Fibromyalgia: An Overview

What exactly is Fibromyalgia?

Fibromyalgia (FM) is a common yet complex chronic disorder which results in widespread pain and tenderness to touch. The pain and tenderness may occur in the whole body and varies in intensity over time. FM impacts individuals in multiple ways; physically, mentally and socially. Approximately ten million Americans, which comprise 2-4% of the US population, have FM with a ratio of about eight to two in females and males. It can affect people of all age groups including children. The literal meaning of the word Fibromyalgia is pain inside the muscle tissues, ligaments and tendons. However, FM does not only cause pain but creates a lot of other symptoms that differ from individual to individual.

What causes Fibromyalgia?
Science hasn’t yet been able to pinpoint the root cause of Fibromyalgia. Nevertheless, research has identified multiple factors that could be responsible for causing Fibromyalgia.

What are the Most Common Fibromyalgia Symptoms?

The intensity of the symptoms of Fibromyalgia can vary from person to person. Fatigue, sleep disturbances (sleep apnea and/or not waking up fresh), cognitive difficulties (memory difficulties or considering clearly), and stiffness are the most prevalent symptoms. Other symptoms may include depression or anxiety, migraines, tension, headaches, pelvic pain, problems with bladder, irritable bowel syndrome (IBS), TMJD (which includes tinnitus), and gastrointestinal reflux disease (GERD). Anxiety generally worsens the connected difficulties and symptoms. Let’s assess the symptoms in much more detail.

  • Pain – The key symptom of Fibromyalgia is chronic and continual pain that occurs simultaneously in multiple body parts. The pain may possibly be described as a deep muscular aching, soreness, stiffness, burning, or throbbing. Sufferers could also feel numbness, tingling, or unusual “crawling” sensations within the arms and legs. Even though some degree of muscle pain is normally present, it varies in intensity and is aggravated by certain conditions, such as anxiousness or anxiety, poor sleep, exertion, or exposure to cold or dampness.

    People with Fibromyalgia usually have muscle stiffness when they wake up and experience relative relief as the time passes. Nevertheless, in some situations, muscle stiffness can stay all day. A well-known description is, “It feels as if I have the flu.” The pain could be limited to specific areas, mostly the neck or shoulders, early in the course of the disease. Numerous muscle groups may eventually get involved, with most patients experiencing pain within the neck, middle and lower back, arms and legs, and chest wall. These areas can feel really painful with even slight stress and are named tender points. Many sufferers with Fibromyalgia feel that their joints are swollen, without any visible inflammation on the joints (arthritis).

    Other pain symptoms – Patients with Fibromyalgia are typically affected by other pain symptoms. Many sufferers encounter migraines or muscular headaches.

  • Symptoms of irritable bowel syndrome (IBS), such as frequent abdominal pain and episodes of diarrhea, constipation, or both, are widespread in Fibromyalgia. Bladder pain, urinary Fibromyalgia: An Overviewurgency, and frequency are generally experienced by many patients.
  • Some individuals with Fibromyalgia have facial and jaw pain or tenderness resulting from temporomandibular joint (TMJ) syndrome. Individuals with TMJ syndrome could experience limited jaw movement, various sounds when opening or closing the mouth, pain inside facial or jaw muscles, pain in or around the ear, or headaches.
  • Fatigue and sleep disturbances – More than 90% sufferers experience fatigue and issues with sleep. People today with Fibromyalgia may well also have sleep apnea (when the person stops breathing to get a few moments even though sleeping) or restless leg syndrome (when there’s an uncontrollable urge to move the legs). It is recommended to go for formal testing if these symptoms are present.There appears to become a close link between this order and chronic fatigue syndrome (CFS), which is mainly characterized by constant, debilitating fatigue. The two diseases overlap to a great extent with regard to their symptoms and criteria.
  • Depression and anxiety – Approximately 30 % of folks with Fibromyalgia have key depression when they are diagnosed; the ratio of depression or anxiety in people suffering from Fibromyalgia is about 74 and 60 percent, respectively.
  • Infectious ailments – Chronic pain and tenderness might be triggered by some infections, which include Lyme illness. Continued symptoms of Fibromyalgia are usually not as a consequence of “chronic” Lyme illness.

What Causes Fibromyalgia?

  1. Genetics
    Fibromyalgia can run in families. It’s likely that some unidentified genetic abnormality expose certain individuals more to the risk of getting Fibromyalgia. As per the National Institute of Arthritis, Musculoskeletal and Skin Ailments (NIAMS), certain genes could be responsible for the way that the body responds to pain. Scientists are of the view that individuals with Fibromyalgia might have one particular, additional gene that causes them to react strongly to the same stimuli that another person may not perceive as painful.
  2. Emotional or Physical Triggers
    For many people who suffer from this order, symptoms start soon after emotional or physical trauma or possibly an episode of an infectious illness. It does not necessarily mean that these events cause Fibromyalgia by themselves, but they might trigger the disease in individuals who are already at risk.
  3. Sleep Disturbances
    This disorder usually entails problems with regard to getting sufficient sleep, or spending adequate time in the deepest stages of sleep. However, there is no agreement among doctors whether this is a symptom or a cause of the disorder. Irregular sleep patterns can influence the levels of multiple brain chemical compounds.

