Other Musculoskeletal Pain (11)
Gout is a term used to refer to a group of disease states caused by tissue deposition of monosodium urate due to prolonged hyperuricemia. Clinical manifestations of gout include acute and chronic arthritis, soft tissue inflammation, tophus formation, gouty nephropathy, and nephrolithiasis. Untreated hyperuricemia in patients with gout may lead to chronic destructive deforming arthritis
(ĐTĐ) - Pain in the lower back/legs is thought to be caused by a dysfunction in the sacroiliac, or SI, joint. Leg pain can be very difficult and could feel like sciatica or pain from a herniation of a lumbar disc.
(ĐTĐ) - The aggravating pain in the back, head or muscle can be fibromyalgia. People who have gone through this excruciating pain know the horrible experience that they had to undergo every day. The thought of remembering that state sends shiver down their spine. We do not want you to have Goosebumps again! The time has come to shoot the agonizing feeling with the best treatment available.
(ĐTĐ) - Before we can talk about the triggers for fibromyalgia, you must first know what exactly it is. Fibromyalgia is actually the second most common musculoskeletal condition, surpassed only by osteoarthritis. However, it is quite often misunderstood and misdiagnosed. The characteristics of fibromyalgia include widespread joint and muscle pain, fatigue, and other symptoms. Due to these symptoms, it can ultimately lead to depression/anxiety and even social isolation.
(ĐTĐ) - Spending time at the gym to strengthen and define your biceps is great – it’s an important muscle area. But like any other muscle, it is possible to strain it, and tendon injuries are among the most common.
(ĐTĐ) - Fibromyalgia is a condition affecting around 6% of the population in the US. It affects both men and women, although almost 90% of those suffering are women. The condition causes chronic pain to develop across the body, but doctors are still unsure why. For this reason, Fibromyalgia is categorized as an idiopathic condition. How do you know if you have this debilitating condition? What are the signs of Fibromyalgia?
Individuals who are suffering with Fibromyalgia oftentimes deal with life-altering changes. Some days are harder than others, as the severity levels of the condition also vary. Some days the sufferer may be able to enjoy a totally normal life while other days it seems impossible to even do something as simple as get out of the bed.
In addition to the physical pain that Fibromyalgia causes, there are also a number of other consequences of the condition, including an increased risk of mental conditions such as anxiety and depression.
There are a number of medications that a doctor can prescribe for a Fibromyalgia patient. As with any type of drug for any condition, some work better than others. In many instances it is the combination of several different medications that prove to be most beneficial to the patient.
One of the very best medications that the doctor can prescribe is a drug known by the name of Amitriptyline. This medication is an anti-depressant, however, numerous research studies have concluded that it is also beneficial in the treatment of many different types of pain. Doctors around the states prescribe it to patients in conjunction with other medications, and in most cases it is beneficial.
With the use of Amitriptyline, Fibromyalgia patients can find themselves with less pain, more energy and much less fatigue, better sleep and more flexible joints. The medication works to stop herpetic neuralgia and to stop migraines. It does this by increases the amount of natural substances found in the brain.
There are side effects associated with the use of the drug, however. The doctor will evaluate your specific situation against the side effects to better determine if the mediation is right for your needs. The side effects are minimal for most users of the medication, but they can include dizziness, trouble eating, anxiousness and others.
Amitriptyline is most effective when given in a 50 mg dosage, however, most patients benefit greater when the amount is started small and gradually increased with time. Starting the use of Amitriptyline with a 10 mg dosage is usually recommended by most physicians.
Along with the use of this medication, doctors recommend Fibromyalgia patients make a number of lifestyle changes to appease the condition. This doesn’t necessarily mean that life is over, and there are still many ways that you can find life enjoyable even as you live with Fibromyalgia. Those changes include those with the diet (we will talk about this later on,) exercise, deep breathing techniques or mediation, yoga, and many others.
