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2April 28, 2009Fibromyalgia Awareness Day – May 12, 2009

Posted Apr 28 2009 12:00am

Fibromyalgia (FM) is a common and complex chronic pain condition that affects a person both physically and emotionally. It is considered a syndrome rather than a disease. The reason that it is not considered a condition is because medical conditions have specific causes and symptoms. A syndrome is different in that it includes several different signs, symptoms and medical problem that come together but yet are not related to any specific or identifiable cause. The main characteristic of Fibromyalgia is chronic widespread pain, including multiple tender points, unexplained abdominal pain, sleep disturbances, fatigue and psychological distress. Fibromyalgia affects millions of people worldwide.

Chronic widespread body pain is the primary symptom for those with fibromyalgia. Most people also experience moderate to extreme fatigue, sleep disturbances, sensitivity to light, sound and touch, and may have cognitive difficulties. Many suffers may also have overlapping conditions such as irritable bowel syndrome, lupus and arthritis. In many case, I have Rheumatoid Arthritis (RA) in addition to FM.

The pain associated with Fibromyalgia can be described as profound, chronic and widespread. It can travel to all parts of the body and vary in terms of intensity. FM pain can be described as stabbing and shooting, deep muscle aching, throbbing and twitching. Neurological complaints include numbness, tingling, and burning that add additional discomfort. Pain and stiffness are often times worse in the morning. Factors that aggravate pain include: cold/humid weather, lack of sleep, physical and/or mental fatigue, excessive physical activity, physical inactivity, anxiety and stress.

Fatigue associated with FM is more than just a feeling of being tired. It can be described as a large scale exhaustion that can get in the way of one’s personal and professional life. Symptoms include extreme and overwhelming exhaustion and lack of energy.

Many fibromyalgia suffers have associated sleep disorders that keep them from getting deep, restful and restorative sleep. Studies have shown that fibromyalgia patients are constantly interrupted by bursts of awake-like brain activity, thus indicating that deep sleep is limited.

Other symptoms and over lapping conditions include, but are not limited to, irritable bowel and bladder, headaches and migraines, restless legs syndrome (periodic limb movement disorder), impaired memory and concentration, skin sensitivities and rashes, dry eyes and mouth, anxiety, depression, ringing in the ears, dizziness, vision problems, Raynaud’s Syndrome, neurological symptoms, and impaired coordination.

Fibromyalgia can be quite difficult to diagnose as there are no current laboratory testing available for diagnosis. Doctors rely on patient history, self-reported symptoms, and a physical examination that looks for specific tender points. The exam criteria is based on the American College of Rheumatology’s guidelines and proper implementation of the exam is practiced to determine the presence of multiple tender points at specific locations on the body.

It is estimated that the average patient can wait up to five years to get an accurate diagnosis. Believe me, I have been there and suffered for many years without accurate diagnosis and even got to a point to where I was embarrassed to seek medical attention because no one could figure out what was wrong with me. The impression I was getting from the numerous health care providers I visited was that it was all my head. The truth is that many doctors are not sufficiently informed or educated about FM. Laboratory results can be negative and many FM symptoms overlap with other conditions which only lead to excessive medical costs and frustration for doctors and their patients. Of significant importance is the consideration of other diseases such as RA or lupus which do not rule out an FM diagnosis. In fact, FM is not a diagnosis that should be excluded and must be diagnosed by its own characteristics and symptoms.

For a doctor to diagnose a patient with FM, the patient must meet the following criteria:

Widespread pain in all four quadrants of the body for a minimum duration of three months
Tenderness or pain in at least 11 of the 18 specified tender points when pressure is applied

Doctors may not know what causes fibromyalgia but associate a variety of factors working together such as genetics, infections and trauma.

Genetics. Because fibromyalgia tends to run in families, there may be certain genetic mutations that may make you more susceptible to developing the disorder.
Infections. Some illnesses appear to trigger or aggravate fibromyalgia.
Physical or emotional trauma. Post-traumatic stress disorder has been linked to fibromyalgia.

As to the pain, there is a theory called “central sensitization.” This theory states that people with fibromyalgia have a lower threshold for pain because of increased sensitivity in the brain to pain signals. Researchers also believe repeated nerve stimulation causes the brains of people with fibromyalgia to change. This change involves an abnormal increase in levels of certain chemicals in the brain that signal pain (neurotransmitters). In addition, the brain’s pain receptors seem to develop a sort of memory of the pain and become more sensitive, meaning they can overreact to pain signals. Source: Mayo Clinic

Treatments for RA include medication, self-care and alternative medicine to minimize symptoms and improve general heath. Medications include: analgesics, anti-depressants and anti-seizure drugs. Lyrica is one of the first drugs approved by the Food and Drug Administration to treat fibromyalgia and results can be seen within seven days on Lyrica treatment. Therapy for Fibromyalgia includes physical therapy and counseling. In addition, self-care is critical in the management of fibromyalgia which includes reducing stress, getting enough sleep, regular exercise, pacing one’s activities and maintaining a healthily lifestyle. Alternative medicine can include: massage therapy, chiropractic care and acupuncture.

Currently, there is no cure for Fibromyalgia, but better ways of diagnosis and treatment continue through research and development. Since June of 2007, the FDA has introduced several no medications for treatment, including Lyrica and many others are currently in development phase. Research efforts are expanding as well. According to the National Fibromyalgia Association: “In 1990 there were approximately 200 published research papers on fibromyalgia studies. Today there are more than 4,000 published reports”.

I have learned many things about dealing with several chronic pain conditions. One that specifically comes to mind is the lack of understanding about conditions such as rheumatoid arthritis, lupus and fibromyalgia. All that we can do is educate ourselves, our families, friends and coworkers. In addition, it helps to know you are not alone. Organizations such as the Arthritis Foundation , the American Chronic Pain Association and the National Fibromyalgia Association (FMA) provide classes and support groups. These groups can often provide help and advice that cannot be found elsewhere. They can also put you in touch with others who are going through the same things and can understand what it is you are going through.

2009 National Fibromyalgia Awareness Day

The major theme for this year’s National Fibromyalgia Awareness Day campaign is “Fibromyalgia Affects Everyone” and will “focus on the far-reaching effects of this disorderfrom broken lives to the economic costs to patients and society.” For more information on this important event, click HERE and you will be directed to FMA’s awareness day page. I will blog some more about the 2009 awareness day on May 12.

Sources: The Mayo Clinic
National Fibromyalgia Association

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