be ordered to rule out other health problems that can be confused with fibromyalgia but there is no diagnostic test specific for this condition.


Treatment

Strategies to minimize symptoms include medication and therapy. There is no one treatment that works for everyone. Patients need to work with their healthcare team to tailor a treatment plan. Strategies may include a combination of:

  • Antidepressants. Several different classes of drugs used to treat depression can be effective in treating fibromyalgia symptoms as well.

  • Anti-seizure medications. Anti-seizure drugs such as pregabalin and gabapentin may help relieve pain and improve sleep.

  • Pain-relievers. Over-the-counter medications such as acetaminophen may help with short-term pain relief.

  • Exercise. Regular exercise such as biking, swimming, and walking can help reduce pain and increase muscle strength.

  • Physical therapy. A physical therapist can prescribe exercises and stretches appropriate for each individual.

  • Relaxation therapy. Stress-reduction through tai-chi and yoga can help with some symptoms.

  • Cognitive behavioral therapy (CBT). CBT can help change the way pain is perceived and to deal with the illness more positively.




References

www.cdc.gov/arthritis/basics/fibromyalgia.htm

www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Fibromyalgia

www.niams.nih.gov/health-topics/fibromyalgia

www.womenshealth.gov/a-z-topics/fibromyalgia

www.uptodate.com/contents/treatment-of-fibromyalgia-in-adults-not-responsive-to-initial-therapies

https://www.arthritis.org/diseases/fibromyalgia