The purpose of this article is to share awareness about fibromyalgia, what actually is fibromyalgia, its underlying causes, symptoms, past, and current diagnostic protocols, and treatment methodologies. The FDA approved medications, exercise plans, natural remedies and to clarify, is fibromyalgia an autoimmune disorder or not? which gender is at risk of being diagnosed.
What is Fibromyalgia
Fibromyalgia is defined as a condition that creates torment or pain all across the patient’s body. It is also known as a widespread musculoskeletal pain-causing fatigue, mental distress, and sleep disturbance. It is the second common disorder that affects bones and muscles. Fibromyalgia patients are more sensitive to pain than the normal population. It is a chronic problem but there are no tests present to confirm the diagnosis made by a healthcare professional. Therefore, most of the time it is misdiagnosed. Fibromyalgia is difficult to diagnose and treat. But lifestyle modification, using physiotherapy modalities and medications a healthcare professional can overcome this disorder. The brain misinterprets the pain signals and the patient overreacts to normal pain stimulation.
Symptoms of Fibromyalgia
Trigger points are present in the human body. Fibromyalgia patients experience pain in more than one region of the body. The body is divided into five regions if on diagnosis patients complain of pain in 4 out of 5 regions then health professionals consider it a diagnosis of fibromyalgia, and the diagnostic protocol is termed as “multisite pain.” In the entire process of diagnosing the disorder, a healthcare professional focuses on the area involved, the intensity of pain, pain duration, and time of onset. The common signs and symptoms include:
- Eye Dryness
- Musculoskeletal pain
- Sleep disturbance
- Bladder problem
- Fatigue and depression
Who is at more risk of fibromyalgia?
Males are at less risk of fibromyalgia. But yet it affects males as well and compromises their living, career, and lifestyle. But females are at more risk of fibromyalgia due to ligament laxity and hormonal imbalances. Research from the year 2016 finds more males to be affected by the anomaly. So it is hard to evaluate which gender is at more risk to be diagnosed with fibromyalgia. But we can say fibromyalgia symptoms in females are worse than males. In females, symptoms get worse after menopause.
What are the trigger points of myalgia?
In the past, health care professionals checked out the trigger points. If they find pain in 11 out of 18 trigger points they consider it as fibromyalgia. But currently, trigger points are no longer a diagnostic protocol. Healthcare professionals check for the regions of pain according to the multisite pain protocol. Trigger points used in past for diagnostic purposes are given below:
- Lateral elbows
- Upper chest
- Knees and hips
- Back of head
- Shoulders top
Fibromyalgia Pain in different segments:
Patients with fibromyalgia experience pain in different segments of the body in soft tissues and muscles. Pain intensity varies from patient to patient, it ranges from mild to unbearable pain. The underlying cause is still unknown but it appears to be caused by the abnormal nervous system. An abnormal response causes the patient to feel pain in different segments. Chest pain due to fibromyalgia may feel like a sharp, stabbing, and burning kind of pain. It may interrupt your breathing, in some cases, it becomes difficult to breathe. In low back pain back muscles are pulled and the patient feels a hurting pain, strengthening and stretching can help relieve the symptoms. Leg pain due to fibromyalgia is of deep, throbbing and burning nature. Patients might feel tingling and numbness in legs.
Causes of Fibromyalgia
It is idiopathic, researchers and healthcare professionals are not able to show evident causes of fibromyalgia. But current research shows that there might be different factors causing fibromyalgia including infections, genetic disposition, stress and trauma. Infections might be a link. The virus causing any particular infection might be a reason. The symptoms caused by that particular virus might get worse over the period of time and cause fibromyalgia. Trauma or stress might be of physical, mental, or emotional nature; a prolonged trauma might develop an anomaly. Stress causes hormonal imbalance and changes in the human body. Gene mutations or family history might be a cause. There are some genes present in the human body which might affect pain signals transmission across the body and brain.
