How To Recognize the Signs of Fibromyalgia
by Carol Eustice
The symptoms of fibromyalgia can overlap with autoimmune diseases and other musculoskeletal conditions making it difficult to diagnose. The defining symptoms of fibromyalgia are often associated with other subjective and objective symptoms which occur in combination. It is estimated that fibromyalgia affects about 2 percent of the U.S. population.
In 1990, the American College of Rheumatology (ACR) listed two primary criteria for the classification of fibromyalgia. The first is a history of widespread pain involving all four quadrants of the body (right side, left side, above waist, below waist) for a period of at least 3 months.
The second criteria from the ACR which points to fibromyalgia is, upon physical examination, the presence of pain in at least 11 of 18 tender points when touched or pressed with force amounting to the equivalent of 4 kg. or 9 lbs.
More recent data indicates that there may be an increased sensitivity to pain throughout the body, pain may be migratory (move around) or may exist as chronic regional pain. Most experts are said to believe fibromyalgia results from abnormal central nervous system function. Response to stress and psychobehavioral factors may also contribute to fibromyalgia.
Fibromyalgia primarily occurs in women of childbearing age. Children, the elderly, and men can also be affected. Besides the defining symptoms of pain and tenderness, there are many nondefining symptoms associated with fibromyalgia including:
o Fatigue, sleep disturbances, night sweats
o Memory difficulties, cognitive difficulties
o Tension or migraine headaches, temporomandibular joint syndrome, noncardiac chest pain, chronic pelvic pain, plantar or heel pain
o Fluctuations in weight, heat or cold intolerance, subjective feeling of weakness
o Ear-nose-throat complaints, multiple chemical sensitivities, wide array of allergic symptoms
o Hearing, vision, and vestibular (balance) abnormalities
o Heartburn, palpitations, irritable bowel syndrome
o Evidence on echocardiogram of mitral valve prolapse, esophageal dysmotility (muscles of esophagus not working properly), neurologic conditions causing hypotension (low blood pressure) and syncope (fainting).
o Mood disorders such as depression and anxiety occur more commonly in people who have fibromyalgia.
1. Fibromyalgia can be difficult to diagnose because its symptoms can be non-defining and mimic other diseases. Persist in getting a proper diagnosis.
2. Aerobic exercise, such as swimming and walking, improves muscle fitness and reduces muscle pain and tenderness.
3. Heat and massage may also give short-term relief.
4. Antidepressant medications may help to elevate mood, improve quality of sleep, and relax muscles (there are also some recent reports that Wellbutrin may be helpful in pain management).
5. Patients with fibromyalgia may benefit from a combination of exercise, medication, physical therapy, and relaxation.
What You Need:
o A good relationship with your rheumatologist/physician.
o A physical therapy regimen you will follow.
o A treatment program involving medication and exercise.
o Education which is ongoing - be aware of news/research related to fibromyalgia.