Water based exercises are recommended since they provide a full body workout. But, this is just one of the many ways that you can add physical activity to the agenda and benefit the condition. There are many different exercises that work well for fibromyalgia patients.
Again, the doctor is the best person to provide you with information on the changes that should be made to increase livelihood while dealing with Fibromyalgia.
Foods that Intensify Fibromyalgia Pain
Although doctors are still unsure what causes Fibromyalgia, one thing they do know is that there are a number of different things that can increase the pain associated with the condition. This includes a number of different foods. For people with Fibromyalgia, avoiding these foods in the diet is a must. When these foods are eliminated from the diet and combined with other treatments, Fibromyalgia pain can be effectively managed.
Let’s take a look at some of the foods that should be eliminated from the diet to gain the upper hand of fibromyalgia pain.
Not only should Aspartame be avoided if you have Fibromyalgia, some doctors think that it is a substance that actually causes the condition to develop. Aspartame stimulates the visual and audio receptors in the brain, and since people with the condition are sensitive to those receptors, intense effects are usually noted. There are number of complications that can result with the use of Aspartame, including conditions that lead to blindness, increased risk of infection, restless leg syndrome, anxiety, depression and others. Aspartame is probably a name very familiar to you, and perhaps one even currently being consumed. The product can be found inside of diet soda, candy, chewing gum, etc.
Gluten can be found inside a number of foods that most people consume on a regular basis. Those foods include wheat, barley and rye products like whole-wheat bread and pasta. Glutens can cause the pain being experienced to intensify immensely.
Caffeine can be found inside of beverages such as tea and soda, but it is also inside of some candies, energy drinks and even diet aids and pills. Consumption of caffeine while afflicted with Fibromyalgia can cause exhaustion and waste precious energy. People with the condition that have eliminated caffeine from their diet have reported great benefits, including fewer headaches and an increased amount of energy.
In the Diet
Now that we’ve covered some of the foods that you want to avoid, let’s take a look at the foods that should be included in your diet.
Fresh fruits and vegetables are always beneficial to the body. The more colorful your plate, the more you are doing for your body, and the pain and side effects associated with Fibromyalgia. Keep in mind that you do not want to eat tomatoes or some of the flesh vegetables as these foods can actually intensify the effects of Fibromyalgia.
Broccoli, spinach, cauliflower and kale are all good choices, just as you can benefit by eating beets and even okra. Keep in mind the foods that we have mentioned avoiding earlier. You should be sure that you consume three servings of vegetables each day. Fresh fruits are also something that you should consume, but only sparingly. One to two servings of fresh fruit is recommended each day. You should buy fruit that contains only natural sugars and no artificial ingredients. Fruit contains natural sugars, thus keeping them at a minimum will reduce problems that can occur with too much sugar being consumed. Apples, oranges, pears, bananas, kiwi and cantaloupe are all great fruit choices.
The menu should include lean meats such as fish and chicken, as well as nuts and seeds.
By following a menu that is recommended by your doctor, the symptoms of Fibromyalgia can be greatly decreased. Many people find that making small, gradual changes is much easier than trying to do it all at one time, however, this is something that is entirely up to you. As long as these foods are eliminated, and those that you need are gained, you will find the awesome benefits that come along with it.
You are Not Alone: Celebrities with Fibromyalgia
When you are suffering with a condition that is as debilitating as Fibromyalgia, it can make you feel isolated and alone. You feel like there is no one out there who understands what you are going though, and that no one else in this world is experiencing it. Chances are there are people all around you with the condition, however, and you do not even realize it. The fact of the matter is that there are thousands of people with the condition in the US, and you are far from being alone. There are a number of forums, discussion groups and support groups out there that can help you feel less isolated as well as help you gain the support you need to deal with the condition in an effective manner. It is a good idea to take advantage of those groups as they are needed. You can learn plenty about the condition as well as gain new friends along the way. In addition, having the support of family and friends can aid you greatly in the treatment of Fibromyalgia and how you deal with that condition.