Causes – a deeper look

Although the root cause of the disorder is yet to be determined, most researchers think that the widespread pain, the key symptom of FM, is a consequence of abnormalities in the function of central nervous system. Additionally, it has been hypothesized that aberrations in the tension response can play an important part in symptom expression. Due to the prevalence of emotional issues in sufferers of FM, it’s also believed that psycho-behavioral aspects may contribute to the pathogenesis and/or individual expression of FM.Fibromyalgia: An Overview

With regard to nervous system function, it’s believed that persons with FM experience pain amplification resulting from abnormal sensory processing in the central nervous system. This is supported by research showing a range of physiological aberrations in persons with FM including elevated levels of substance P in the spinal cord, low levels of blood flow for the thalamus area with the brain, and abnormalities in cytokine function.

It has also been suggested that FM could relate to an anomaly in deep sleep. That’s, abnormal brain waveforms have been discovered in deep sleep in many people with FM. Additionally, tender points could be developed in normal volunteers by depriving them of deep sleep for a few days. By the same token, satisfactory levels of human growth hormone, integral to maintaining muscle and other soft tissue health, are generated during deep sleep – they can become low in persons with FM.

Finally, recent studies show that genetic variables may possibly predispose men and women to a genetic susceptibility to FM. For some people, FM is triggered slowly; nevertheless, in a substantial percentage of persons, the disorder is generally started after an illness or injury that causes trauma to the body. These events may well elicit an undetected physiological dilemma that is already present.

Do the patients get better with time?

Fibromyalgia is really a chronic condition, which means that it lasts for a long time period sometimes the whole life. However, the good part is that Fibromyalgia is not a progressive disease. It does not lead to death, and it doesn’t result in problems with the joints, muscles, or internal organs.

How is FM Diagnosed?

No blood test or X-ray can diagnose Fibromyalgia. The diagnosis is created solely by taking a history and carrying out a physical exam. Your medical professional might still desire to do blood tests or X-rays to rule out illnesses that are similar in nature.

As outlined by the American College of Rheumatology, prior to the diagnosis of Fibromyalgia is usually made, the muscle pain need to be present for longer than 3 months. Also, pain must take place at distinct sites called tender points. There are 18 such spots, mostly on the neck and back.

Your physician makes the diagnosis by exerting mild pressure on the tender points. If discomfort occurs at 11 or more of these points, then the physical exam is constructive for Fibromyalgia.

Treatments

With regard to treatment of Fibromyalgia, various treatment options are available including drugs, alternative remedies, and lifestyle changes that Fibromyalgia: An Overviewcould help in pain reduction and boosting sleep. Your doctor may prescribe pain medication and/or antidepressants to ease the symptoms such as pain, fatigue, depression, and anxiousness that come with this disorder. Furthermore, your medical professional may advise physical therapy, moist heat, common aerobic workout, relaxation, and anxiety reduction to assist you in managing your symptoms.

There’s no single medicine that can cure Fibromyalgia. A multidisciplinary strategy that makes use of both medication and alternative therapies or lifestyle techniques seems to be ideal for treatment of Fibromyalgia symptoms.

Prevention

There aren’t any identified ways to prevent Fibromyalgia because the triggers are not yet fully understood. A healthy lifestyle, getting sufficient sleep, and having a positive mindset are some of the ways that are generally helpful in being healthy and avoiding all diseases.

What research is being done on Fibromyalgia?

The National Institute of Arthritis and Musculoskeletal and Skin Ailments sponsors analysis to help understand Fibromyalgia and find better solutions to diagnose, treat, and avoid it. Researchers are studying the following subjects.

  • Why do individuals with Fibromyalgia feel such a great deal of pain?
  • How can physical exercise help patients with Fibromyalgia?
  • Medicines and behavioral treatments.
  • Alternative therapies that do not involve traditional medicines to assist in pain relief.
  • Approaches to boost sleep in sufferers.
  • Whether or not genetics play a part in making a person vulnerable to Fibromyalgia?

Fibromyalgia and Diet

In case you have Fibromyalgia, you must have thought if you can find strategies to modify your diet to find relief from the symptoms such as fatigue and muscle pain.

Research hasn’t shown that there are certain foods that all Fibromyalgia patients must use or avoid. However, it may be worthwhile to study the connection between food and your mood.

