Fibromyalgia, also known as Fibromyalgia Syndrome (FMS), is a long-term disorder characterised by pain all over the body, accompanied by fatigue and memory and mood issues. Many people struggling with this condition also experience headaches, anxiety, depression and irritable bowel syndrome (IBS).
Doctors believe that the condition intensifies painful sensations by affecting the way your brain and spinal cord process painful and non-painful signals.
There is currently no cure for fibromyalgia; therefore, it can be difficult to treat. However, medications, exercise, therapy, and lifestyle changes can help you to deal with your symptoms and improve your quality of life.
Causes
There is no known cause as to why some people develop fibromyalgia, but it is thought there is more than one factor that can come into play. According to recent studies, the cause appears to be a combination of a genetic disposition and a trigger, or set of triggers, such as an infection, stress or trauma. It is also more common in women than in men.
Many researchers believe that repeated nerve stimulation causes an abnormal increase in levels of certain chemicals in the brain that signal pain. In addition, the brain’s pain receptors appear to develop a memory of the pain and become sensitised, causing an overreaction to painful and non-painful signals.
There are a number of factors that may influence why people develop fibromyalgia, including:
Chemical imbalance
It has been found that people with fibromyalgia have abnormally low levels of the hormones serotonin, noradrenaline and dopamine in their brains.
Low levels of these hormones may be a key role in the cause of fibromyalgia, as they are important in regulating things such as appetite, mood, behaviour, sleep and the way you respond to stressful situations. These hormones also play a part in processing pain messages sent by the nerves. Increasing the hormone levels with medication can disturb these signals.
Sleep problems
A disturbed sleep pattern may be a cause as opposed to a symptom. Fibromyalgia can cause you to sleep badly and result in extreme tiredness (fatigue). People with the condition who sleep poorly may also experience higher levels of pain, suggesting that sleep problems contribute to the other symptoms of fibromyalgia.
Genetics
Research has suggested that genetics may play a small role in the development of fibromyalgia. There may be a genetic mutation that causes you to be more susceptible to developing the disorder, including after a trigger.
Triggers
Fibromyalgia can be triggered by a stressful physical or emotional event. Possible triggers for fibromyalgia include:
- Injury
- Labour
- An infection
- Undergoing a surgical procedure
- Going through a break up or divorce
- An abusive relationship
- Death of a loved one
In some cases, however, fibromyalgia does not develop following any obvious trigger.
Symptoms
Fibromyalgia causes what is known as regional pain. The pain in these regions feel like a constant dull ache. Other symptoms of fibromyalgia include:
- Widespread pain in the muscles and bones (musculoskeletal pain)
- Areas of tenderness
- Extreme fatigue (tiredness) and difficulty sleeping
- Muscle stiffness
- Headaches and migraines
- Difficulty with mental processes (known as fibro-fog) such as problems with concentration or memory
Irritable bowel syndrome, intestinal cystitis or painful bladder syndrome - Anxiety and depression
In people with fibromyalgia, the brain nerves can misinterpret or amplify normal pain signals. This may be caused by a chemical imbalance in the brain or an abnormality in the dorsal root ganglion.
If you believe you may have the condition, make an appointment to see your doctor. Treatment is available to reduce symptoms, although they are unlikely to vanish completely.
Diagnosis
Fibromyalgia can be difficult to understand, even for doctors. It shows symptoms similar to other conditions, and there are not any specific tests to diagnose the problem. As a result, the condition can often be misdiagnosed.
During your diagnosis, you will be asked about your symptoms and how they are affecting your everyday life. The doctor will also carry out a physical examination to check for any visible signs of other conditions, such as swollen joints, which may point to arthritis.
