Fibromyalgia: A Chronic Pain Syndrome That Affects Six Million American People
Fibromyalgia syndrome is a disorder that may or may not exist according to some clinicians and medical researchers. Fibromyalgia may be a single clinical disease or may actually be a group of clinical predicaments with a wide range of symptoms forming a neuropsychiatric pattern. It is a chronic pain syndrome that affects almost six million american people. Chronic means that it affects the patient for a period greater than three months. Most patients are young adult women who complain of widespread muscle pain with multiple other diffuse symptoms. Fatigue, headache, and sleep disturbances are characteristic. There are many other difficulties associated with the syndrome and include joint pain, numbness and tingling, muscle spasms and abnormal bowel, bladder and uterine problems. Sensitivity to light may occur. The muscle pain occurs on light touch and pressure to tender areas or trigger points. These are muscle-nerve bundles in the tissues which become hyper-sensitive to pressure and touch. The brain apparently becomes centrally sensitized to normal nerve signals that are interpreted as abnormal: a lower pain threshold is thought to be related to causation.
The primary condition is chronic and diffuse pain to touch. There are tender areas in the muscles. For diagnosis, 11 such areas out of eighteen defined areas must be affected. These areas are found on the top of the shoulders, neck, inside of the knees and thighs, hips, anterior chest and low back areas. They are bilateral and found in all body quadrants. There is no laboratory or blood tests that are definitive. There are other diseases that may be associated: irritable bowel syndrome, osteoarthritis, rheumatoid arthritis, and lupus, depression, and endometriosis.
Etiology is unknown but it appears that stress and trauma, both physical and emotional, and infection are related. Weather changes, automobile travel and physical activity may also increase the degree and onset of the syndrome. There is a family history so genetics are also involved. There do appear to be some definite abnormal changes in brain activity seen by neuroimaging described by medical researchers.
Treatment is based on simple analgesics for pain relief. Local anesthetic injections or simple needle placement in the tender areas may give relief. Physical therapy with cold spray (ethyl chloride) and meditation or yoga techniques have been found helpful. Massage therapy is also beneficial. Recently, some newer anti-seizure drugs have been promulgated for treatment by several pharmaceutical companies. Whether the syndrome exists as a single entity or as a group of somatic maladies, two percent of the population experiences the symptoms and recent developments offer new hope.
May 11th, 2009 at 3:25 am
I have had fibromyalgia since 2003, and it is not “all in your head” as I was told by different doctors. My own personal philosophy regarding the onset of this syndrome is when the body has exceeded its allotted tolerance to pain. My theory is that all people with fibromyalgia have had some kind of trauma to the head, neck, or back. In my case, I had suffered several herniated discs in my lower back before developing fibro. Trust me, this is a real disease. By the grace of God, Lyrica was developed, and it is a drug for neuropathic pain. It really works to combat the body pain. Another thing that helps is heat. Sitting in a tub filled with hot water, sitting in a jacuzzi, or standing under a shower of hot water helps relieve some of the pain. Unfortunately, nothing has been developed to combat the fatigue that accompanies the pain in this disease. The best exercise for fibro is aquatics in a heated pool. Yoga and Pilates also help. Since the muscle fibers seem to bundle up and form “knots” all over your body, massage is also helpful. Of course, insurance doesn’t pay for any of the treatments that actually work, except for the Lyrica. Provigil helps with the fatigue, but you can’t take it every day because then it becomes useless. Besides that, it’s over $400/month, and insurance won’t pay for it. I am ready to try acupuncture next. There are critics out there who have the nerve to say that there is nothing really wrong with us. Really? That’s why I spent my life as a chauffeur for my kids’ athletic activities only to miss the one grand slam my son hit, to miss my daughter’s induction into National Honor Society, to miss my godfather’s funeral, etc.. My social life is past being a wreck; it’s nonexistent. How can anybody plan anything when they have no idea of whether the fibro will act up at that time? I have had to learn to pace myself and force myself to rest, even on the “good” days, knowing that if I don’t, I will crash and be bedridden for at least two days.