An excellent method to get started identifying the foods that might worsen your symptoms is by maintaining a regular food journal. If a Fibromyalgia patient has a great deal of irritable bowel symptoms, they should try an elimination challenge diet plan. They should quit eating a particular meal they suspect they are sensitive to for six to eight weeks. Then they must add it back to their diet and notice the variation in how they feel.Fibromyalgia: An Overview

Patients most frequently attempt eliminating dairy products or foods containing gluten. After you learn you are sensitive to a particular food and eliminate it from your diet program, it could make a huge difference. Some individuals get many benefits in terms of reduction of pain, but more often they notice a reduction in fatigue and an improvement in irritable bowel symptoms like bloating and constipation. It makes sense for individuals with Fibromyalgia -just like every person else -to attempt to eat a diet healthier diet.

A well-balanced diet can provide you with additional power to keep you physically active and can potentially improve your general well being. Keep in mind that individuals with Fibromyalgia have a tendency to benefit the most from simultaneously adopting various approaches for managing their symptoms and this includes diet modifications.

Apart from maintaining a healthy lifestyle and taking any medications your doctor may prescribe for pain or other symptoms; there are actually quite a few other therapies worth exploring.

These therapies include yoga, massage, and deep-breathing exercises. Each person with Fibromyalgia has multiple symptoms and thus can choose from different options to get the best possible quality of life.

Common Medications for Fibromyalgia

  • Anticonvulsants – Anticonvulsants (drugs made use of mainly for treating epilepsy) could help to relieve pain and improve sleep.
  • Pregabalin was the first drug authorized in the United states for the treatment of Fibromyalgia in 2007.It operates as an alpha-2-ligand inhibitor, and its pain relief is associated to blocking specific chemical compounds that increase pain transmission.Side effects – The most common side effects of this drug include feeling sedated or dizzy and gaining weight; even so, many people tolerate these medications effectively.
  • Dual-reuptake inhibitors – Duloxetine and milnacipran, each inhibitor of norepinephrine and serotonin reuptake by nerve cells, have helped relieve pain and fatigue, and improve well-being in individuals with Fibromyalgia, no matter whether or not the person was depressed. Probably the most widespread side effects are nausea and dizziness, but they are frequently less problematic in the event the dose is started at a low level and is increased gradually.

Many other medications have been utilized to handle the symptoms pertaining to Fibromyalgia. The medications which have been most effective in relieving symptoms of Fibromyalgia in clinical trials are drugs that target chemical substances within the brain and spinal cord which might be crucial in processing pain. In contrast, medications and tactics that reduce symptoms of pain locally, which include anti-inflammatory drugs and analgesics, are significantly less powerful.

Other Medications for FM treatment

Tricyclic antidepressants (TCAs) – Taking TCAs prior to bedtime could promote deeper sleep and may sometimes alleviate muscle pain. Examples of TCAs are medicines that contain amitriptyline or cyclobenzaprine. Although cyclobenzaprine is commonly thought of as a muscle relaxant, its chemical structure and mode of action are similar to those of amitriptyline. Studies have shown that treatment with these TCAs results in considerable improvement in about 25 to 45 percent of individuals with Fibromyalgia, even though the effectiveness may lessen over time. TCAs are ordinarily started at an extremely low dose and are gradually increased towards the most efficient and tolerable dose. Even at low doses, side effects are common and might include dry mouth, fluid retention, weight gain, constipation, or difficulty in concentrating.

Selective serotonin reuptake inhibitors (SSRIs) – Selective serotonin-reuptake inhibitors (SSRIs) like fluoxetine and paroxetine might also be helpful in Fibromyalgia. SSRIs are a group of antidepressant drugs that enhance the concentration of serotonin within the brain. Serotonin is a naturally made chemical that regulates the delivery of messages between nerve cells.

Anti-inflammatory drugs – Fibromyalgia doesn’t trigger tissue inflammation. Neither nonsteroidal antiinflammatory drugs (NSAIDs) employed alone nor glucocorticoids (steroids) help people with Fibromyalgia. Nevertheless, when utilized in combination with other medications, NSAIDs like ibuprofen or naproxen might offer some benefits.

Analgesics – Analgesics are pain medications; some are obtainable over-the-counter and others require a prescription. The prescription analgesic tramadol, whether it is taken alone or in combination with acetaminophen, was found to be beneficial in alleviating the pain connected with Fibromyalgia in clinical trials. Tramadol may lead to dizziness, diarrhea, or sleep disturbances in some people. Use of tramadol is less most likely to result in addiction as compared with other, much more powerful pain relievers that contain narcotics.

Narcotic or opioid pain medications have not been studied for the treatment of Fibromyalgia. Most doctors don’t suggest using narcotic pain medications in the long-term, though they might be suitable for some people for short-term relief of symptoms that do not improve with all other treatments.

Outlook

Though there isn’t any remedy for Fibromyalgia, combining home remedies along with your doctor’s care can help ease your pain and manage the symptoms. The patients having this disorder can be hopeful as several companies are testing new medicines to fight this painful disease.

 

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