Fibromyalgia (FM) has been
described as being a “myth” as well as “real” (and probably everything in
between the two). This is a VERY controversial disorder that some doctors push
under the rug by saying, “….there is no such thing,” while others stake their
reputation on it. So with this wide variance in attitude and beliefs about FM,
what ARE the facts?
Fibromyalgia has been defined
as, “…a complex chronic pain disorder that affects an estimated 10 million
Americans” (ref: National Fibromyalgia Association). Women are affected the
greatest, but it can affect men and children as well. This condition can be
subtle, hardly interfering with life and all of its activities to being totally
disabling, disallowing participation in work and the most desired aspects of
daily living.
DIAGNOSIS: In 1990, the American College of Rheumatology (ACR) introduced
the diagnostic criteria for FM. This includes a patients history of “wide
spread pain” for at least three months, AND pain in 11 or more of the 18
specifiic tender points using 4 kg of pressure. Due to the significant
controversy about the reality of the disease (as stated in the opening
paragraph), ONLY a physician knowledgable about FM should make the diagnosis.
Along with this diagnostic responsibility, ALL other conditions having similar
presenting symptoms as FM, “…must be ruled out” BEFORE making the diagnosis of
FM.
SYMPTOMS: Though the hallmark of
FM is widespread, generalized pain (in all four body quadrants), a number of
other symptoms are common amongst FM sufferers. Some of these include fatigue
(moderate to severe), sleep disorders, brain fog, irritable bowel syndrome
(IBS), headaches (including migraine), anxiety, depression, and environmental
sensitivities. Studies suggest that there is a “neuroendocrine” (nerves and
hormones) abnormality that may contribute to the FM symptoms.
CAUSES: Research has found a
genetic link, as FM is OFTEN seen in several family members (among siblings
and/or mothers and their children). “Secondary fibromyalgia” arises AFTER other
health-related issues occur such as physical trauma (like an acute injury or
illness), which can act as a “trigger” for initiating FM. Recently, more
attention has been directed to the central nervous system as the “underlying
mechanism” for developing FM. Here, the threshold or level of a stimulus that
triggers a painful response is found to be much lower in FM patients compared
to a healthy group of people (this is called “central sensitization”). Thus, a
pain response is amplified in the FM patient due to this lowered threshold of
pain tolerance.
TREATMENT: As there is NO KNOWN
cure for FM, symptomatic support and functional improvement are two important
primary goals when treating patients with FM. In the medical world, there are
MANY drugs that have been utilized for FM (such as sleep aids, muscle relaxers,
anti-inflammatory, analgesics, and anti-depressants / -anxiety meds).
ALTERNATIVE therapies include massage therapy, chiropractic, myofascial release, acupuncture, herbal supplements,
yoga, and other exercise approaches such as swimming and/or simply walking are
popular care options for many FM patients. Increasing rest, pacing daily
activities (to avoid “over-use”), stress management (relaxation tapes,
exercise, and nutritional support can ALL HELP reduce FM symptoms and improve
quality of life!
If you, a friend or family member
requires care for Fibromyalgia, we sincerely appreciate the trust and
confidence shown by choosing our services!
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