There are also a number of celebrities are currently affected with Fibromyalgia, and chances are, you were not even aware that they had the condition either. Take a look at some of those celebrities and ensure that you do not feel like you are the only person in this world that is dealing with the condition.
Morgan Freeman is one of the greatest actors of our time, and he is also a Fibromyalgia patient. Freeman believes a car accident resulted in the condition, which occurred in 2008. Morgan is open about his Fibromyalgia, but he refuses to let it slow him down and continues to enjoy his career and a plentiful life.
If you are a fan of soap operas, Suzan Flannery is probably a name that you are familiar with. The actress stared on the show Bold and the Beautiful. She was suffering with the condition long before accepting the role, but retired from her career as a result of the symptoms in 2007. She is active in avocation of Fibromyalgia these days.
Sinead O’Conner is an English singer that is most known for her 1990 rendition of Prince’s ‘Nothing Compares to You.’ The singer took a break from her career to deal with the pain of Fibromyalgia, but returned some time later to continue after stating she had it under control.
Florence Nightingale changed the world of nursing. She is the first ever nurse, and today the image of Ms. Nightingale is embellished in a pin upon every nursing student at graduation. Florence Nightingale was also a sufferer of Fibromyalgia.
Michael James Hastings
‘The West Wing” actor retired from his career to deal with his Fibromyalgia pain. He now serves as a spokesman for the condition and can be seen in commercials, publications and more.
Jo Guest is a former model as well as a spokesman for Fibromyalgia. She retired from modeling in 2007 after the pain of the condition interfered with her day-to-day life.
Rosie Hamlin was popular in the 1960s with the band ‘Rosie.’ She was considered one of the best singers of her time. She no longer tours because of Fibromyalgia, but openly discusses the topic frequently.
Paula Abdul was an 80’s pop sensation with hits like ‘Straight Up’ and ‘Forever Your Girl.’ Before her rise to fame in the 80s, Abdul was also a Los Angeles Lakers cheerleader. After a few years under the limelight, Abdul returned to the spotlight, and is one of the current hosts of reality TV show phenomenon ‘American Idol.’ Although Abdul has not publically talked about Fibromyalgia, it is suspected that she is affected with the condition.
The Bottom Line
As you can see, Fibromyalgia can be managed, if you know the right techniques to manage the condition. It is something that takes many adjustments, and no one will ever say that it is easy. But, it can be done if you are willing to put forth the effort that it takes. You’re not alone in dealing with the condition, and there is a lot of support out there if you want to take advantage of that support.
The list of celebrities above suffering with fibromyalgia is just the beginning of the names of people who know all too well what you are going through. There are many celebrities that have chosen to remain quite about their condition and not bring it to the attention of the public.
If you have Fibromyalgia, it certainly puts a damper on things. But, you can live a normal, productive and happy life with this information as well as the advice of your doctor. Put it to good use and do not allow Fibromyalgia to bring you down. There is hope if you are ready to take advantage of the help that is available.
(ĐTĐ) - Plenty of people experience lower back pain. Though, one of the most common causes of lower back pain originates from injuries to the sacroiliac joint (SI joint) and its associated ligaments.
About sacroiliac joint dysfunction
Sacroiliac joint dysfunction typically occurs when the sacroiliac joint becomes inflamed or damaged. To understand how an inflamed sacroiliac joint may cause lower back pain, it’s also important to understand how the sacroiliac joint works.
The sacroiliac joint connects the pelvic bone (the ileum) to the spine’s lowest part, also known as the sacrum. Two sacroiliac joints exist in that areas, and both reside on each side of the sacrum. These joints are actually pretty strong, although they’re small. They’re strong enough to provide the structural stability and support that the spine needs to function right.
They also work as shock absorbers for the lower back and pelvis, allowing the forces of the upper body to properly disperse without harming the rest of the region. When a sacroiliac joint unexpectedly gets injured and/or irritated, the resultant joint dysfunction is known to cause pain within the lower back and the rest of the legs.
