Neuropathic Pain
Fibromyalgia Syndrome is a disease characterized by chronic pain, stiffness, and tenderness of muscles, tendons, and joints, without detectable inflammation. Fibromyalgia does not cause body damage or deformity. There’s no cure. But a combination of medication, exercise, managing your stress, and healthy habits may ease your symptoms enough that you can live a normal, active life. Unlike arthritis, this isn’t because you have problems with your joints, bones or muscles. It’s thought to be caused by your nervous system in your brain and spine not being able to control or process pain signals from other parts of your body.
Signs and Symptoms
Even with the many treatment options, patient self-care is vital to improving symptoms and daily function. In concert with medical treatment, healthy lifestyle behaviors can reduce pain, increase sleep quality, lessen fatigue and help you cope better with fibromyalgia.
Healthcare providers and researchers don’t know what causes fibromyalgia. According to the latest research, the cause appears to be a multiple-hit theory that involves genetic disposition (hereditary characteristics) complemented by a trigger, or a set of triggers, such as infection, trauma, and stress. Let’s take a closer look at these potential factors and several more that may influence why people develop fibromyalgia.
Infections : A past illness could trigger fibromyalgia or make its symptoms worse. The flu, pneumonia, GI infections, such as those caused by Salmonella and Shigella bacteria, and the Epstein-Barr virus all have possible links to fibromyalgia.
Genes : Fibromyalgia often runs in families. If you have a family member with this condition, you’re at higher risk for developing it. Researchers think certain gene mutations may play a role. They’ve identified a few possible genes that affect the transmission of chemical pain signals between nerve cells.
Trauma : People who go through a severe physical or emotional trauma may develop fibromyalgia. The condition has been linkedTrusted Source to post-traumatic stress disorder (PTSD).
Stress : Like trauma, stress can leave long-lasting effects on your body. Stress has been linked to hormonal changes that could contribute to fibromyalgia. Healthcare providers don’t fully understand what causes the chronic widespread nature of fibromyalgia pain. One theory is that the brain lowers the pain threshold. Sensations that weren’t painful before become very painful over time.
Another theory is that the nerves overreact to pain signals.
Pain is
real, but
so is Hope
Fibromyalgia Diagnostic Criteria (2016)
There is no definitive diagnostic test currently available to determine the presence of FMS. A diagnosis of FMS is generally made based upon the results of a physical examination and ruling out other similar conditions. No special laboratory or radiologic testing is necessary for making a diagnosis; however, some recommended lab tests can be performed in order to rule out other conditions. These tests used to rule out include: CBC, ESR, basic chemistry (blood urea nitrogen, creatine, hepatic enzymes, serum calcium), thyroid levels (TSH, T3, and T4), and Rheumatoid factor. Many symptoms of fibromyalgia are similar to those of other conditions, such as rheumatoid arthritis, Sjögren’s syndrome (sher-grenz sin-drome) and an underactive thyroid gland.
Fibromyalgia may now be diagnosed in adults when all of the following criteria are met[6]:
Widespread pain index (WPI) ≥7 and symptom severity scale (SSS) score ≥5 OR WPI 4–6 and SSS score ≥9.
Generalized pain, defined as pain in at least 4 of 5 regions, is present.
Symptoms have been present at a similar level for at least 3 months.
A diagnosis of fibromyalgia is valid irrespective of other diagnoses. A diagnosis of fibromyalgia does not exclude the presence of other clinically important illnesses
Medication
Active rehabilitative approaches have primacy in management, but drugs can help to control symptoms. There is evidence to support the use of amitriptyline, duloxetine, milnacipran or pregabalin, but pure opioids should be avoided. Neuromodulatory drugs such as antidepressants, or drugs targeting nerve pain, including pregabalin and gabapentin. They were originally used to treat conditions such as depression and epilepsy but have since proved effective for treating fibromyalgia.
Physical Therapy Management & Exercise
Education about the pathophysiology and the neuroscience behind the condition is the most effective method in reducing catastrophizing pain symptoms in patients experiencing FMS according to current research. Simple acknowledgement and explanation of symptoms and relaxation strategies can alter a patient’s ability to cope with their condition. Explanation of disorder, Reassurance of condition and symptoms, Activity management – Pacing, self-monitoring, rest breaks, AVOID exacerbations, set realistic activity goals, etc. Relaxation Techniques – Minimize environmental stress, deep breathing, healthy & active lifestyle habits, adequate sleep, therapeutic massage, etc.
Psychological therapies
Pain is never just a physical experience, especially if it lasts a long time. Pain can affect your mood and behaviour. Psychological approaches to pain management try to address the emotional effects of your pain and the things that can make your pain worse. They help you look at how your pain affects your thoughts and habits, and how your emotions can affect your pain. Therapies such as cognitive behavioural therapy (CBT), which is a talking therapy, try to reduce the overwhelming effect of problems such as stress, unhappiness and pain.
Prevention and Self care
Even with the many treatment options, patient self-care is vital to improving symptoms and daily function. In concert with medical treatment, healthy lifestyle behaviors can reduce pain, increase sleep quality, lessen fatigue and help you cope better with fibromyalgia. With proper treatment and self-care, you can get better and live a more normal life. Here are some self-care tips for living with fibromyalgia:
