The Disease Fibromyalgia


Fibromyalgia is a chronic condition characterized by extensive pain in your muscles, ligaments and tendons, as well as tiredness and multiple tender points (places on your body where slight pressure causes pain).

Fibromyalgia occurs in about two percent of the population in the United States. Women are much more probable to develop the disorder than men, and the risk of fibromyalgia increases with age. Fibromyalgia symptoms often begin after a physical or emotional trauma, but in many cases there appears to be no originating event. Although increased sensitivity to pain is the main symptom of fibromyalgia, fibromyalgia syndrome and other types of chronic pain diseases form a family of corresponding syndromes. Therefore, even though the most common symptoms are pain and fatigue in muscles and tendons, often it is noticed that those suffering from fibromyalgia will have other associated conditions and symptoms. It is because of these corresponding symptoms that fibromyalgia came to be considered as a syndrome rather than a disease.

The signs and symptoms of fibromyalgia are: chronic muscle pain, muscle spasms, muscle tightness, weakness in the limbs, leg cramps, moderate or severe fatigue, insomnia or waking up feeling just as tired as when you went to sleep, stiffness upon waking or after staying in one position too long, difficulty remembering and concentrating, abdominal pain, bloating, nausea, constipation, tension or migraine headaches, jaw and facial tenderness, sensitivity to odors or bright lights, feeling anxious or depressed, numbness in the face and extremities, increase in urinary urgency or frequency, reduced tolerance for exercise and muscle pain after exercise, a feeling of swelling (without actual swelling) in the hands and feet, painful menstrual periods, and dizziness.

Fibromyalgia symptoms may increase depending on the time of day. The mornings, late afternoons, and evenings tend to be the worst times. From 11:00 a.m. to 3:00 p.m. tends to be the best time. They may also get worse with fatigue, tension, inactivity, changes in the weather, cold or drafty conditions, overexertion, hormonal variations (just before menopause), stress, depression, or other emotional factors.

There are three main ways to treat fibromyalgia. The first is pain management. There are a number of pharmacological treatments available for fibromyalgia. The first medication approved by the FDA (Food and Drug Administration) was Lyrica, the second was Cymbalta, and the third was Savella. Physicians may also treat the symptoms of fibromyalgia with non-narcotic pain relievers, such as Tramadol, or low doses of anti-depressants or benzodiazepines. Lidocaine injections into the patient’s tender points also work well on localized areas of pain. An important aspect of pain management is a regular program of gentle exercise and stretching which helps maintain muscle tone and reduces pain and stiffness.

Sleep management is also effective in relieving symptoms of fibromyalgia. Improved sleep can be obtained by implementing a healthy sleep regimen. This includes going to bed and getting up at the same time every day, making sure the sleep environment is appropriate for sleep; avoiding caffeine, sugar and alcohol before bed; doing some type of light exercise during the day; avoiding eating immediately before bedtime; and practicing relaxation exercises as you fall asleep.

The third form of treatment for fibromyalgia is psychological support. Learning to live with a chronic illness often challenges an individual emotionally. The fibromyalgia patient needs to develop a program that provides emotional support and increases communication with family and friends. Many communities throughout the United States have organized fibromyalgia support groups. Counseling sessions with a trained professional may help to improve communication and understanding about the illness and help to build healthier relationships within the patient’s family.

In addition to these three forms of treatment, there are other treatments that might be effective. These treatments may include: physical therapy, therapeutic massage, myofascial release therapy, water therapy, light aerobics, acupressure, application of heat or cold, acupuncture, yoga, relaxation exercises, breathing techniques, aromatherapy, cognitive therapy, biofeedback, herbs, nutritional supplements, and osteopathic or chiropractic manipulation.

Fibromyalgia can be mild or disabling and the emotional toll can be extensive. People with fibromyalgia experience greater psychological distress and a greater impact on quality of life than those with other conditions, such as chronic low back pain. About half of all patients have difficulty with routine daily activities, or are unable to perform them. An estimated 30-40% of patients with fibromyalgia have had to quit work or change jobs. Patients with fibromyalgia are more likely to lose jobs, possessions, and support from friends and family than are people suffering from other conditions that cause fatigue.

Some studies show that fibromyalgia symptoms remain stable over the long term, while others report a better outlook, with 25-35% of patients reporting improvement in pain symptoms over time. Studies suggest that regular exercise improves the outlook. Those with a significant life crisis, or who are on disability, have a poorer outcome, as determined by improvements in the patients’ ability to work, their own feelings about their condition, pain sensation, and levels of disturbed sleep, fatigue and depression. Although the disease is life-long, it does not get worse and is not fatal.

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