Why sacroiliac joint dysfunction occurs
There’s a reason why your inflamed sacroiliac joint leads to sacroiliac joint dysfunction, which subsequently leads to lower back pain and leg pain. In most cases, the sacroiliac joints start feeling painful when a sudden alternation in their normal function occurs.
Sacroiliac joint dysfunction may develop if:
- Too many changes in sacroiliac joint movement occur, whether too much (hypermobility) or too little (hypomobility).
- Abnormal motions, such as those from work or sports, directly injure the joints via straining or over-stretching their corresponding ligaments.
- Direct trauma, like injuries, causes the sacroiliac joint’s ligaments to become strained, sprained and/or outright injured.
Any changes to the mobility of the sacroiliac joints plays a direct role in causing sacroiliac joint dysfunction. While it’s not always the main cause of lower back pain, it presents one reason why people might feel pain in the first place.
The symptoms of sacroiliac joint dysfunction
So, now that we’ve reviewed some causes behind sacroiliac joint dysfunction, let’s look at the symptoms of the condition. The most common symptoms occur as soon as a person moves around, particularly when they put their lower back into action. Many of the symptoms are associated with symptoms from other conditions that cause lower back pain, so it’s more or less difficult to diagnose sacroiliac joint dysfunction without a full examination.
The symptoms generally include:
- Mild to sharp pain in the lower back
- Mild to sharp pain in the buttocks, thighs or the rest of the legs
- Difficulty sitting in one place for a long period of time
- Difficulty standing in one place for a long period of time
Sometimes, the pain gets aggravated by bending at the waist. When the pain grows to be severe, it starts affecting several areas at once, including the leg, groin and the hips. On an interesting note, the pain originating from sacroiliac joint dysfunction is said to feel much like pain originating from forms of sciatica, a type of pain affecting the body due to an inflamed sciatic nerve.
This condition is more common in younger and middle-aged women, mainly due to childbirth. During pregnancy, female hormones release within the body to allow the connective tissues to significantly relax and, subsequently, allows the pelvis to stretch enough for birthing. The stretching of the pelvic causes the sacroiliac joints to change, making them hypermobile. During pregnancy, the changes in the sacroiliac joints cause discomfort for women. Over time, the wear and tear of these changes causes both sacroiliac joints to wear down.
Treatments for sacroiliac joint dysfunction
Luckily, medical research on sacroiliac joint dysfunction is plentiful enough to give doctors options for treating the condition. The following sections of this article will cover a few of those treatments. Treatments for sacroiliac joint dysfunction typically focus on helping restore normal function to an inflamed sacroiliac joint.
Heat and/or ice with rest
The most common treatment is placing a hot or cold compress against the sacroiliac joint region. Either compress should be applied for 15 to 20 minute intervals to help reduce the inflammation and irritation in the area. It typically takes days to weeks of hot or cold compress application to subside pain. In most cases, cold compresses are better, while hot compresses are best suited for milder bouts of pain. Resting the inflamed sacroiliac joints also helps them recover, and that usually involves limiting movement during the recovery process.
Doctors also prescribe medications for treating inflamed sacroiliac joints. Pain medications are the most common. They typically include over-the-counter and prescription painkillers (like acetaminophen) and anti-inflammatory medications (like naproxen and ibuprofen) to help subside any swelling associated with the pain.
Some cases of sacroiliac joint inflammation may need chiropractic treatments to help subside pain. This typically applies to patients who may have a ‘stuck’ or fixated sacroiliac joint, in addition to cases where the sacroiliac joints are hypermobile.
Chiropractors, osteopathic doctors and other licensed health practitioners typically perform chiropractic methods like side-posture manipulation, blocking techniques and other instrument guided methods to help reduce and eliminate pain.
Supports or braces for sacroiliac joints
Sometimes, when the sacroiliac joints are too hypermobile or loose, the patient may need an orthotic to help stabilize them. Supports or braces for treating sacroiliac joint pain typically come in the form of a wide belt. They wrap around the waist and secure snugly around the area to keep it stabilized.
