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Diagnosis and Treatment of Fibromyalgia

What Is Fibromyalgia?

Fibromyalgia is a disorder that causes aches and pain all over the body. It is a chronic (sometimes unremitting) condition of pain, stiffness, often associated with significant fatigue.

Fibromyalgia affects millions people in the US. Fibromyalgia appears to affect between 2% to 13% of the population. Generally 80% to 90% are women during the period of middle age of their life although symptoms may start earlier. 10% - 20% are of men and children are also diagnosed.


There are Two types of Fibromyalgia

  • Primary Fibromyalgia: Often referred to as idiopathic, as there are no known causes.
  • Secondary fibromyalgia: Where a cause can be identified.

Primary fibromyalgia is the most common type diagnosed. Many experts believe that fibromyalgia is not a disease but rather a chronic pain condition brought on by several abnormal body responses to stress. Physical injury, emotional trauma, or viral infections such as Epstein-Barr are also suspected as triggers for this disorder. Unfortunately, none have proven to be a cause of primary fibromyalgia.


Why Does Fibromyalgia Occur?

The exact causes of fibromyalgia are not known. It has been linked to one or more of the following:

  • Emotional or physical stress
  • Anxiety
  • Depression
  • Traumatic events such as a car accident
  • Infections or other illness
  • Lack of restful sleep.

Women who have a family member with fibromyalgia are more likely to have it themselves. It is not known if this is due to hereditary or environmental factors, learned or suggested behavior or all or these.


Symptoms Most Commonly Associated with Fibromyalgia

  • Pain is the main symptom
  • Generalized fatigue and/or tiredness
  • Chronic headache
  • Sleep disturbance
  • Muscle and joint stiffness, joint swelling
  • Neurologic and psychological complaints
  • Numbing or tingling sensations
  • Problems with the digestive system, especially trouble swallowing, recurrent abdominal pain, or diarrhea.
  • Sicca symptoms also known as Sjogren syndrome, dry eyes, dry mouth, with or without rheumatoid arthritis, lupus, scleroderma or polymyositis.


You May Also Experience:

  • Problems with thinking and remembering things
  • Feelings of depressed, anxiety or nervousness
  • Feeling dizzy or light headed
  • Feeling cold
  • Upset stomach
  • Exercise intolerance
  • Women often experience painful menstruation (dysmenorrhea)


The aches, pains, and stiffness in muscles, joints, and other parts of the body vary from day to day or week to week. The pain also tends to move from one part of the body to another. It is most common in the neck, chest, arms, legs, hips, and back.

People with fibromyalgia also are tender throughout the body. The tenderness is most noticed at certain places called tender points. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them.

The symptoms may get worse with overexertion or when the weather is damp and cold. Younger adults with fibromyalgia are more likely to have chronic headaches, anxiety, and symptoms worsened by weather, mental stress, or poor sleep.


How Is Fibromyalgia Diagnosed?

There is no single test for fibromyalgia. Diagnosis is generally based on the pattern of symptoms.


Major Criteria for Diagnosis

  • Generalized aches and stiffness of at least 3 anatomic sites for at least 3 months
  • Six or more typical, reproducible tender points
  • Exclusion of other disorders that can cause similar symptoms


Minor Criteria
for Diagnosis

  • Generalized fatigue
  • Chronic headache
  • Sleep disturbance
  • Neurologic and psychological complaints
  • Joint swelling
  • Numbing or tingling sensations
  • Irritable bowel syndrome
  • Variation of symptoms in relation to activity, stress, and weather changes


In order to make the diagnosis of fibromyalgia one must fulfill all three Major Criteria and four or more Minor Criteria or abnormal tenderness at 11 or more 18 specific anatomic tender point (TnP) sites.


How Is Fibromyalgia Treated?

There is no approved medicine that can cure fibromyalgia. The most successful treatment for fibromyalgia is a healthy diet, regular exercise, and rest. Stress reduction is essential. A correct exercise program is also essential. Techniques to help and improve sleep are valuable. Certain medications, dietary supplements and herbal treatments can be very helpful.

If you think you have fibromyalgia or know that you do and need help set up an appointment at Preventive Medicine Clinic of The Desert a caring relationship with competent physician can greatly help you. For more information, call 760-320-4292 and make an appointment for help.

 

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