What is Fibromyalgia and How to Treat It
Fibromyalgia (FM) is a medical condition characterised by chronic widespread pain and a heightened pain response to pressure. Other symptoms include feeling tired to a degree that normal activities are affected, sleep problems, and troubles with memory.
Some people also report restless legs syndrome, bowel or bladder problems, numbness and tingling, and sensitivity to noise, lights or temperature. Fibromyalgia is frequently associated with depression, anxiety, and posttraumatic stress disorder. Other types of chronic pain are also frequently present.
The cause of fibromyalgia is unknown but believed to involve a combination of genetic and environmental factors with half the risk attributed to each. The condition runs in families and many genes are believed to be involved. Environmental factors may include psychological stress, trauma, and certain infections. The pain appears to result from processes in the central nervous system and the condition is referred to as a “central sensitization syndrome”.
Fibromyalgia is recognized as a disorder by the US National Institutes of Health and the American College of Rheumatology. There is no specific diagnostic test. Diagnosis involves first ruling out other potential causes and verifying that a set number of symptoms are present.
The treatment of fibromyalgia can be difficult. Recommendations often include getting enough sleep, exercising regularly, and eating a healthy diet. Cognitive behavioral therapy may also be helpful. The medications duloxetine, milnacipran, or pregabalin may be used. Use of opioid pain medication is controversial with some stating their use is poorly supported by evidence and others saying that weak opioids may be reasonable if other medications are not effective. Dietary supplements also lack evidence to support their use. While fibromyalgia can last a long time, it does not result in death or tissue damage.
Fibromyalgia is estimated to affect 2–8% of the population. Females are affected about twice as often as males. Rates appear similar in different areas of the world and among different cultures. Fibromyalgia was first defined in 1990 with updated criteria in 2011. There is controversy about the classification, diagnosis, and treatment of fibromyalgia. While some feel the diagnosis of fibromyalgia may negatively affect a person, other research finds it to be beneficial.
- Chronic muscle pain, muscle spasms, or tightness
- Moderate or severe fatigue and decreased energy
- Insomnia or waking up feeling just as tired as when you went to sleep
- Stiffness upon waking or after staying in one position for too long
- Difficulty remembering, concentrating, and performing simple mental tasks (“fibro fog”)
- Abdominal pain, bloating, nausea, and constipation alternating with diarrhea (irritable bowel syndrome)
- Tension or migraine headaches
- Jaw and facial tenderness
- Sensitivity to one or more of the following: odors, noise, bright lights, medications, certain foods, and cold
- Feeling anxious or depressed
- Numbness or tingling in the face, arms, hands, legs, or feet
- Increase in urinary urgency or frequency (irritable bladder)
- Reduced tolerance for exercise and muscle pain after exercise
- A feeling of swelling (without actual swelling) in the hands and feet
There are drugs, alternative remedies, and lifestyle habits that may help decrease pain and improve sleep. Your fibromyalgia specialist may prescribe pain medication or antidepressants to help treat the pain, fatigue, depression, and anxiety that comes with the disease. In addition, your doctor may recommend physical therapy, moist heat, regular aerobic exercise, relaxation, and stress reduction to help you self-manage your symptoms.
There is no one “pill” that treats or cures fibromyalgia. A multidisciplinary approach that uses both medication and alternative or lifestyle strategies seems to work best to treat fibromyalgia symptoms.
Physical therapy can help relieve fibromyalgia pain and stiffness. Regular visits to a licensed physical therapist can increase confidence with exercise, help relax tense muscles, and teach you more about your body and movement. In addition, physical therapy helps with ‘new’ muscle memory and neuroendocrine changes in a positive way to help you muscles recover.
Your physical therapist will show you the proper way to stretch painful muscles to get optimal relief. In addition, using hydrotherapy (moist heat or ice packs) along with physical therapy may ease pain even more.
Physical therapy can enable you to regain control of your illness. That’s because you can focus on lifestyle changes rather than on the chronic dysfunction. Proper posture, which your physical therapist will help you with, allows efficient muscle function. That way, you can avoid undue fatigue and pain.
- Acupuncture – Some findings show that acupuncture may alter brain chemistry and help increase pain tolerance.
Chiropractic . Chiropractic may improve pain levels, ease low back pain, and increase cervical and lumbar ranges of motion.
- Deep tissue massage – Deep tissue massage may stimulate circulation and release chronic patterns of muscular tension.
- Neuromuscular massage – Neuromuscular massage combines the basic principles of ancient Oriental therapies, such as acupressure and shiatsu, with specific hands-on deep tissue therapy to help reduce chronic muscle or myofascial (soft-tissue) pain.
- Biofeedback – Using electronics to measure stress-related responses in the body, biofeedback helps some people control the stress response and relieves chronic pain, according to the National Institutes of Health.
Meditation . Studies show that meditation produces brain waves consistent with serenity and happiness, which help to relieve anxiety.
- Tai Chi and qi gong – These are two Chinese practices that have been found to be helpful with some fibromyalgia symptoms including pain, sleep troubles, and depression.
- Herbal remedies – Although there are few studies on herbal remedies and fibromyalgia, some patients report improved sleep or more energy with herbal supplements such as echinacea, black cohosh, lavender, milk thistle, and B vitamins.
- Natural dietary supplements – While the studies are limited on natural dietary supplements and fibromyalgia, some patients have found relief with over-the-counter natural dietary supplements such as 5-HTP, melatonin, St. John’s wort, L-carnitine, SAM-e, and probiotics. Many of these, including St John’s wort, have drug interactions, so avoid these if you are on any prescription medications or on several supplements. Some may not be safe for you if you have other medical problems.
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Source: Wikipedia, Webmed