Fibromyalgia is a condition in which somebody persistently feels pain throughout the body.
Description and Symptoms
Fibromyalgia is a disease that features an unusual sensitivity to pain, and sufferers also tend to suffer from other symptoms, such as fatigue, insomnia, stiff muscles, and headaches.
Unlike conditions such as arthritis, there is no underlying damage to the muscles or joints. There are cases of people who suffer from both arthritis and fibromyalgia, but the conditions are distinct.
Those with the condition tend to have difficulty concentrating on mental tasks; this is a symptom known as “fibro-fog.” Sufferers from fibromyalgia often also suffer from depression and irritable bowel syndrome.
Fibromyalgia is a rheumatic disease characterized by widespread chronic pain for more than three months. Usually, the patient locates this pain in the locomotor apparatus.
According to the Episer study carried out by the Spanish Society of Rheumatology (SER) in 2000, some experts estimated that in the Spanish population the prevalence of fibromyalgia is 2.73%, being more frequent in women than in men.
This pathology can manifest itself at any age. However, it is much more prevalent in the middle ages of life and is considered the most frequent cause of musculoskeletal pain.
Fibromyalgia is caused by various imbalances of neurochemicals in the brain, leading to changes in the way the body processes the sensation of pain.
Research is continuing into the exact biochemical causes of the disease, with experts putting forward many theories having.
The disease is much more common in women than men. It may be initially triggered by a traumatic event, such as bereavement, giving birth, a severe injury or operation, or the ending of a relationship. There also seems to be a limited genetic component to the condition.
The condition is sometimes related to depression, but it is not clear if such mood is the result of the fibromyalgia, or if they both have a separate underlying cause.
Although the causes that give rise to this disease are unknown, SER explains that fibromyalgia is now thought to be caused by an alteration in certain neurotransmitters of the nervous system.
The society points out that when there is an imbalance of the neurotransmitters, a series of alterations can occur that could explain the symptoms of the pathology.
Thus, generalized pain occurs as a consequence of a change in the pathways of pain modulation.
For these reasons, the generalized pain reported by most patients originates because there is an anomalous perception of the sensory stimuli and therefore they interpret pressure, heat, vibration or any other small sensation as painful.
Doctors make the diagnosis through the clinical examination of the patient and the existence of different symptoms, such as pain, stiffness or sleep disorders, without there being an alternative explanation to justify that it is another disease.
As indicated by SER, the result of the general physical examination is usually average, and there is currently no imaging or laboratory test to confirm the diagnosis, although the tests may help to rule out other diseases such as lupus, hypothyroidism, or Rheumatoid arthritis.
The differential diagnosis is usually confirmed when the specialists detect a set of 18 points, called pressure points, located in various muscle areas of the body, mainly around the neck, elbow, knees, and pelvis.
Exercise has been found to reduce the severity of fibromyalgia in some patients. Patients may respond well to swimming or training in a warm pool.
Painkillers are often used to treat fibromyalgia. Non-steroidal anti-inflammatory drugs, such as ibuprofen or aspirin, can be taken. However, these drugs can have side-effects, such as damaging the stomach lining.
Some use Acetaminophen (paracetamol). Stronger painkillers, such as codeine or tramadol, may be prescribed in severe cases.
These can also have side-effects and often give very unpleasant withdrawal symptoms when patients try to come off them. People should not take them lightly.
Before starting treatment experts should make sure the diagnosis is correct. Next, the specialists will proceed to explain to the patients what the disease consists of and what is happening exactly.
Finally, they should involve them in such approach and the therapies through specific guidelines, sport, and pharmacological treatment.
Experts recommend performing aerobic physical exercise gradually, steadily and steadily. Enrique Hornilla, Rheumatologist at Clínica Universidad de Navarra, highlights the effectiveness of pool exercises and hydrotherapy.
Antidepressants are used to treat fibromyalgia. These drugs work by modifying the brain chemistry, so they can be useful in dealing with fibromyalgia, even when significant depression is not present.
Tricyclic antidepressants, such as amitriptyline (Elavil), are often used, although a recent thorough review of the scientific evidence suggested that amitriptyline was not particularly useful.
Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine and milnacipran, may be used. A review of various scientific studies on duloxetine confirmed that it was more effective than a placebo.
All antidepressants have multiple side-effects, so patients should be cautious about taking them on a long-term basis.
Anticonvulsant drugs, such as gabapentin and pregabalin, benefit some patients with fibromyalgia. However, many patients report little or no improvement with them.
5-Hydroxytryptophan (5-HTP) has shown some promise in combatting fibromyalgia. Not all sufferers respond to this substance.
Melatonin can be used to help sufferers sleep.
Sodium Oxybate, a drug used to treat narcolepsy, has been shown in clinical trials to help sufferers of fibromyalgia, by improving sleep quality and reducing pain.
However, the drug has not been approved by the FDA for use against the disease, due to concerns about potential abuse.
It is an illegal drug in most countries, apart from a limited prescription use to treat narcolepsy. It is the sodium salt of the γ-hydroxybutyric acid (GHB).
Guaifenesin is cough medicine, sometimes promoted as a “cure” for fibromyalgia. A double-blind study has shown that it was no more effective than a placebo (a dummy treatment).
It was supposed to remove calcium phosphate deposits from the muscles and joints; such deposits were postulated to be the cause of the disease.
Scientists have found no evidence of excess calcium phosphate in the tissues of those suffering from fibromyalgia.
Since only the possible causes of the disease are suspected, there are currently no preventive measures to mitigate its occurrence.