What is Fibromyalgia (FM)?
Fibromyalgia (FM) is a chronic disorder that causes widespread pain, including back and neck discomfort. In addition, the body may also be tender to the touch (known as allodynia). This sensitivity can occur across the entire body, or the pain can migrate to different areas. Along with the many symptoms associated with FM, pain and tenderness can ebb and flow over time.
Furthermore, this condition is known to affect people in mental, physical, and social ways. Roughly 10 million Americans currently have FM, with women being four times more likely to have the condition. FM occurs throughout all age groups, even affecting children. Though the literal translation of “fibromyalgia” is pain in the muscles, tendons, and ligaments, it can be more complicated. FM can be much more than neck and lower back pain and it can have many different symptoms that range from person to person.
FM is diagnosed based on the aggregation of relevant symptoms. This is how the person feels, including symptoms such as tenderness, fatigue, functionality, and overall well-being. For a diagnosis, a doctor will use lab tests to rule out co-existing conditions.
Unfortunately, there is no cure for FM. Multiple disciplinary approaches for symptom relief and management are usually needed. This includes medications, gentle exercise, and cognitive behavioral therapies. With the help of a doctor, long-term health goals and self-management strategies may reduce chronic symptoms. This also includes the duration, frequency, and intensity of the symptoms experienced. Unfortunately, there are cultural stereotypes involved with chronic pain conditions. These stigmas often cause people with FM to distance themselves from friends and family. This isolation and loneliness can lead to mental disorders such as depression.
Symptoms of Fibromyalgia (FM)
FM symptoms vary in intensity. A list of common symptoms includes:
- Fatigue: People with FM are tired all of the time, even after sleeping for long periods. Sleep is often disrupted by the chronic muscle or neck pain, and many patients develop other sleep disorders as well. This includes conditions such as sleep apnea and restless leg syndrome.
- Widespread Pain: Patients describe FM pain as a constant dull ache that lasts for at least a period of three months. In order for a doctor to classify pain as widespread, it must occur on both sides of the body. In addition, the pain must occur above and below the waist. Widespread stiffness is also very common in patients with FM. Furthermore, pain seems to result from neurochemical imbalances in the central nervous system. This causes an amplified pain perception known as allodynia (stimuli that were previously not painful become painful).
- Cognitive Difficulties: Patients with FM have trouble focusing, paying attention, and concentrating on mental tasks. Medical experts refer to this array of symptoms as “fibro fog.”
FM commonly occurs with other painful conditions, such as:
- Irritable bowel syndrome (IBS)
- Painful bladder syndrome or interstitial cystitis
- Tension headaches and migraines
- Temporomandibular joint disorder (including tinnitus)
- Gastrointestinal reflux disease (GERD)
- Increased stress levels (depression & anxiety)
- Vision problems
- Weight gain
- Difficulty breathing
- Cold or flu-like symptoms
- Rheumatic diseases
- Temperature sensitivity
Causes of Fibromyalgia (FM)
When a person experiences pain, nerve signals travel from the affected spot in the body through the spinal cord. This signal then reaches the brain, which senses these signals as pain. It’s a natural defense mechanism that warns us that something is not quite right. As a person heals, pain symptoms are relieved, and eventually it goes away entirely.
FM does not work on these principles. If you have FM you hurt all over even when you are not injured or sick. This pain is widespread and chronic, and it simply does not go away. Doctors believe this occurs due to some kind of glitch in the way the brain handles spinal signals. That being said, no one is really sure what causes this glitch, but there are a few theories.
- Genes: A pattern with FM is that it tends to run in families. A person’s parents may pass on genes that make you more sensitive to pain. Likewise, other genes can make a person prone to mental conditions such as anxiety or depression. These conditions tend to make the pain worse.
- Emotional or Physical Abuse: Children who experience abuse are more likely to develop FM when they grow up. Experts believe that this may happen because abuse changes the way the brain handles stress and pain.
- Post-Traumatic Stress Disorder (PTSD): This mental health problem occurs in people who have experienced a terrible event, such as war or a car crash. In some cases, FM has been linked to people with PTSD.
- Gender: FM is roughly four times more likely to occur in women than in men. Experts believe that this could be due to the differences in the ways that men and women feel and react to pain. Some believe that how society expects these respective groups to respond to pain exacerbates this.
- Anxiety & Depression. Many mood disorders show a significant statistical link to people with FM. That being said, there is no proof that this can actually cause the condition.
- Inactivity: FM is more common in those who are not as physically active. Additionally, exercise just so happens to be one of the best treatments for FM. Normally, it can help alleviate pain and stiffness symptoms.
- Other Diseases: Painful conditions such as an infection or arthritis increases a person’s chance of getting FM.
Diagnosis of Fibromyalgia (FM)
Previously, doctors would check 18 specific points in the body to see how many of them were painful when touched. Today, new guidelines do not require this tender point test. Instead, a doctor can make an FM diagnosis if a person has had widespread pain for more than three months. That, and the pain, must not be caused by another underlying medical condition.
There is no lab test to confirm an FM diagnosis. That being said, a doctor may want to rule out other conditions that have similar symptoms. To do this, blood tests such as these are taken:
- Erythrocyte sedimentation rate
- Complete blood count
- Rheumatoid factor
- Thyroid function tests
- Cyclic citrullinated peptide test
Treatment of Fibromyalgia (FM)
Generally speaking, treatments for FM include both self-care and medication. The goal of treatment is to alleviate symptoms and improve general health. Unfortunately, there is no one treatment that works for all symptoms of FM.
Medications can help to alleviate FM pain and may improve sleep. Common treatments are:
- Anticonvulsants: Medications usually used to treat conditions such as epilepsy are often helpful in reducing specific types of pain. Gabapentin (Neurontin) can often reduce FM symptoms. Additionally, pregabalin (Lyrica) was the first drug approved by the FDA to treat FM.
- Pain Relievers: Over-the-counter pain relievers such as tylenol, naproxen sodium, or ibuprofen may be helpful. In some cases, your doctor may suggest a prescription pain reliever such as tramadol. Generally, narcotics are not advised because they have dependency issues and can sometimes worsen the pain over time.
- Antidepressants: Cymbalta and Savella may help ease the fatigue and pain that is common with FM. Additionally, your doctor may prescribe muscle relaxants to help promote sleep. This can help battle conditions such as restless leg syndrome.
There are a number of different therapies that can help alleviate FM symptoms and improve overall quality of life. For example:
- Physical Therapy: Exercise is one of the best treatments for people suffering with FM. A physical therapist will teach you the right exercises that will improve your flexibility, strength, and stamina. Many physical therapists recommend water-based exercises such as swimming.
- Occupational Therapy: This treatment is great for making tweaks to the way you perform day-to-day tasks. An awareness of ergonomics goes a long way in alleviating the stress that FM causes on the body.
- Alternative Therapy: This form of treatment is generally not provided by conventional doctors, but some find it very effective. Examples include enzymes, nutritional supplements, diet, lifestyle changes, detoxification, stress control, prevention, and biofeedback.
- Counseling: Stress caused by anxiety and depression can worsen the symptoms of FM. Talking with a counselor can help to reduce this stress greatly. A counselor can teach you to believe in yourself and teach you strategies to cope with FM-associated stress.
If you believe you have FM or are experiencing any chronic pain symptoms, call The Advanced Spine Center at (973) 538-0900. Our team uses the most up-to-date means to treat conditions in and around the spinal cord. If you’re experiencing pain, contact us by phone or online and improve your quality of life instantly. We treat both adult and pediatric patients and look forward to finding a personalized care plan for you.