Fibromyalgia or Fibromyalgia Syndrome (FMS)

What Is Fibromyalgia?

Fibromyalgia or fibromyalgia syndrome is a chronic or long-lasting condition characterized by muscle pain, joint pain, fatigue, sleep problems, memory loss, and mood swings. It affects women more than men and starts during middle adulthood. It is believed that this condition increases the sensation of pain experienced by a person by altering how the brain processes distress signals. There is no permanent cure for this disease, but medicines give substantial symptomatic relief.

These symptoms begin after an injury, surgery, infection, or a lot of mental stress. The other symptoms that are commonly seen in fibromyalgia patients are tension headaches, temporomandibular joint (TMJ) disorders, anxiety, depression, and irritable bowel syndrome. In addition, it is now described as a central pain amplification disorder as this increases the pain sensation in the brain.

Fibromyalgia is considered a benign condition because even though it affects the quality of life, it is not fatal and does not cause heart attacks, stroke, cancer, or physical deformities. However, rheumatic diseases increase the risk of fibromyalgia such as -

• Osteoarthritis (wearing down of protective tissue at the end of the bones).

• Lupus (a disorder in which the body's immune system attacks its own tissues and organs).

• Ankylosing spondylitis (an inflammatory disease affecting the spine and large bones).

• Rheumatoid arthritis (an autoimmune disorder affecting joints, including hands and feet).

What Are the Common Misconceptions About Fibromyalgia?

As the pain caused by this condition is subjective and cannot be measured, the common myths about this illness are -

• The pain and discomfort are all in mind and are not real.

• This condition only affects older women.

• The pain experienced is minimal and cannot affect daily life.

What Causes Fibromyalgia?

Is it still unclear what causes fibromyalgia, but it is believed to be caused due to some problem in the nervous system, which makes some people more sensitive to pain when certain triggers come into play. These triggers can be -

• Spine problems.

• Arthritis.

• Physical stress.

• Emotional stress.

• Trauma.

• Genetics.

• Infection.

What Are the Symptoms of Fibromyalgia?

There are a lot of symptoms seen in fibromyalgia; some of the common ones are -

• Generalized pain.

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• Jaw stiffness or pain.

• Headaches.

• Joint stiffness or pain.

• Sleep disturbances.

• Irritable bowel syndrome or IBS (intestinal disorder leading to diarrhea, pain, and discomfort in the stomach).

• Restless leg syndrome or RLS (a condition causing an uncontrollable urge to move legs).

• Tiredness.

• Difficulty concentrating.

• Memory problems.

• Tingling or numbness in hands and feet.

It might also cause:

• Vision problems.

• Dizziness.

• Pelvic problems.

• Weight gain.

• Nausea.

• Urinary problems.

• Depression.

• Anxiety.

• Breathing and chest troubles.

• Skin problems.

Who Is Commonly Affected?

As mentioned earlier, this disease is more common in women than in men. It is usually diagnosed between 35 to 45 years of age, but pain symptoms begin much earlier in life. Moreover, it is more likely to develop in patients with a family history of this condition.

Why Does It Hurt So Much?

It is believed that repeated nerve stimulation causes the following changes -

• An abnormal increase in the levels of neurotransmitters, which are chemicals in the brain that signal pain.

• And the pain receptors in the brain become more sensitive to pain and start overreacting to pain signals.

What Are the Tender Points Used to Diagnose Fibromyalgia?

It can be tricky to diagnose this condition, as the pain can be caused due to many other reasons. So to diagnose fibromyalgia, doctors check for pain and tenderness in at least 11 points out of the 18 (nine pairs) known tender points when a patient complains of pain all over the body for a long time. The tender points are -

1. The base of the skull.

2. Neck and shoulder.

3. Lower neck in front.

4. Edge of upper breast.

5. Below the elbow.

6. Inner shoulder.

7. Hip bone.

8. Buttocks.

9. Above the knee.

These points are no longer used to diagnose this condition.

How Is Fibromyalgia Diagnosed?

When a patient complains of widespread pain for three months or longer, and if blood tests show no abnormality like hypothyroidism, the doctor might diagnose the condition as fibromyalgia. There is no specific lab test to diagnose this condition, but the other blood tests performed are -

• Complete blood count (CBC).

• Erythrocyte sedimentation rate (ESR).

• Rheumatoid factor.

• Thyroid function test.

• Cyclic citrullinated peptide test.

The three criteria for diagnosing this condition as proposed by the American College of Rheumatology are:

1. Pain in the tender points and other symptoms over the last week with fatigue, sleep, and memory problems.

2. The presence of symptoms for three months or more.

3. Absence of any other health condition that might cause the same issues.

What Are the Treatment Options for Fibromyalgia?

Fibromyalgia is not curable, and treatment is done to manage symptoms. The treatment options include -

Medications:

• Painkillers - Acetaminophen or Paracetamol, Ibuprofen, and Naproxen sodium.

• Antidepressants - Duloxetine and Milnacipran are used to reduce pain and fatigue.

• Antiepileptic Drugs - Gabapentin and Pregabalin are also helpful in treating pain.

Therapies:

• Physiotherapy - Water-based exercises and other exercises might help increase strength and flexibility.

• Counseling - This condition can be stressful, so counseling will help deal with it.

• Occupational Therapy - It will help you make changes to your workplace, which might reduce stress.

Alternative Medicine:

• Acupuncture - Here, very fine needles are inserted into the skin to restore the normal balance of life forces. It also helps change the levels of blood and neurotransmitters in the brain, which might relieve some symptoms.

• Massage - Massage helps relax your muscles, improves flexibility, and helps the body produce natural painkillers.

• Yoga and Meditation - Breathing and relaxation techniques help control symptoms.

Home Remedies:

• Avoid overexerting yourself and reduce emotional stress.

• Get sufficient sleep every day.

• Exercises like walking, swimming, and water aerobics might reduce pain, so do them regularly.

• Eat a balanced diet.

• Be as active as possible.

What Are the Foods That Are Beneficial and Foods to Be Avoided?

It is said that a vegetarian diet is better, as it is low in fat and protein and high in fiber, beta carotene, antioxidants, and minerals. Foods that can be beneficial are -

• Food rich in antioxidants, like kidney beans, dark chocolate, cilantro, artichokes, and berries.

• Food containing iron and ferritin includes green leafy vegetables, shellfish, red meat, and pumpkin seeds.

• Fish like salmon, tuna, red meat, and turkey are rich in amino acids.

• Foods containing Coenzyme Q10 like soy oil, beef, peanuts, and sardines.

• Anti-inflammatory vegetables like kale, spinach, arugula, and bok choy.

• Fruits low in the glycemic index, like apples, berries, peaches, and citrus fruits.

Food items to be avoided that can cause flare-ups are -

• Bread.

• Sugary beverages.

• Pasta.

• Cakes.

• Cereals.

• Candy.

Conclusion:

Chronic pain and sleep disturbances associated with this illness generally interfere with a patient's daily activity and work, which can result in depression and anxiety. If you are suffering from widespread pain without apparent cause, it is best to consult a rheumatologist online.