The main cause needed for a fibromyalgia diagnosis is widespread pain (pain on both sides of your body, above and below the waist) throughout your body for at least three months. To meet the criteria, you must feel pain in at least four of these five areas:
- Upper left region, including shoulder, arm or jaw
- Upper right region, including shoulder, arm or jaw
- Lower left region, including hip, buttock or leg
- Lower right region, including hip, buttock or leg
- Axial region, which includes neck, back, chest or abdomen
Your doctor may also want to eliminate the chance of other conditions that cause similar symptoms by using blood tests.
If there is a chance that you may be suffering from sleep apnoea, your doctor may suggest an overnight sleep study.
Treatment
In general, treatment for fibromyalgia include both medication and self-care strategies. The goal of treatment for this condition is to ease symptoms and improve quality of life.
In some cases, a number of different healthcare professionals may be involved in your care such as a Rheumatologist, a Neurologist and a Psychologist. You may need to try a variety of treatments to find a combination that works well for you. This is usually a mixture of medication and lifestyle changes.
Medication
Medication can help ease the pain, improve sleep and quality of life. Common medications include:
Pain relievers
Over the counter pain, medication such as ibuprofen can help ease painful symptoms. Opioid medications are not recommended, as they can lead to side effects and dependence that can worsen pain over time.
Antidepressants
Antidepressant medication can help reduce the pain and fatigue connected with fibromyalgia. Your doctor may propose Amitriptyline or the muscle relaxant Cyclobenzaprine to help encourage sleep.
Anti-seizure drugs
Medications intended to treat epilepsy are often useful in easing certain types of pain. Gabapentin (Neurontin) can be helpful in reducing fibromyalgia symptoms.
Self-care
Self-care is crucial in the control of fibromyalgia. Some self-care steps include:
Stress management
If you have fibromyalgia, it is important to limit overexertion, emotional stress and take time to practice relaxation techniques. Stress can make your symptoms worse or cause them to flare up. However, try not to completely change your routine. People who remain active do better than those who stop work or drop all commitments. Stress management techniques such as meditation and deep breathing exercises. Talking therapies such as counselling can also be helpful when combating stress.
Sleep hygiene
As fatigue is one of the main symptoms of fibromyalgia, it is essential to achieve good quality sleep. In addition to allowing yourself enough time for sleep, practice good sleep habits such as:
- Going to bed and waking up at the same time every day
- Reduce or avoid daytime napping
- Wind down and relax before bed
- Create a bedtime routine such as taking a bath or having a milky drink
- Avoid eating a heavy meal late at night
- Avoid caffeine, alcohol and nicotine before going to bed
- Ensure your bedroom is a quiet, dark and a comfortable temperature
- Avoid checking the time throughout the night
Exercise regularly
At first, exercise may increase your pain. However, regularly performing aerobic activities and strengthening exercises can often ease symptoms. Suitable exercises may include walking, swimming, biking and water aerobics. A physiotherapist can help develop a home exercise programme for you.
Pace yourself
Balancing periods of activity with periods of rest is important if you have fibromyalgia. Moderation means not overdoing it on your good days, or doing too little on the more painful days. If you do too much on your good days, you may end up with more bad days, although you may find that you can gradually increase your periods of activity.
Maintain a healthy lifestyle
Eat healthy food, avoid tobacco products and limit your caffeine intake. Do something that you find enjoyable and rewarding every day.
Outlook
Fibromyalgia can be a lifelong condition that causes pain, fatigue, and tenderness. While there is no single cause identifiable, there are many treatment options available to ease symptoms.
Most people who have fibromyalgia can reduce symptoms with medications and lifestyle changes. In some cases, symptoms disappear after you take steps to reduce stress. Although symptoms can return during stressful times. Only a small number of people experience pain or fatigue so severe that they are unable to work.
Need Help?
Fibromyalgia treatment is available at One Ashford Hospital in Kent with a leading Pain Management Consultant, and we can book you in for a consultation, usually within 48 hours.
One Ashford Hospital is ideally located for patients in Ashford, Maidstone, Dover, Canterbury, Folkestone and all nearby areas. To book an appointment, call the hospital direct on 01233 364 022 or email here.
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