Risk factors of Fibromyalgia
It can be caused by chronic illness, stress, infections, traumas, hormonal imbalance and gene mutations but there are some factors which increase the risk of being diagnosed including gender, family history, diseases and age. Females are at greater risk due to hormonal imbalance in females, especially after menopause. Family history or gene mutation might be the cause. Middle-aged people are more prone to fibromyalgia and symptoms get worse with ageing. People suffering from arthritis might also be diagnosed with the anomaly.
Diagnosis and examination
It is diagnosed using multisite pain protocol. There are no lab tests or MRI, Imaging scans available to confirm it. This is the reason it is hard to make a diagnosis for healthcare professionals and most of the time it is misunderstood.
Autoimmunity and Fibromyalgia
The symptoms of autoimmune diseases (multiple sclerosis, rheumatoid arthritis) are somehow similar to fibromyalgia symptoms. Some of the professionals thought it to be an autoimmune disease. But yet not claimed due to lack of research on it. Inflammation or swelling is not seen nor antibodies reproduction in fibromyalgia so we can not claim it as an autoimmune disease.
Treatment and Prevention
There is no well-known or evidence-based treatment but there are different methods using medications and physiotherapy modalities, lifestyle modification, improving diet, and self-care techniques that can help to cope up with the symptoms.
Medicines can help relieve pain and create ease for the patients. Antidepressants and anti-seizure drugs are used. Antidepressants control symptoms and rebalance neurotransmitters. Anti-seizure drugs contain gabapentin and pregabalin. The Pregabalin drug blocks pain signals from nerve cells, and it is the first drug approved by the FDA for treating fibromyalgia.
Other treatment options
There are different available remedies for controlling symptoms. These include physical therapy, dry needling, exercise plan, tai chi, acupuncture, behavioral therapy, meditation and yoga. Physical therapy strengthens the muscles and tissues and helps control pain. Exercise can make you feel healthy and active.
Some patients complain that some foods make their symptoms worse. There are some foods like gluten, dairy foods, or cheese products that make symptoms worse. Inform your healthcare professional about the list of those foods which enhance your symptoms making them worse. So he may design a diet plan for you, he may ask you to:
- Reduce sugar intake
- Drink a lot of water
- Exercise twice a day
- Eat fresh vegetables
- fruits and whole grains
- Eat low fat food
Summary and conclusion
Fibromyalgia is a chronic disorder, the underlying cause is still unknown, but might be caused by infections, traumas, stress, gene mutations, and family history. Patients feel more sensitive to pain due to chemical or hormonal imbalance. Healthcare professionals work to reduce pain and cope with the symptoms. Medications, exercise plans, physiotherapy, behavioral, psychological, and occupational therapy along with lifestyle modifications can improve the quality of life.
- Clauw, Daniel J. “Fibromyalgia: a clinical review.” Jama 311, no. 15 (2014): 1547-1555.
- Chakrabarty, Sangita, and Roger Zoorob. “Fibromyalgia.” American family physician 76, no. 2 (2007): 247-254.
- Clauw, Daniel J. “Fibromyalgia: an overview.” The American journal of medicine 122, no. 12 (2009): S3-S13.
- Goldenberg, Don L., Carol Burckhardt, and Leslie Crofford. “Management of fibromyalgia syndrome.” Jama 292, no. 19 (2004): 2388-2395.
- Mountz, James M., Laurence A. Bradley, Jack G. Modell, Ronald W. Alexander, Mireya Triana‐Alexander, Leslie A. Aaron, Katharine E. Stewart, Graciela S. AlarcóN, and John D. Mountz. “Fibromyalgia in women.” Arthritis & Rheumatism: Official Journal of the American College of Rheumatology 38, no. 7 (1995): 926-938.
- Bradley, Laurence A. “Pathophysiology of fibromyalgia.” The American journal of medicine 122, no. 12 (2009): S22-S30.