All that you want to know fibromyalgia?
Fibromyalgia is a long-term condition that causes pain and tenderness all over your body. 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.
The condition is also linked to:
- poor sleep
- feeling you can’t concentrate or remember things
- extreme and constant tiredness that doesn’t improve with sleep or rest – which is known as fatigue.
In the past, some healthcare providers even questioned whether fibromyalgia was real. Today, it is much better understood. Some of the stigma that used to surround it has eased. Fibromyalgia can still be challenging to treat. But medications, therapy, and lifestyle changes can help you to manage your symptoms and to improve your quality of life.
Fibromyalgia causes what is now referred to as “regions of pain.” Some of these regions overlap with what was previously referred to as areas of tenderness called “trigger points” or “tender points.” However, some of these previously noted areas of tenderness have been excluded. The pain in these regions feels like a consistent dull ache. Your healthcare provider will consider a diagnosis of fibromyalgia if you’ve experienced musculoskeletal pain in 4 out of the 5 regions of pain outlined in the 2016 revisions to the fibromyalgia diagnostic criteria.
This diagnostic protocol is referred to as “multisite pain.” It’s in contrast to the 1990 fibromyalgia diagnostic criteria definition for “chronic widespread pain.” This process of diagnosis focuses on the areas of musculoskeletal pain and severity of pain as opposed to an emphasis on pain duration, which was the previously the focal criteria for a fibromyalgia diagnosis.
Other symptoms of fibromyalgia include:
- trouble sleeping
- sleeping for long periods of time without feeling rested (nonrestorative sleep)
- trouble focusing or paying attention
- pain or a dull ache in the lower belly
- dry eyes
- bladder problems, such as interstitial cystitis
It’s common for your condition to flare-up, making your symptoms suddenly worse.
Fibromyalgia can also cause:
- forgetfulness or poor concentration
- stress, worry or low mood
- tingling, numbness or swelling of your hands and feet
- restless legs syndrome – a tingling, uncomfortable feeling in your legs, especially at night
- irritability, or feeling low or weepy
- feeling like you urgently need to urinate, especially at night
- painful menstrual periods
- diarrhoea, constipation and stomach pain – sometimes separately diagnosed as irritable bowel syndrome (IBS)
- increased sensitivity to things like cold, sound, knocks and bumps
- tender or overly sensitive joints and muscles.
The pain may feel like it’s affecting your whole body, or it may be particularly bad in just a few areas. Some people say their pain gets worse in extreme temperatures, such as very hot, cold or damp weather.
People often say that besides the pain, fatigue is the worst part of fibromyalgia. This can be linked to a difficulty to think clearly or remember things properly, which is sometimes called fibro fog or brain fog.
Though the reason is not very specific, there does seem to be a common link with things such as arthritis, a traumatic event, and mental health and well-being.
Fibromyalgia isn’t caused by damage or an injury to the body. But it does increase the sensitivity of your nerve endings, which means you could feel pain from a small amount of pressure or minor knocks. One theory is that the condition is caused by problems with a person’s central nervous system – which controls all the sensations and movements the body makes.
Studies have shown that parts of the brain that register pain react differently if you have fibromyalgia. This means you feel pain when other people just feel uncomfortable or stiff. People with fibromyalgia often don’t get enough deep sleep. Research shows that lack of good quality sleep can make pain worse, and maybe even cause pain. Pain, unhappiness, depression and stress can all make you sleep badly. Symptoms often start after an illness, accident, or a time of emotional stress and anxiety. When you’re low or depressed, your pain can also feel worse. At the same time, your pain can make you feel more stressed.
Unlike conditions, such as arthritis, the pain you feel with fibromyalgia isn’t caused by visible inflammation or damage to your body. This doesn’t mean the symptoms of fibromyalgia are unreal or ‘all in your mind’. However, anxiety, physical or mental trauma, and sleep disturbance are all thought to play a part in the condition.
