| 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.
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Known Causes
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.
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Diagnosis
Diagnosis 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.
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Conventional
treatments
T
here 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.
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