2. What are the symptoms of fibromyalgia?
3. What are the causes and risk factors of fibromyalgia?
4. Why does it pain in fibromyalgia?
5. How do doctors diagnose fibromyalgia?
6. Is fibromyalgia different from lupus and arthritis?
7. Which specialist treats fibromyalgia?
8. What are the treatment options for fibromyalgia?
9. What lifestyle and home remedies can a person with fibromyalgia adopt?
Fibromyalgia, also called Fibro or fibromyalgia syndrome (FMS) is a medical condition in which a person experiences chronic and widespread musculoskeletal pain. The pain in this condition is associated with fatigue and issues related to memory, sleep, and mood.
Although there is no definitive cure for fibromyalgia, it is possible to manage the condition well by consulting an expert rheumatologist and regular follow up care under the guidance of a rheumatologist and pain management physician in a pain management clinic. Symptoms of fibromyalgia can be managed by a variety of medications, exercise, relaxation and stress-management techniques customized to a person’s medical and personal needs.
In certain cases, symptoms of fibromyalgia appear after physical or psychological triggers like surgery, trauma, infection or significant stress. In some cases, symptoms appear gradually over some time. Some of the commonly reported symptoms include:
The exact underlying cause of fibromyalgia is uncertain, however, scientists believe that there could be a variety of factors that cause an effect. These factors may include:
Some common risk factors for fibromyalgia include:
It is believed by the scientific community that repeated nerve stimulation alters how the brain processes the pain signals and the pain sensations get amplified. This change is associated with an abnormal increase in levels of the neurotransmitters or chemicals within the brain that signal pain. The receptors of pain in the brain also become over-reactive to pain signals as they develop a memory of the pain, thereby making them more sensitive.
Diagnosis of fibromyalgia is made by a rheumatologist based on medical history, physical examination, and medical tests. Fibromyalgia is suspected if a person has a history of widespread pain that lasts for more than three months and there is no assignable medical cause of the pain. Some of the commonly performed medical tests are:
Blood tests: While none of the investigations is a confirmatory test for the diagnosis of fibromyalgia, imaging tests, and blood tests are often advised by rheumatologists to rule out other conditions that present with similar symptoms. Some of these blood tests may include:
Even though fibromyalgia has certain symptoms that may be common to lupus or arthritis and it’s not uncommon for fibromyalgia to be misdiagnosed as lupus or arthritis, they have distinct causes and treatment. All of them are chronic diseases that may take a long time before the diagnosis is made.
Lupus is an autoimmune disorder which means that the immune system of the body mistakenly attacks the body’s healthy tissues as if they were foreign substances. This leads to a widespread inflammation that can damage joints and other areas in the body. Widespread chronic pain and tenderness, muscle and/or joint pain, brain fog, and fatigue are also common symptoms of these conditions. However, unlike lupus and arthritis, fibromyalgia is not an autoimmune disorder or inflammatory disorder and it does not damage joints. Some people may have these conditions at the same time. Persons having conditions like osteoarthritis, rheumatoid arthritis, and axial spondyloarthritis are also at an increased risk of also developing fibromyalgia.
If a person is suspected to have symptoms suggestive of fibromyalgia, it is usually desirable to seek consultation from a rheumatologist, who is a physician specializing in diagnosing and treating diseases of the musculoskeletal system i.e muscles and bones system. The diagnosis of fibromyalgia is made by excluding other conditions with similar symptoms, hence a rheumatologist would likely perform a thorough physical exam and advise blood tests and imaging tests to determine the cause. Once a diagnosis of fibromyalgia is confirmed, the rheumatologist may recommend the person to join a pain management program at a designated pain clinic within the hospital for better management of pain and reducing its effect on the quality of life of a person.
Pain clinics are specialized multidisciplinary care centers that provide customized treatment or rehabilitation therapies for persons with chronic conditions like fibromyalgia. They have a wide range of professionals such as:
For a person with fibromyalgia, a rheumatologist may advice different treatments and therapies to tackle specific symptoms for the person, which includes drug treatments, physical and psychological therapies in varying combinations.
Medications
Drug therapy can help reduce the pain associated with fibromyalgia and improve sleep. In addition to prescription medicines that are specifically approved to treat fibromyalgia, some of the commonly advised medications include:
Therapy
Different physical therapies can help in reducing the effect of fibromyalgia on a person’s body and quality of life. Some of the commonly advised therapy options include:
Self-care is important in the management of fibromyalgia. There are many things that a person with fibromyalgia can do to have a good quality of life. Some of these include:
Exercise: Remaining physically active is an important aspect of the management of fibromyalgia and can also prevent other health problems. A combination of aerobic exercise and strengthening and stretching exercises that improve flexibility and strength can not only help improve symptoms and general health but also help in improving fatigue and the ability to control pain.
Sleep: Poor sleep is considered to be a significant cause of fibromyalgia. Getting enough good-quality sleep is an important aspect of the management of fibromyalgia. Not only does it help with tiredness and fatigue, but it may also improve the pain.
Some of the ways to get a better night’s sleep can be:
Do’s
Don’ts
As the symptoms of fibromyalgia may vary from person to person, some of the following tips can be tried to see what works:
Fibromyalgia is a common syndrome of musculoskeletal origin. It is characterized by a heightened sensitivity to pain, fatigue, disturbance of sleep and widespread pain in the body. While at the moment, an exact cause of the condition remains uncertain, many theories are under investigation. Although there is no certain cure for the condition, persons with fibromyalgia can lead their lives with improved quality and reduce pain with the availability of proper treatment under the care of a well-informed rheumatologist and pain management specialist. A variety of newer techniques and agents for pain management have shown the capability of beneficially improving the symptoms of persons with fibromyalgia. Many treatment options are currently available to assist persons with fibromyalgia in relieving their symptoms and preventing flare-ups. However, holistic management can be successful only if a prompt diagnosis is made and timely treatment is initiated. Consequently, it is highly recommended that treatment should be sought at a center of excellence that offers services of expert rheumatologists with vast experience in the diagnosis of fibromyalgia and differentiating it from other conditions. With regular follow up in pain management clinics under the care of expert pain management specialist persons with fibromyalgia can experience substantial improvement in the quality of their life.
About Author –
Dr. I. Rajendra Vara Prasad, Consultant Rheumatologist, Yashoda Hospital, Hyderabad
MD, DM (Rheumatology)
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