Gradual and controlled physical therapy helps strengthen the muscles around both sacroiliac joints, while also increasing their range of motion. This helps both sacroiliac joints heal after the initial bout of swelling and pain heals. Low impact, gentle aerobic exercise helps stimulate blood flow in the sacroiliac joint’s area, helping the entire area heal better over time. Alternative methods, like water therapy, may help relieve severe pain.
Injections for sacroiliac joint pain relief
People with severe pain may be administered sacroiliac joint injections to immediately subside pain. The injections typically consist of an anti-inflammatory medication like a corticosteroid to help reduce any inflammation around both sacroiliac joints. As a result, it helps immediately alleviate any associated pain.
(ĐTĐ) - A new blood test may predict fibromyalgia, a condition that can be hard to diagnose. Research about the new test was presented Sunday at the annual meeting of the American College of Rheumatology in San Diego.
EpicGenetics of Santa Monica, Calif., developed the test, called the FM/a test, says Bruce Gillis, MD, MPH. Gillis is the company’s CEO and an assistant professor of medicine and emergency medicine at the University of Illinois College of Medicine.
"It is objective, very accurate, and definitive," he says.
But the test’s high price tag -- $744 -- may keep its use limited for now, one expert says.
"Due to the cost and my lack of experience with this new test, I would initially use it in patients in whom I suspect as having fibromyalgia but lack some of the classic features, making the diagnosis more difficult," says Scott Zashin. Zashin is a clinical professor of medicine at the University of Texas Southwestern Medical School, Dallas.
Fibromyalgia causes widespread pain, tenderness, and stiffness in the muscles and connective tissues. The cause is not known. Six million people or more in the U.S. may have it, Gillis says. Usually doctors take a medical history and note symptoms. Often, it is a diagnosis made after excluding other diseases.
"The biggest problem is the skepticism that physicians have that don't believe that fibromyalgia is a real medical ailment," Gillis says. Often, he says, they label the patient as being depressed or being a hypochondriac.
"What our test does more than anything else is legitimize the diagnosis," Gillis says.
(ĐTĐ) - Fibromyalgia syndrome is a common disorder characterized by multiple tender points, widespread deep muscle pain, fatigue, and depression. The term fibromyalgia comes from the Latin word for fibrous tissue (fibro) and the Greek terms for muscle (myo) and pain (algia).
What are tender points?
Tender points are pain points or localized areas of tenderness around joints, but not the joints themselves. These tender points hurt when pressed with a finger.
Tender points are often not deep areas of pain. Instead, they are superficial areas seemingly under the surface of the skin, such as the area over the elbow or shoulder.
Are tender points large areas of pain?
No. The actual size of the point of most tenderness is usually very small, about the size of a penny. These areas are much more sensitive than other nearby areas. In fact, pressure on one of the tender points with a finger will cause pain that makes the person flinch or pull back. Tender points are scattered over the neck, back, chest, elbows, hips, buttocks, and knees.
Tender Points in Fibromyalgia
What causes tender points?
The cause of these pressure points is not known. Even though it would seem these areas might be inflamed, researchers have not found particular signs of inflammation when examining the tissue. What is known is that the locations of tender points are not random. They occur in predictable places on the body. That means many people with fibromyalgia experience similar symptoms with tender points.
Can my doctor diagnose fibromyalgia from the tender points?
Your doctor can test the painful tender points during an examination.Yet even with tender points, you need to tell your doctor about the exact pain you feel in those areas. You also need to tell the doctor about your other symptoms of fibromyalgia, such as deep muscle pain, fatigue, sleep problems, depression, irritable bowel syndrome, and more.
If you don't explain all your fibromyalgia symptoms fully to your doctor, the doctor will not be able to effectively treat the fibromyalgia. As a result, you won't get good relief from the chronic pain and other symptoms.
