Fibromyalgia often unrecognized
Affects 2-4% of the population, predominantly women.
Diagnosis based on patient symptoms and physical examination
Lab tests are usually normal
Medicines are important but not the only treatment
Self care is integral to effective care
LIVING WITH FIBROMYALGIA
Patient self-management is integral to a meaningful improvement in symptoms and daily function.
Schedule time to relax each day. Deep-breathing exercises and meditation will help reduce the stress that can bring on symptoms.
Establish a regular pattern for going to bed and waking up. Getting enough sleep allows the body to repair itself, physically and psychologically
Exercise regularly. This is a particularly important part of fibromyalgia treatment.
Keep in mind that establishing healthy lifestyle behaviors in concert with medical treatment can reduce pain, increase sleep quality, lessen fatigue and help you cope effectively with fibromyalgia.
Fibromyalgia causes persistent pains in many areas of the body as well as tiredness or fatigue. Often there is also tenderness i.e. you get pain even on slight touching or pressing.
You may also have some other symptoms; the common ones being
- Sleep disturbance
- Irritable bowel (pain, bloating in stomach, loose stools/ constipation)
- Frequent urination
- Palpitations (increased heart beat)
- Problem with remembering, concentration
- Restless leg (uncomfortable sensation of legs with urge to move them frequently)
It is a very common condition affecting about 2-4% population but often misunderstood and often unrecognized. Since lots of patients complain of joint pains it is not uncommon to find Fibromyalgia patients unnecessarily taking arthritis medicines. One of the reasons this condition is often missed is that there are no tests available to diagnose this condition. In fact one of the common features is that majority of lab tests are normal. The diagnosis is made on patient’s symptoms and physical check up. Tests are generally carried out to rule out other diseases.
The cause of fibromyalgia is not known. The current main theory is that people with fibromyalgia have an oversensitivity to pain signals in the brain. This is called 'central sensitisation' as a result of which normally non painful stimuli such as touch also become painful. There can be some triggering factors like sleep deprivation, trauma, emotional disturbance, stress, arthritis, chronic diseases etc.
Fibromyalgia is more common in women, though men can also be affected. Most commonly in middle age but can occur in children, young people and old age.
A common concern for patient’s is how serious there condition is, are they suffering from arthritis or some form of cancer or other life threatening disorder. It is reassuring for a lot of patient’s to know that Fibromyalgia is not arthritis, it is not due to cancer, does not damage any joint or tissue. It does not shorten lifeexpectancy. However, in many cases it can be a persistent and frustrating condition which can affect quality of life.
There is no cure for fibromyalgia, so it must be managed as a chronic condition. Treatment needs to be tailored according to the patient. Often it takes time for improvement to start. It may take a couple of weeks to months before any improvement begins. So patience and perseverance is required.
Management should include both medication and non-drug treatments for symptoms.
A wide variety of drugs are available for treatment of fibromyalgia. NSAIDs like diclofenac are generally not effective. Tramadol, paracetamol are more effective and safer also if taken under proper supervision. They however give only slight relief. At times some drugs used for anxiety or depression are prescribed. These drugs are generally required at lower doses in fibromyalgia and are not used as antidepressants or anxiolytics primarily. The basis for use of these drugs is to restore the levels of certain chemicals in brain (neurotransmitters) that have become imbalanced.
Exercise forms a very important part of treatment. Aerobics, yoga, tai chi are quite useful. While difficult at first, regular exercise often reduces pain symptoms and fatigue. Patients should follow the adage, “Start low, go slow.” Then push harder. Remember, it takes time to establish a comfortable routine, so just get moving, stay active and don't give up!
In addition counseling, self management skills, cognitive behavioral therapy also have important role to play.
Some people try complementary or alternative treatments such as acupuncture, aromatherapy, massage, etc. There is little evidence that such treatments relieve the core symptoms of fibromyalgia.