Although the term is quite new, fibromyalgia was described in the Bible. Other terms include fibrositis, myofibrositis, and tender point syndrome. Fibromyalgia is a major, costly cause of long-term disability. One large insurance company in Canada made payments of $11 million a year to clients with fibromyalgia.
We do not know what causes fibromyalgia. Although there are many theories, none have stood the test of time. It was once thought that pain in the muscles came from inflamed tissue. One doctor named the condition fibrositis, as ‘itis’ means inflammation. However, studies on muscle tissue of fibromyalgia patients did not show inflammation.
Other studies tried without success to link virus or bacteria. Though some people with fibromyalgia have high stress levels, stress has never been shown to cause it. For reasons that are not understood, some people involved in motor vehicle crashes develop symptoms. Some studies in their early stages suggest the problem may exist within the nerve function.
The main symptom of fibromyalgia is muscle pain. Muscle stiffness, joint pain, disturbed sleep, headaches, fatigue, abdominal cramps and bloating are other signs.
Morning is the most difficult part of the day for many, as muscles feel stiff and sore. Waking during the night with muscle pain makes matters worse. Daily activities are difficult. People with this condition feel tired. Exertion can cause more muscle pain, while sitting at a desk makes muscles feel stiff.
Fibromyalgia can be hard to diagnose. Symptoms are similar to those of many forms of arthritis. Even after a careful history and physical exam, a long time of observation may be needed to be sure. Blood tests and x-rays may search for evidence of other causes, but no lab tests can diagnose fibromyalgia.
You may be referred to many doctors in the search for a cause of the pain. Uncomfortable and costly procedures may be done before diagnosis is made.
Fybromyalgia - Tender Points
One key in diagnosing fibromyalgia is finding tender points. These tender points, 18 in all, are at specific sites throughout the body.
Tender points are represented by the glowing red dots on the image above. Tender points are present above and below the waist and on both sides of the body. Guidelines for diagnosing fibromyalgia include tenderness in at least 11 of the 18 points.
Understanding the condition
Education plays a major role in treating fibromyalgia. Many people worry about becoming unable to care for themselves. However, this is not a disease that damages muscle and joints. Others, when told that their lab tests are normal, fear doctors suspect them of pretending to be ill. Learning about the condition is essential to understanding it. As well, doctors must learn to recognize fibromyalgia and resist ordering more tests in a futile search for another cause.
Exercise is an important part of fibromyalgia treatment. Up to 80 per cent of fibromyalgia patients are not fit. Aerobic exercise helps reduce pain. However, many are reluctant to begin an exercise program. Some say that it will increase pain, while others feel too tired to exercise. Advice and encouragement is often needed to start and continue exercising.
Evidence shows that supervised aerobic exercise helps fibromyalgia symptoms. Strength training may also be a benefit. Slowly increase exercise intensity until you reach a moderate level. If symptoms get worse, cut back until they improve. Check with a health care provider about any ill effects.Why exercise?
In studies, aerobic exercises were done at least 20 minutes a day (or twice for 10 minutes), two or three days a week. Strength training was done two to three times a week, with at least eight to 12 repetitions per exercise. The program lasted two and a half to 24 weeks. Results suggest that compared to no exercise:
No specific medication is available for fibromyalgia. Except for a small number of patients, anti-inflammatory drugs do not help. Over-the-counter painkillers relieve a few patients. However, usually neither these nor more powerful prescription painkillers help.
Low doses of some anti-depressant medications can ease sleep disturbance and fatigue. Still, many have problems with side effects. Some people with fibromyalgia are depressed. In this case, treating depression can improve symptoms.
Alternative medicines may relieve the symptoms of fibromyalgia. Keep in mind that no large studies have been done on these treatments.
Fibromyalgia is a common, painful muscle condition with no known cause. It will not permanently damage muscles, bones or joints, but does cause fatigue and sleep disturbance. Understanding this condition, and following a proper exercise program, can make a difference. Drug treatment mainly relieves pain and improves sleep patterns.