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Fibromyalgia

Fibromyalgia is a common and complex chronic pain disorder that causes widespread pain and tenderness to touch that may occur body wide or migrate over the body. ‘Fibro’ refers to the fibrous tissue, ‘myo’ refers to the  muscles and ‘algia’  refers  to  pain.

The pain and tenderness tend to come and go, and move about the body. Most often, people with this chronic (long-term) illness are fatigued (very tired) and have sleep problems. The diagnosis can be made with a careful examination.

Fibromyalgia is most common in women, though it can occur in men. It most often starts in middle adulthood, but can occur in the teen years and in old age. You are at higher risk for fibromyalgia if you have a rheumatic disease (health problem that affects the joints, muscles and bones). These include osteoarthritis, lupus, rheumatoid arthritis or ankylosing spondylitis. Although fibromyalgia is often considered an arthritis-related condition, it is not truly a form of arthritis (a disease of the joints) because it does not cause inflammation or damage to the joints, muscles, or other tissues. Like arthritis, however, fibromyalgia can cause significant pain and fatigue, and it can interfere with a person’s ability to carry on daily activities.

Scientists estimate that fibromyalgia affects 5 million Americans 18 or older. Between 80 and 90 percent of people diagnosed with fibromyalgia are women. However, men and children also can have the disorder. Most people are diagnosed during middle age.

Causes

The causes of fibromyalgia are unclear. They may be different in different people. Fibromyalgia may run in families. There likely are certain genes that can make people more prone to getting fibromyalgia and the other health problems that can occur with it. Genes alone, though, do not cause fibromyalgia.

There is most often some triggering factor that sets off fibromyalgia. It may be spine problems, arthritis, injury, or other type of physical stress. Emotional stress also may trigger this illness. The result is a change in the way the body “talks” with the spinal cord and brain. Levels of brain chemicals and proteins may change. For the person with fibromyalgia, it is as though the “volume control” is turned up too high in the brain’s pain processing centers.

Fibromyalgia has also been linked to –

  • Stressful or traumatic events, such as car accidents
  • Repetitive injuries
  • Illness
  • Certain diseases.

Fibromyalgia can also occur on its own.

 

Symptoms

The main symptoms of fibromyalgia are:

  • Widespread pain in your muscles
  • Tiredness (fatigue)
  • Sleep disturbance

The severity of symptoms varies from person to person and from day to day. Many people have flare-ups from time to time when their symptoms become suddenly worse. People with fibromyalgia often say that the fatigue is the worst part of the condition and that they can’t seem to think clearly or remember things properly (this is sometimes called ‘fibrofog’).

The pain may feel as though it affects your whole body, or it may be particularly bad in just a few areas. Some people find that their pain feels worse in very hot, cold or damp weather.

Less frequent symptoms of fibromyalgia include –

  • Poor circulation – tingling, numbness or swelling in your hands and feet
  • Headaches
  • Irritability or feeling miserable
  • Feeling an urgent need to urinate, especially at night
  • Irritable or uncomfortable bowels (diarrhoea or constipation and abdominal pain)

 

Treatment

Medication

  • Painkillers like paracetamol can help to ease pain. Where paracetamol isn’t strong enough, some people find drugs like co-codamol or co-dydramol useful. These contain paracetamol plus a stronger painkiller such as codeine, but they can cause side-effects such as constipation.
  • Opiate drugs include tramadol, codeine and buprenorphine or fentanyl patches. They’re very strong painkillers with many side-effects and it can be difficult to stop taking them once they’re started. Doctors, especially in pain clinics, may offer these if the pain is seriously affecting your quality of life but they don’t always work in fibromyalgia and should be used as sparingly as possible due to the risk of long-term side-effects.
  • Capsaicin gel or non-steroidal anti-inflammatory gels rubbed into the painful areas may help you, but there’s no convincing evidence that they’re effective in most people with fibromyalgia, especially as many different areas of your body can be affected at the same time.
  • Drugs such as low-dose amitriptyline and dosulepin can reduce muscle pain and improve your sleep pattern. These drugs need to be taken 2–3 hours before you settle at night. They may not work straight away, so you may need to try them for a few months to see whether they help. Your doctor will gradually increase the dose to an effective level.
  • Antidepressants, such as fluoxetine or paroxetine, can help with both pain and low mood. Drugs such as pregabalin and gabapentin have been used to treat pain. You’ll need to take them for a period of 6 weeks to assess whether they’re helpful. These can cause side-effects such as dizziness and weight gain.
  • Duloxetine can help with pain and sleep disturbance.

 

Alternative Treatment

Omega-3 fatty acids, such as fish oil helps to reduce inflammation and improve immunity.

A multivitamin daily, containing the antioxidant vitamins A, C, D, E, the B-vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.

Alpha-lipoic acid for antioxidant support. Alpha-lipoic acid may decrease thiamine levels.

L-carnitine for muscular support. L-carnitine may make symptoms of hypothyroidism worse, and can potentially increase the likelihood of seizure in people with a history of seizures.

Magnesium for symptoms of fibromyalgia. Magnesium can potentially interact with certain medications, including high blood pressure medicines and some antibiotics.

S-adenosylmethionine or SAMe for mental and immune support. People who have manic or bipolar disorder should not take SAMe.

Probiotic supplement (containing Lactobacillus acidophilus) for maintenance of gastrointestinal and immune health. Some acidophilus products may need refrigeration.

Calcium/vitamin D supplement, for support of muscle and skeletal weakness.

Coenzyme Q10 for antioxidant, immune, and muscular support. Coenzyme Q10 can interfere with the actions of some blood-thining medications, such as warfarin (Coumadin) and others

Chlorella (Chlorella pyrenoidosa), a blue-green algae, may help lessen symptoms. Chlorella contains large amounts of vitamin K, a nutrient that helps the body’s clotting function and may interfere with blood-clotting effects of certain medications, such as warfarin (Coumadin) and others.

Melatonin for sleep and immune support.

Green tea (Camelia sinensis) for antioxidant and immune effects. Use caffeine-free products.

Cat’s claw (Uncaria tomentosa) for inflammation, immune, and antifungal activity. Cat’s claw can interfere with a variety of medications, and may worsen certain conditions, such as leukemia and some autoimmune disorders.

Bromelain (Ananus comosus) for pain and inflammation. Bromelain can have a blood thinning effect and increase the effectiveness of blood-thinning medications, such as aspirin and warfarin.

Turmeric (Curcuma lon ga) for inflammation. Turmeric can have a blood-thinning effect and can increase the effectiveness of blood-thinning medications, such as aspirin and warfarin (Coumadin).

Rhodiola (Rhodiola rosea), for antioxidant, anti-stress, and immune activity.

 

 

Reference –

http://sacfs.asn.au/download/consensus_overview_fms.pdf\

http://www.awmf.org/fileadmin/user_upload/Leitlinien/041_D_Interdisziplinaere_V_fuer_Schmerztherapie/041-004le_S3_Fibromyalgiesyndrom_2012-04.pdf

http://www.niams.nih.gov/health_info/fibromyalgia/#b

http://www.medicinenet.com/fibromyalgia_facts/article.htm

http://www.mayoclinic.org/diseases-conditions/fibromyalgia/basics/risk-factors/con-20019243

http://www.rheumatology.org/Portals/0/Files/2010_Preliminary_Diagnostic_Criteria.pdf

http://www.healthline.com/health/fibromyalgia-causes#Overview1

http://www.nhs.uk/Conditions/Fibromyalgia/Pages/Causes.aspx

http://www.everydayhealth.com/fibromyalgia-pictures/8-natural-fibromyalgia-treatments.aspx