Dr. M.J. Bazos MD,
Patient
Handout
Fibromyalgia
WHAT IS
FIBROMYALGIA?
Fibromyalgia, sometimes
called fibrositis, is a common condition that is associated with widespread
aching, stiffness and fatigue, and originates in muscles and soft tissues.
People with fibromyalgia are found to have multiple tender points in specific
muscle areas. Most individuals complain of aching and stiffness in areas around
the neck, shoulders, upper back, lower back and hip areas. Many patients have no
underlying disorders while others who develop fibromyalgia may have conditions
such as rheumatoid arthritis, spinal arthritis or Lyme disease. Some people have
symptoms of irritable bowel syndrome, tension headaches and numbness or tingling
of the
extremities.
CAUSE
The
cause of fibromyalgia is unknown. There may be a link between fibromyalgia and a
sleep disturbance, since most patients have disruptive sleep patterns. Other
factors that may contribute to the development of fibromyalgia or sustain
symptoms are psychological stress, immune or endrocrine abnormalities, or
biochemical abnormalities in the central nervous system, such as altered
serotonin levels.
HEALTH IMPACT
Fibromyalgia is common, affecting
approximately two percent of the U.S. population.
- It occurs seven times more frequently in women
than in men.
- It occurs most frequently in women of
childbearing age.
DIAGNOSISDiagnosis
is based on the patient’s description of chronic widespread pain and the
finding of tender points at specific locations by a physician. There are no
blood or x-ray tests that are abnormal in
fibromyalgia.Common conditions that may
mimic fibromyalgia include hypothyroidism, lupus, rheumatoid arthritis and
infections. These can usually be excluded by examination and laboratory
tests.TREATMENTThere
is no known cure for fibromyalgia. Patients may be reassured that the condition,
while painful, does not damage tissues and that it can be managed successfully
in many cases. Physical modalities are
often beneficial, including heat treatments, occasionally cold application,
massage, and regular stretching and range-of-motion exercises. Supervised
aerobic conditioning exercises are valuable. Occupational therapy, such as
adaptive activities, can improve functional
performance.Certain medications have
an important role. Various medications to improve sleep and relax muscles, such
as amitriptyline and cyclobenzaprine, are widely used. Hypnotic agents,
anxiolytic drugs and anti-depressant medications may be appropriate. Local
anesthetic or corticosteroid injections may be appropriate for painful local
tender points.Attention to mental
health, including psychological consultation, is also important, since
depression may precede or accompany
fibromyalgia.THE PHYSICIAN’S
ROLE IN TREATING FIBROMYALGIAPeople
with fibromyalgia often need a rheumatology consultation to determine the cause
of multiple rheumatic symptoms, to be educated about fibromyalgia and its
treatment, and to exclude other potentially progressive rheumatic diseases. A
treatment program must be planned to meet the patient’s needs. The
physician, as the team leader, enlists and coordinates the expertise of other
health care professionals in the care of the
patient.Websites:www.arthritis.org.