21 Apr Top Fibromyalgia Treatment
Fibromyalgia is a condition characterized by generalized muscular pain and fatigue. This condition is not a form of arthritis, but because joint pain is often present, fibromyalgia is often described as a joint disease.
How common is fibromyalgia?
Fibromyalgia is not damaging to the body, but it is a chronic condition. However, with proper management, many people with fibromyalgia improve and are able to live a normal life. Based on current statistics, fibromyalgia affects around 3.4% of women and 0.5% of men in the U.S.
What type of pain is associated with fibromyalgia?
Fibromyalgia causes generalized, widespread muscle pain and tender points. The pain is felt “all over,” but certain areas of the body are tender to touch, including the neck, shoulders, buttocks, and thighs. The pain sensations vary, being described as burning, gnawing, radiating, sore, aching, stiff, and dull. Pain often gets worse due to activity, weather, lack of sleep, and increased stress.
What symptoms are related to fibromyalgia?
Common symptoms seen in patients with fibromyalgia include:
- Fatigue – Other than pain, around 90% of patients with fibromyalgia also have moderate to severe fatigue, decreased exercise endurance, and lack of energy. Patients report feeling tired even after sleeping through the night, or they awaken more fatigued than before they slept. According to scientific studies, most individuals with fibromyalgia have an abnormal sleep pattern with interruption in deep sleep (REM cycles).
- Mood changes – Changes in mood and depression are associated with fibromyalgia. Many people report feeling down and have a personal history of anxiety and depression.
- Trouble concentrating – Many patients with fibromyalgia have trouble concentrating and difficulty with simple mental tasks.
- Odd sensations – Many people with fibromyalgia report feelings of tingling and numbness in the arms, hands, legs, feet, and face. These odd sensations often mimic multiple sclerosis, carpal tunnel syndrome, and neuritis, but test results for these diseases are normal.
- Headaches – Muscle tension can cause headaches in people with fibromyalgia.
- Gastrointestinal complaints – Other common symptoms are constipation, diarrhea, spastic colon, bladder spasms, and urinary frequency.
What causes fibromyalgia?
No one knows what causes fibromyalgia, but experts have several theories. These include:
- Abuse – There is evidence that some patients with fibromyalgia have a history of neglect or abuse at some point during life. Experts are unsure if this is a real cause or an association.
- Stress – Some doctor believe that fibromyalgia is triggered by stressors, such as emotional trauma, a physical illness, or hormonal changes. Researchers speculate that people with fibromyalgia internalized their stress, and it is expressed as pain and muscle tension.
- Neurotransmitter changes – Neurotransmitters are brain chemicals that affect a person’s perception of pain.
- Dysregulation of the autonomic system – This system releases hormones that affect pain perception.
- Genetics – Fibromyalgia tends to run in families and has a heredity component.
How is fibromyalgia diagnosed?
The diagnosis of fibromyalgia is made by medical history and physical examination. The doctor will assess for tender points, joint mobility, and causes of fatigue. The work-up for fibromyalgia involves extensive diagnostic testing to rule out serious causes of symptoms. Testing often involves blood tests, x-rays, and magnetic resonance imaging (MRI) scans.
How is fibromyalgia treated?
As with other types of chronic conditions, treatment is aimed at alleviating symptoms and improving quality of life. Treatment options include:
- Counseling – For depressed mood and irritability, counseling is recommended. Education about the illness is imperative, and the counselor will also discuss ways to improve productivity and quality of life.
- Physical therapy – A progressive exercise program involves cardiovascular fitness and stretching exercises. Relaxation techniques are used to relax tense muscles and relieve stress. For pain, electrical stimulation, ultrasound, and heat therapy may help.
- Chiropractic therapy – Because fibromyalgia causes back and neck pain, chiropractic care involves spinal manipulation and adjustments. In a clinical study conducted recently, 77% of people with fibromyalgia improved with chiropractic care, including improved sleep, reduction of fatigue, and pain relief.
- Acupuncture – This treatment involves placing tiny needles along body regions (which are called meridians) to promote healing, ease pain, and restore energy. In a study of 16 patients with fibromyalgia, researchers found that acupuncture offered significant improvement in pain relief.
- Transcutaneous electrical nerve stimulator (TENS) – This small device is worn outside the body, and involves attachment of small electrodes to various body regions. Wires run from the small unit to the device, which emits pleasant electrical current that interferes with pain signal transmission. In a scientific study, participants reported that TENS was useful for pain relief, and it improved fatigue.
- Trigger point injections – Trigger points (contracted muscle) develop causing severe pain. The doctor will inject them with an anesthetic with or without a corticosteroid into these areas.
- Botox injections – A new therapy involves injecting tense muscles with Botox, which relieves pain and muscle tension. A recent clinical study found that Botox and standard physical therapy reduced pain by around 40%. More than half of the study participants said they would have Botox injections again.
What medications will help with fibromyalgia?
Medications commonly used include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) – These agents include ibuprofen, ketoprofen, and naproxen, which lessen stiffness and reduce tissue inflammation.
- Sleep aids and mood stabilizers – These drugs include amitriptyline, nortriptyline, doxepin, and selective serotonin reuptake inhibitors (SSRIs), such as Prozac and Paxil.
- Muscle relaxants – For tension and to promote deeper sleep, a mild muscle relaxant may be prescribed, such as Flexeril and Baclofen.
- Pregabalin (Lyrica) – This is the first medication approved by the FDA to treat fibromyalgia.
- Topical agents – Muscle pain often responds to topical analgesics, such as menthol, capsaicin, and Aspercreme.
- Supplements – These include vitamin C, omega-3 fatty acids, probiotics, L-carnitine, alpha-lipoic acid, S-adenosylmethionine, and magnesium.
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