FIBROMYALGIA – What is it and How to treat?

Fibromyalgia is a widespread problem characterized by chronic widespread pain and multiple muscular tenderpoints on examination or associated symptoms of fatigue, un-refreshing sleep and tiredness.

Now question is that what is chronic widespread pain? Chronic widespread pain is defined as pain for at least three months, affecting both sides of thebody, both above and below the waist.

What causes fibromyalgia?

Most commonly fibromyalgia is seen in females. We do not know exactly what causes fibromyalgia. It is said that in people suffering from fibromyalgia, the pain processing mechanisms in the centralnervous system are dysfunctional and there is amplification of pain signals within the spinal cord.

The Psychological and social factors play a key role in development such pains in patients suffering from fibromyalgia.

How is Fibromyalgia diagnosed?

No blood tests or imaging modalities are helpful in diagnosing fibromyalgia. The inflammatory markers like C reactive protein, erythrocyte sedimentation rate and joint radiographs are normal and they are used to rule out inflammatory rheumatologic diseases

So, the diagnosis of fibromyalgia based on the clinical signs and symptoms.

Tender Points Examination

In a tender point exam, each point is pressed with fingertip, and tenderness is evaluated.

There are nine pairs of tender points that are often associated with fibromyalgia:

1. Both sides of the back of the head

2. Both sides of the neck

3. Top of each shoulder

4. Shoulder blades

5. Both sides of the upper chest

6. Outside of each elbow

7. Both sides of the hips

8. Buttocks

9. Insides of the knees

Diseases Mimicking Fibromyalgia

1. Rheumatologic diseases like Rheumatoid arthritis and inflammatory joint diseases.

2. Osteoarthritis.

3. HIV

4. Lyme Disease

5. Cancer

6. Degenerative diseases of spine.

7. Hypothyroidism.

Management of Fibromyalgia

Non-drug treatments

Non-drug treatments can be physical or psychological. Physical therapies include active (exercise) and passive approaches (joint manipulation and massage). Exercise is strongly recommended for Fibromyalgia.

Psychological therapies includes Cognitive Behavior Therapy.

The non drug treatments have been found to be very effective in controlling the symptoms of Fibromyalgia.

Drug treatment

Drugs for fibromyalgia include analgesics, opioids, andantidepressants. Some drugs, such as pregabalin, gabapentin,and serotonin and adrenaline reuptake inhibitors (for example,milnacipran and duloxetine) are very helpful in conjugation with Non drug treatment approach.