Fibromyalgia
What Is Fibromyalgia?
Fibromyalgia is a neurosensory disorder marked by persistent musculoskeletal pain and tightness, usually at sore points in the neck, shoulders, chest, back, knees and hips.
The exact cause and underlying mechanisms of fibromyalgia remain unclear. It is thought to be hypersensitivity of the central nervous system, causing muscles and soft tissues to go into spasm (hence the tightness and stiffness of muscles and joints). Patients with fibromyalgia often complain of fatigue, cognitive difficulties, and migraines and various other physical complaints. Disturbed sleep and sometimes depression are often associated with this condition.
Fibromyalgia is a disorder characterised by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain and spinal cord process painful and nonpainful signals.
Symptoms often begin after an event, such as physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event.
Women are more likely to develop fibromyalgia than are men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression.
While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Exercise, relaxation and stress-reduction measures also may help.
Symptoms and Signs
Fibromyalgia is characterized by a spectrum of symptoms, the main one being chronic widespread pain. The pain is often reported as a constant dull ache, typically arising from muscles.
In addition to pain, individuals with fibromyalgia may experience:
Fatigue
Patients often feel tired, even after sleep, which can be disrupted by pain. The fatigue in fibromyalgia can be all-consuming and can impact daily functioning.
Cognitive Difficulties
Sleep Disturbances
Problems such as restless legs syndrome and sleep apnoea are common in fibromyalgia patients.
Sensory Sensitivities
Increased sensitivity to pain, known as hyperalgesia, is a defining symptom, alongside possible sensitivity to light, noise, or temperature.
Stiffness
Many individuals with fibromyalgia report feeling stiff, particularly upon waking or after long periods of inactivity.
Other Symptoms
Headaches, including migraines, irritable bowel syndrome, depression, and anxiety, are frequently associated with fibromyalgia.
Causes and Risk Factors
Primary Fibromyalgia
Primary fibromyalgia, also known as idiopathic fibromyalgia, has no identified cause. The development of primary fibromyalgia is linked to several hypothesised mechanisms:
- Genetic Factors: A familial predisposition suggests that genetic mutations may influence the development of fibromyalgia.
- Neurotransmitter Dysregulation: Having abnormal levels of certain chemicals in the brain, such as serotonin and noradrenaline, which are involved in pain processing, mood, and sleep.
- Sleep Disturbances: Dysfunctional sleep patterns are thought to be both a symptom and a contributing factor to the onset of fibromyalgia.
- Psychological Stress: There is an observed association between psychological stress and the onset of fibromyalgia, though the nature of this relationship is not fully understood.
Secondary Fibromyalgia
Secondary fibromyalgia arises as a consequence of other medical conditions or external factors. Known associations include:
- Physical Trauma: Events such as accidents or surgeries can trigger the onset of fibromyalgia symptoms.
- Infections: Certain viral or bacterial infections have been implicated in triggering or exacerbating the symptoms of fibromyalgia.
- Autoimmune Diseases: Fibromyalgia can co-occur with systemic autoimmune diseases, such as rheumatoid arthritis and lupus.
Risk Factors
The development of fibromyalgia can also be influenced by various risk factors:
- Gender: Fibromyalgia is diagnosed more often in women than in men.
- Age: The condition most commonly manifests during middle adulthood, but can occur at any age.
- Family History: Individuals with a family history of fibromyalgia have a higher risk of developing the condition.
- Lifestyle: Factors such as obesity and lack of physical activity may contribute to the severity of fibromyalgia symptoms.
Diagnosis
Even though fibromyalgia is considered by many to be a physical disorder, there is no objective method for diagnosing this condition.
According to the American College of Rheumatology’s criteria for diagnosing fibromyalgia, there needs to be at least 11 areas on the body that are intensely painful (not just tender) when pressed on.
Below are the 18 trigger points that are used to diagnose fibromyalgia.
- On left or right side of the back of the neck, directly below the hairline;
- On left or right side of the front of the neck, above the collar bone (clavicle);
- On left or right side of the chest, right below the collar bone;
- On left or right side of the upper back, near where the neck and shoulder join;
- On left or right side of the spine in the upper back between the shoulder blades (scapula);
- On the inside of either arm, where it bends at the elbow;
- On left or right side of the lower back, right below the waist;
- On either side of the buttocks right under the hip bones;
- On either knee cap.
Impact on Daily Life
Fibromyalgia can exert a considerable impact on daily living. The pervasive nature of its symptoms often leads to substantial alterations in an individual’s lifestyle, work ability, and social interactions.