When a doctor tests tender points for pain, he or she will also check "control" points or other non-tender points on your body to make sure you don't react to these as well. Some physicians use a special instrument called a "doximeter" or "dolorimeter" to apply just the right amount of pressure on tender points.
How many tender points are important for fibromyalgia?
There are 18 tender points important for the diagnosis of fibromyalgia (see illustration below). These tender points are located at various places on your body. To get a medical diagnosis of fibromyalgia, 11 of 18 tender point sites must be painful when pressed. In addition, for a diagnosis of fibromyalgia, the symptom of widespread pain must have been present for three months.
Is there a prescription medication that eases the pain of tender points?
Pain management for tender points with fibromyalgia involves a multifaceted treatment program that employs both conventional and alternative therapies. While the reason is not entirely clear, fibromyalgia pain and fatigue sometimes respond to low doses of antidepressants. However, the treatment for fibromyalgia and tender points involves medications, daily stress management, exercise, hydrotherapy using heat and ice, and rest. Other remedies for symptoms may also be used.
What at-home treatments might help in managing tender point pain?
Alternative treatments or home remedies are important in managing fibromyalgia and the pain of tender points. As an example, therapeutic massage can manipulate the muscles and soft tissues of the body to help ease pain, muscle tension, spasms, and stress.
Twice daily moist heat applications are also helpful in easing the deep muscle pain and stiffness. To benefit from moist heat, you can use a moist heating pad, warm shower, or a heat "cozy" that you warm in the microwave. You can also relax in a Jacuzzi.
With fibromyalgia, it's extremely important to manage your schedule and to control your level of stress. Be sure to block time each day to rest and relax. Avoid making too many commitments that can increase stress and fatigue. In addition, you can do relaxation exercises such as guided imagery, deep-breathing exercises, or the relaxation response to manage how you respond to stress.
Staying on a regular bedtime routine is also important. Doing so allows your body to rest and repair itself. In addition, regular exercise is vital to managing the pain, depression, and other symptoms of fibromyalgia.
What can make fibromyalgia symptoms and tender point pain worse?
A number of factors can make fibromyalgia symptoms worse. They include:
- Changes in weather -- for example, cold or humidity
- Hormonal fluctuations such as PMS or menopause
- Lack of sleep or restless sleep
- Periods of emotional stress
- Physical exhaustion
- Sedentary lifestyle
(ĐTĐ) - A drug related to thalidomide may be more potent and less toxic than thalidomide, which is often used to treat lupus skin conditions.
In a small study from Spain, lupus patients showed dramatic improvements in skin lesions while taking the drug, lenalidomide (Revlimid), and most relapsed soon after they stopped taking it.
Thalidomide’s Infamous Past
Thalidomide is best known as the drug that caused thousands of children to be born with missing limbs and other birth defects in the late 1950s and early 1960s.
In more recent years it has been brought back to the market to treat a number of serious conditions, but its use is monitored closely to ensure that it is not taken by women who are pregnant or who might become pregnant.
Dermatology professor Andrew G. Franks Jr., MD, of the NYU Langone Medical Center, says thalidomide is very effective for treating people with lupus skin conditions who do not respond to standard treatments such as steroids and antimalarial drugs.
He says about 75% of patients with affected skin will go into remission with these standard treatments.
“The question has been, ‘What do you do with the rest?’” he says.
Franks says thalidomide can help an additional 75% of patients achieve remission. But side effects are common and some, including nerve damage in the hands and feet, can be permanent.
Lenalidomide Highly Effective in Small Study
The lenalidomide study included 15 women with lupus skin conditions; six had lupus in other areas of the body, too. They all were followed for seven to 30 months.
All had received standard treatments, and 14 had been treated with thalidomide previously.
The majority of the patients (60%) had the most common subtype of lupus-related skin disease, known as discoid lupus erythematosus, which is characterized by red, scaly patches that can scar.
