21 September 2010
Fibromyalgia is a complex disease plagues many people. While most prominent among women ages 30-50, fibromyalgia can in fact affect anyone regardless of age or sex.
Fibromyalgia is a disease that presents a challenge when attempting to diagnose and treat. It is characterized by painful, tender points on the extremities and in the back and neck, however, inflammation is noticeably not apparent. For those suffering from fibromyalgia, the symptoms are the aforementioned tender points, anxiety, fatigue and sleeplessness, and often stiffness among other symptoms.
Although pain must be present at the specific tender points for a physician to make the conclusive diagnosis of fibromyalgia, those who suffer from this condition often will feel widespread pain, and may have tingling in the extremities. Also to be noted is that, according to WebMd.com, approximately 75% of patients feel stiffness upon wakening. While stiffness with arthritis is localized to the specific arthritic joint, those with fibromyalgia will feel stiffness in many joints and muscles, and may be as widespread as to affect the back, legs and feet, shoulders, hands and arms.
According to Raj (2008), there are other factors that a patient with fibromyalgia may suffer from. Many report a “cognitive impairment,” such as finding it difficult to concentrate on simple activities, or even slight memory impairment. Furthermore, according to Raj (2008), a fibromyalgia patient will often suffer severe chronic insomnia, characterized by midinsomia, where the patient awakes after a few hours of sleep and feels extremely alert. They will then have difficulty falling asleep again until it is nearly morning, which will cause them to awaken feeling sluggish, “foggy” and completely un-refreshed by sleep. It is noted by Raj that, “it is surprising that these chronically sleep-deprived individuals have difficulty napping during the day.” Also to be noted is that, as a direct result of this chronic insomnia, most fibromyalgia patients also suffer chronic fatigue.
Treatment options consist of many factors, and it is recommended that a fibromyalgia patient try many of them and come up with a plan along with their treating pain management physician. According to Raj (2008), exercise is almost always suggested to those suffering from fibromyalgia, as a regular exercise program has been shown to “reduce pain, improve sleep, balance mood, improve stamina, instill new perspectives, restore cognition, and facilitate a sense of well being. Patients who can exercise sustain less negative impact of fibromyalgia in their lives.” With all of these benefits, exercise should most certainly be a part of a fibromyalgia patient’s daily regimen. It does have to be noted, however, that too much or the wrong kind of exercise can actually exacerbate pain and cause other symptoms to worsen. It should be taken into consideration that low-impact exercise is recommended – such as walking (with proper footwear), stationary bicycling, yoga, or exercises that can be performed in a pool. A patient suffering from fibromyalgia will find that it will become easier and their pain will be reduced the longer and more consistently they continue with their exercise program.
A popular school of thought now is that fibromyalgia is due to central nervous system imbalances. Following this theory, the FDA has now approved three medications for the treatment of fibromyalgia. Prior to this approval, there were no medications on the market specifically for fibromyalgia. Lyrica®, Cymbalta®, and Savella® have been shown to induce regulation of central nervous system imbalances and are now routinely prescribed to those with fibromyalgia.
Many patients who have fibromyalgia also suffer from acute depression and anxiety disorders. The constant pain and feelings of helplessness with fibromyalgia can cause the onset or worsening of these problems. To help the patient cope with these symptoms, physicians will often prescribe anti-depressants, which also have been seen to aid in the symptoms of sleeplessness and insomnia. It should be noted that opioids are generally not prescribed, as they have been found to be ineffective toward fibromyalgia pain, and can lead to dependence.
Other options available are those the patient can perform at home – prayer, meditation and the support of family and friends has been seen to be overwhelmingly beneficial.
References:
Raj, (2008) Raj’s Practical Management of Pain.415. (Benzon, Rathmell, Wu, Turk, Argoff Eds.)Philadelphia: Mosby Elsevier
www.WebMd.com