- Physical Activities: Chronic pain and stiffness can reduce physical endurance and mobility. Individuals with fibromyalgia may find it challenging to engage in regular physical activity, which can lead to a cycle of physical deconditioning and worsened symptoms.
- Employment: The symptoms of fibromyalgia, particularly pain, fatigue, and cognitive difficulties, can affect occupational performance. This may result in reduced productivity, changes in job roles, or even disability.
- Psychological Well-being: The persistent pain and fatigue associated with fibromyalgia are linked to emotional distress. Rates of depression and anxiety are higher in individuals with fibromyalgia, which can further compound the difficulty in managing the condition.
- Sleep Quality: Sleep disturbances are common, with patients often reporting non-restorative sleep. This lack of restful sleep can exacerbate daytime fatigue and pain, creating a negative impact on daily function.
- Social Relationships: The unpredictable nature of symptom flare-ups can affect social engagements and relationships. Individuals may experience a decrease in social activities and can feel isolated due to a lack of understanding from others about the condition.
- Daily Routine Management: Routine tasks can become increasingly burdensome. Simple activities such as household chores, shopping, or personal care routines may require greater effort and can lead to increased symptom severity.
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Treatment Modalities
Pain Medication
This involves the use of medications such as Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), opioids, and other specialised medications designed for pain management. The type and dosage are tailored to the individual’s condition and medical history.
Myospan
Minimally invasive treatments aim to effectively relieve common pain conditions by targeting pain sources.
- Coreflex Injections: Typically contain a corticosteroid and are used for inflamed joints or tissues.
- Platelet-Rich Plasma (PRP) injections: Utilise own platelets to promote healing in damaged tissues.
- Intra-Articular Injections: Most commonly used to treat osteoarthritis in the hip or knee, but they can also be given in other joints, including shoulders, wrists, ankles, hands, and fingers.
For chronic pain conditions originating from spinal issues, Neurospan can be performed by our team of pain specialists from Singapore Paincare Center.
Prevention Strategies
Managing fibromyalgia involves a proactive approach to lifestyle modifications and self-care. These strategies are designed to lessen the severity of symptoms and improve overall quality of life.
- Stress Reduction: Techniques such as meditation, deep-breathing exercises, and mindfulness can help reduce stress levels, which may trigger or exacerbate symptoms.
- Sleep Hygiene: Establishing a regular sleep routine, creating a comfortable sleep environment, and limiting caffeine intake can improve sleep quality.
- Nutrition: A balanced diet rich in fruits, vegetables, whole grains, lean protein, and low in processed foods can support overall health and may help in managing fibromyalgia symptoms.
- Exercise Regimen: Regular exercise, tailored to individual capability, helps maintain muscle strength and reduce pain and stiffness.
- Pacing Activities: Learning to pace daily activities to avoid overexertion can help manage fatigue and pain. It involves balancing rest and activities, and recognising limits.
- Support Networks: Joining support groups or engaging with online communities for individuals with fibromyalgia can provide emotional support and valuable information on managing the condition.
- Education: Understanding the condition empowers individuals to make informed decisions about their treatment and self-care strategies.
- Regular Check-ups: Routine visits to healthcare providers ensure ongoing monitoring and adjustment of treatment plans as needed.
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Frequently Asked Questions (FAQ)
What is Fibromyalgia?
Fibromyalgia is a long-term condition characterised by widespread pain in the muscles and bones, areas of tenderness, and general fatigue.
How serious is Fibromyalgia?
Fibromyalgia is not life-threatening but can be a serious chronic condition that affects an individual’s quality of life.
Who is most at risk for developing Fibromyalgia?
Risk factors for fibromyalgia include gender (more common in women), a family history of fibromyalgia, and having a rheumatic disease such as rheumatoid arthritis.
What are the common signs and symptoms of Fibromyalgia?
Signs and symptoms include widespread pain, fatigue, sleep disturbances, cognitive difficulties, and emotional distress.
How is Fibromyalgia diagnosed?
Diagnosis is based on a history of widespread pain lasting more than three months and the presence of other symptoms. Other conditions are ruled out through clinical evaluation and testing.
What other conditions show the same symptoms as Fibromyalgia?
Conditions with similar symptoms include chronic fatigue syndrome, rheumatoid arthritis, and thyroid disorders.
What treatments are available for Fibromyalgia?
Treatments include medications, cognitive behavioural therapy, exercise, and lifestyle changes, with the aim of symptom management.
Can lifestyle changes alleviate the symptoms of Fibromyalgia?
Yes, lifestyle changes such as stress reduction, good sleep hygiene, regular exercise, and a healthy diet can help manage symptoms.