One patient withdrew from the study after one week due to digestive system side effects. All the other patients showed improvement, and the rash cleared up in 86%.
The researchers note that the study dose was “generally well-tolerated.” No new nerve symptoms were reported.
Similar to treatment with thalidomide, most of the patients had a relapse of their skin problems within weeks of stopping the drug.
No Progression to Full Disease
Several earlier small studies raised concerns that treatment with lenalidomide may be linked to an increased risk of progression to full-blown lupus, not just lupus limited to the skin.
Josep Ordi-Ros, who led the Spanish study, says this was not seen in the latest study, which was published Dec. 6 in the journal Arthritis Research & Therapy.
But Cynthia Aranow, MD, of the Feinstein Institute for Medical Research in Manhasset, N.Y., says larger studies will be needed to determine if the drug is truly safe and effective for patients who do not respond to other treatments.
She adds that the drug appears to have a similar risk for birth defects as thalidomide, so it will need to be monitored just as carefully.
“There are many questions that remain,” she says.
Lenalidomide is available as Revlimid to treat people with multiple myeloma and myelodysplastic syndromes. According to the manufacturer’s site, the cost of Revlimid at the doses used in this study would be about $440 a pill.
Reviewed by Louise Chang, MD - Source WebMD.com
(ĐTĐ) - Fibromyalgia is the most common arthritis-related illness after osteoarthritis. Still, it is often misdiagnosed and misunderstood. Fibromyalgia is a rheumatic condition. Its characteristics include widespread muscle and joint pain and fatigue as well as other symptoms. Fibromyalgia can lead to depression and social isolation.
In this overview of fibromyalgia syndrome (FMS), we'll explain the symptoms. We'll talk about diagnosis and treatment. We'll also explain the impact fibromyalgia has on lives. The impact comes from the tremendous physical and psychological strains that come with FMS. Those strains can lead to loss of work hours, reduced income, and even loss of a job.
What is fibromyalgia syndrome?
A syndrome is a set of symptoms. When they exist together, they imply the presence of a specific disease or a greater chance of developing the disease. With FMS, the following symptoms commonly occur together:
- anxiety or depression
- decreased pain threshold or tender points
- incapacitating fatigue
- widespread pain
Are women more likely to get fibromyalgia than men?
More than 12 million Americans have FMS. Most of them are women ranging in age from 25 to 60. The truth is women are 10 times more likely to get this disease than men.
What are fibromyalgia symptoms?
Fibromyalgia causes you to ache all over. You may have symptoms of crippling fatigue -- even on arising. Specific trigger points or tender points on the body may be painful to touch. You may experience swelling, disturbances in deep-level or restful sleep, and mood disturbances or depression.
Your muscles may feel like they have been overworked or pulled. They'll feel that way even without exercise or another cause. Sometimes, your muscles twitch, burn, or have deep stabbing pain.
Some patients with FMS have pain and achiness around the joints in the neck, shoulder, back, and hips. This makes it difficult for them to sleep or exercise. Other fibromyalgia symptoms include:
- abdominal pain
- anxiety and depression
- chronic headaches
- difficulty maintaining sleep or light sleep
- dryness in mouth, nose, and eyes
- fatigue upon arising
- hypersensitivity to cold and/or heat
- inability to concentrate (called "fibro fog")
- irritable bowel syndrome
- numbness or tingling in the fingers and feet
- painful menstrual cramps
- poor circulation in hands and feet (called Raynaud's phenomenon)
- restless legs syndrome
Fibromyalgia can cause signs and feelings similar to osteoarthritis, bursitis, and tendinitis. Some experts include it in this group of arthritis and related disorders. But the pain of bursitis or tendinitis is localized to a specific area. The feelings of pain and stiffness with fibromyalgia are widespread.
What tests are used to diagnose fibromyalgia?
There are no specific laboratory tests to diagnose fibromyalgia. To make an accurate diagnosis, your doctor will rely on a comprehensive physical examination and your medical history. Your doctor will also use a diagnosis of exclusion. That means the doctor will rule out other conditions that could cause similar symptoms.