Fibromyalgia can sometimes be difficult to diagnose, as the symptoms vary from person to person. There are some common symptoms your doctor will look for to help diagnose fibromyalgia, including:
- severe pain that has lasted three months or more
- regularly waking up feeling unrefreshed
- problems with your memory and understanding.
It may help your doctor understand the problems you’re having if you make a list of any physical or psychological problems you’ve experienced. They will probably then carry out a physical examination.
There aren’t any specific blood tests, x-rays or scans to confirm a diagnosis of fibromyalgia. But you might have blood tests to check for other conditions.
Many symptoms of fibromyalgia are similar to those of other conditions, such as rheumatoid arthritis. Some people may be diagnosed and treated for one of these other conditions. It is also possible to have one of these conditions as well as fibromyalgia.
Your doctor may also suggest a referral to:
- a Rheumatologist – a doctor who specializes in conditions affecting the bones, joints and muscles. They may confirm your diagnosis.
- a Physiotherapist – who can suggest exercises and relaxation techniques
- a Clinical psychologist or counsellor – who may use methods such as cognitive behavioral therapy (CBT) and mindfulness
- an Occupational therapist – who can advise you on the best way to carry out daily activities and work around your condition
- a community or hospital-based specialist pain clinic, or chronic fatigue service – who can help you manage your symptoms.
There are a number of ways your symptoms can be managed.
In many cases, fibromyalgia can be diagnosed and treated by your GP, without the need to see a specialist.
They can advise you on treatments and therapies that tackle specific symptoms. These may include drug treatments. However, physical and psychological therapies can often be a more effective way of managing fibromyalgia than medication.
There are also many things you can do for yourself that can change the way your condition impacts upon your life.
Depending on how your fibromyalgia is affecting you, your doctor may refer you to a physiotherapist or occupational therapist.
Physiotherapy can help relieve the pain of fibromyalgia.
Physiotherapists are trained specialists who can help you stay active and independent. They will show you the best exercises to strengthen your muscles, without hurting yourself or putting your body under too much strain. Physiotherapy shows you how something as simple as improving your posture can help your pain. Physiotherapist may also advise you on relaxation techniques which can be just as important as exercise when you’re dealing with fibromyalgia. It can be quicker to see a physiotherapist privately, but you would pay for the appointment.
Occupational therapy can help you manage your everyday activities around your fibromyalgia, without increasing your pain or overwhelming yourself.
Your occupational therapist may suggest new ways you can get things done. They may also teach you some relaxation techniques. If you still find some activities difficult after you’ve made these changes, they may suggest equipment, known as aids and adaptations, to help you. Your doctor can refer you to an occupational therapist.
Pain clinics and pain management programmes
Pain clinics bring together the skills of a wide range of professionals, such as:
- specialist pain consultants
- occupational therapists
- social workers
- employment advisors.
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 behavioral therapy (CBT), which is a talking therapy, try to reduce the overwhelming effect of problems such as stress, unhappiness and pain. They aim to help you understand how you react to different problems by breaking them down into smaller, more manageable, chunks. This should help you change the way you react to them and the effect they have on you.
Your doctor can prescribe medications to help with the pain, sleep problems or depression you may be experiencing because of your fibromyalgia.
Drugs can’t treat fibromyalgia alone, but they can help reduce your symptoms to a level that will allow you to start some gentle physical activity and rehabilitation therapies.
All drugs have potential side effects. It’s important to talk to your doctor about how to get the best balance between pain relief and any unpleasant effects.
If you feel like a treatment isn’t helping you, talk to your doctor.
Fibromyalgia pain relief
Fibromyalgia pain can be uncomfortable and consistent enough to interfere with your daily routine. Don’t just settle for pain. Talk to your healthcare provider about ways to manage it. Sometimes medicines are prescribed. These medications bring down inflammation. Though inflammation is not a primary part of fibromyalgia, it may be present as an overlap with RA or another condition. Pain relievers may help you sleep better. Please note that NSAIDS do have side effects. Caution is advised if NSAIDS are used for an extended period of time as is usually the case in managing a chronic pain condition.
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