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Fibromyalgia

Fibromyalgia is one of a group of chronic pain disorders that affect connective tissues, including the muscles, ligaments and tendons. It  causes widespread muscle pain, “myalgia,” and excessive tenderness in many areas of the body. Many patients also experience fatigue, sleep disturbances, headaches, and mood disturbances, such as depression and anxiety.

Causes

despite ongoing research, the cause, diagnosis, and optimal treatment of fibromyalgia is not clear.

SYMPTOMS

Pain — The primary symptom of fibromyalgia is widespread, chronic, and persistent pain. The pain may be described as a deep muscular aching, soreness, stiffness, burning, or throbbing. Patients may also feel numbness, tingling, or unusual “crawling” sensations in the arms and legs. Muscle stiffness is typically present upon awakening and tends to improve as the day progresses. However, in some cases, muscle stiffness can remain throughout the day. The pain may be confined to specific areas, often the neck or shoulders, early in the course of the disease. Multiple muscle groups may eventually become involved, with most patients experiencing pain in the neck, middle and lower back, arms and legs, and chest wall. These areas feel painful with even slight pressure and are called tender points. Many patients with fibromyalgia feel that their joints are swollen, although there is no visible inflammation of the joints.

Fatigue and sleep disturbances — Persistent fatigue occurs in more than 90 percent of people with fibromyalgia. Most people complain of unusually light, unrefreshing sleep. Difficulties falling asleep, awakening repeatedly during the night, and feeling exhausted upon awakening are also common problems.

Depression and anxiety — Approximately 30 percent of people with fibromyalgia have major depression at the time of their diagnosis.

Fatigue and sleep disturbances — Persistent fatigue occurs in more than 90 percent of people with fibromyalgia. Difficulties falling asleep, awakening repeatedly during the night, and feeling exhausted upon awakening are also common problems.

Diagnosis

There are no specific laboratory or imaging tests used to diagnose fibromyalgia. Thus, the diagnosis is typically based upon a thorough patient history, a complete physical examination.

Treatment Tips

Treatment of chronic pain and fatigue is challenging.  Medications may be helpful in alleviating pain, improving the quality of sleep, and improving the mood. Exercise, stretching programs, and other activities are also important in helping to manage symptoms.

Understanding fibromyalgia may help to improve response to treatment.

It is important to have realistic expectations concerning the ability to function and manage the condition over the long-term.

Medication

A variety of medications have been used to manage the symptoms associated with fibromyalgia. The medications that have been most effective in relieving symptoms of fibromyalgia in clinical trials are antidepressants medications.

Exercise

Regular cardiovascular exercises, such as walking, swimming, or biking, is helpful in reducing muscle pain and improving muscle strength and fitness in fibromyalgia.

Relaxation therapies

In selected people with fibromyalgia, participating in stress-reduction programs, learning relaxation techniques, or participating in behavioral therapy may help to alleviate certain symptoms.

Acupuncture

some people have benefitted from acupuncture.