To rule out more serious illnesses, your doctor may run some specific blood tests. For example, your doctor may ask for a complete blood count (CBC). The doctor may also ask for tests for chemicals, such as glucose, that can create problems similar to problems caused by fibromyalgia. A thyroid test may also be done. An underactive thyroid (hypothyroidism) can cause problems similar to fibromyalgia. That includes fatigue, muscle aches, weakness, and depression.
Other laboratory tests used to rule out serious illnesses may include Lyme titers, antinuclear antibodies (ANA), rheumatoid factor (RF), erythrocyte (red blood cell) sedimentation rate (ESR), prolactin level, and calcium level.
Your doctor will also use a diagnosis of inclusion. That means your doctor will make sure your symptoms satisfy the diagnostic criteria for fibromyalgia syndrome outlined by the American College of Rheumatology. These criteria include widespread pain that persists for at least three months. Widespread pain refers to pain that occurs in both the right and left sides of the body, both above and below the waist, and in the chest, neck, and mid or lower back.
The doctor will evaluate the severity of related symptoms such as fatigue, sleep disturbances, and mood disorders. This will help measure the impact FMS has on your physical and emotional function as well as on your overall health-related quality of life.
What is the standard treatment for fibromyalgia?
There is no fibromyalgia cure. And there is no treatment that will address all of the fibromyalgia symptoms. Instead, a wide array of traditional and alternative treatments has been shown to be effective in treating this difficult syndrome. A treatment program may include a combination of medications, exercises -- both strengthening and aerobic conditioning -- and behavioral techniques.
What medications are used to treat fibromyalgia?
According to the American College of Rheumatology, drug therapy for fibromyalgia primarily treats the symptoms. The FDA has approved three drugs to treat fibromyalgia: Lyrica, Cymbalta, and Savella. The FDA says Lyrica -- which is also used to treat nerve pain caused by shingles and diabetes -- can ease fibromyalgia pain for some patients. Cymbalta and Savella are in a class of drugs known as serotonin and norepinephrine reuptake inhibitors (SNRIs).
Low doses of tricyclic compounds such as Flexeril, Cycloflex, Flexiban, Elavil, or Endep have been found effective in treating the pain of FMS. In addition, positive results have been shown with the antidepressants known as dual reuptake inhibitors ( Effexor). Ultram is a pain-relieving medicine that can be helpful.
Your doctor may prescribe an antidepressant such as Prozac, Paxil, or Zoloft. These drugs may help relieve feelings of depression, sleep disorders, and pain. Recently, researchers have found that the antiepileptic Neurontin is promising for fibromyalgia treatment.
The nonsteroidal anti-inflammatory drugs (NSAIDS), including COX-2 drugs, have not been found to be effective for treating FMS pain. Opioid pain medications are usually only prescribed if all other drug and non-drug options have been tried to no avail.
Are there alternative treatments for fibromyalgia?
Alternative therapies, although they are not well-tested, can help manage the symptoms of fibromyalgia. For instance, therapeutic massage manipulates the muscles and soft tissues of the body and helps ease deep muscle pain. It also helps relieve pain of tender points, muscles spasms, and tense muscles. Similarly, myofascial release therapy, which works on a broader range of muscles, can gently stretch, soften, lengthen, and realign the connective tissue to ease discomfort.
The American Pain Society (APS) guidelines recommend moderately intense aerobic exercise at least two or three times a week. The APS panel also endorses clinician-assisted treatments, such as hypnosis, acupuncture, therapeutic massage, and chiropractic manipulation for pain relief.
Along with alternative therapies, it's important to allow time each day to rest and relax. Relaxation therapies -- such as deep muscle relaxation or deep breathing exercises -- may help reduce the added stress that can trigger fibromyalgia symptoms. Having a regularly scheduled bedtime is also important. Sleep is essential to let the body repair itself.
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