Fibromyalgia is a serious medical condition that causes debilitating pain. The pain is pervasive and extremely unbearable, it also increases the sensitivity of the body to pain thus what normally was not very painful may become excruciating.
The origins of the word are from Greek and Latin and they very aptly describe the kind of pain that one feels, that is, musculoskeletal pain.
The condition primarily affects processes in the central nervous system, particularly those involved with pain perception.
The severity of pain can handicap a person and make carrying out normal activities immensely difficult.
The heightened sensitivity to pain affects the other senses as well with patients reporting increased sensitivity to light, noise and temperature.
Causes and Diagnosis
The most puzzling aspect of fibromyalgia is that it can be caused by very different means. The condition could develop as a result of infection, after a significant physical trauma, an invasive surgery or after major psychological stress.
In other cases that have been reported just as often, there be no single event that triggers it. So it has hard to take any precautions against it.
The exact cause of the disorder is not known but it is thought that genetic and environmental factors play an equal role.
However, the genetic factor predisposes a person to develop the disorder if the related environmental effects accumulate over time. To add to its mystic, there is no specific diagnostic test which can detect fibromyalgia.
The diagnosis involves ruling out other potential causes of symptoms and checking that fixed number of symptoms are present.
In the past it was thought of as an arthritis-like condition, but it is not as it does not cause any inflammation or damage to joints, muscles or other connective tissue. It is however a rheumatic condition because it has an impairing effect on the joints and muscles.
Symptoms and Pain
There are a few symptoms associated with this condition which are rather easy to identify. The widespread pain is a hallmark of this disease and is often unbearable.
Although the pain is generally throughout the body it is accentuated in some parts such as the back and neck.
There is continuity in the pain, but its intensity fluctuates. The pain intensity is in large dependent on how stressed out a person is, any change is weather that can alter pain perception and the level of physical activity a person undergoes.
The pain is persistent on both sides of the body and is described differently as throbbing, stabbing, pounding, shooting and aching.
It has also been linked with the restless legs syndrome and painful menstrual periods. Other fairly common characteristics are devastating headaches accompanied by migraines.
Patients suffer from fatigue, and the intensity of the pain does not allow them to sleep. If they succeed in catching some shut-eye it they do not feel rested and wake up with a stiffness in their body.
The pain in their nervous system prevents it from inducing deep REM sleep, which has a rejuvenating effect on the body.
The disorder causes the muscles to contract very tightly and painfully and the patient feels the pain deep in his muscles.
Repetitive movements tend to aggravate the pain, hence people limit their activities and avoid exercise. This shift in lifestyle causes them to become unfit and makes their fibromyalgia more unmanageable.
The overpowering fatigue makes it extremely difficult to go about every day activities, as they feel weighed down and drained of all energy.
Patients also report a heightened sensitivity which are medically known as hyperalgesia and allodynia.
This means increased sensitivity to pain and feeling pain from something that is not painful at all. This increased pain threshold is a cardinal identifier of the condition.
People suffering from this condition may also develop some tender points, which have the aforementioned low pain threshold.
The location of these tender points are muscle tendon joints and areas where there is more mechanical force applied. This makes the already amplified pain sensation worst.
Fibromyalgia and Cognitive Disorders
Fibromyalgia’s ability to curtail normal functioning can also be judged from the cognitive impairment that it causes.
It affects the mental processes of thinking, remembering and learning. In this mentally ‘foggy’ state which is also colloquially called ‘fibro-fog’ individuals will find it difficult to remember things and grasp new concepts.
The attention span keeps on decreasing and it may also cause mild speech impairment.
Although the speech will not be slurred, it will be slow and confused due to the hindrance in a coherent thought process.
How long this last varies with case and severity. Described as a chronic illness, its symptoms may persist for a long period of time and a lot of will power is required to go through the illness every day.
Patients need to be wary of depression that either accompanies fibromyalgia or causes it.
Depression can cause patients to drastically alter their lifestyles, neglecting themselves and their medication which would further aggravate their condition.
Depression coupled with fibro-fog can be a very challenging condition to overcome as the patient loses the ability to think clearly and manage his pain.
The disease causes changes in hormonal levels which make patients more prone to depression.
Types of Fibromyalgia and Treatment
There are typically four kinds of fibromyalgia; extreme sensitivity to pain without psychiatric symptoms, fibromyalgia and pain related depression, depression with concomitant fibromyalgia and fibromyalgia caused by somatization.
The treatment for each time varies, common treatment methods include: analgesics and mild opioids for pain management, anti-depressants for depression related or depression causing onset , anti-seizure medication for convulsions and muscle spasm related symptoms and cognitive behavioral therapies for psychological symptoms.
Usually, a multidisciplinary approach utilizing the arsenals across the board is most effective in relieving the patient.
This condition is more prevalent in women than in men. They are twice as more likely to develop this disease.
As fibromyalgia is a relatively new illness, there is much controversy regarding its classification, diagnosis and treatment.
Although physicians unanimously agree that changes in lifestyle and diet are always beneficial to patients.
A healthy diet and exercise is often the best treatment alongside pain management. Hopefully, we will uncover more about this disorder in the future.
Wolfe, Frederick, et al. “Aspects of fibromyalgia in the general population: sex, pain threshold, and fibromyalgia symptoms.” The Journal of rheumatology 22.1 (1995): 151-156.
Wolfe, F., et al. “Serotonin levels, pain threshold, and fibromyalgia symptoms in the general population.” The Journal of rheumatology 24.3 (1997): 555-559.
Kaartinen, K., et al. “Vegan diet alleviates fibromyalgia symptoms.”Scandinavian journal of rheumatology 29.5 (2000): 308-313.
Taggart, Helen M., et al. “Effects of T’ai Chi exercise on fibromyalgia symptoms and health-related quality of life.” Orthopaedic Nursing 22.5 (2003): 353-360.
Younger, Jarred, and Sean Mackey. “Fibromyalgia Symptoms Are Reduced by Low‐Dose Naltrexone: A Pilot Study.” Pain medicine 10.4 (2009): 663-672.
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