Fibromyalgia affects between 3-6 million Americans. It is characterized by pain, sleep disturbances and anxiety. Primarily a condition that affects women of childbearing age, men and elderly are not immune. Successful fibromalgia treatment is a multidisciplinary effort.
Fibromyalgia ranges from the very mild to the very severe. It is a chronic condition that affects 3.4% of women and approximately 0.5% of men. Fibromylagia has been a poorly understood disease for years. Many physicians believed that this was psychosomatic Ė or rather in the patients Ďheadí.
There is no specific conclusive test to diagnose fibromyalgia. However, the American College of Rheumatology established diagnostic criteria, which included tender points and the location of pain over time. Diagnosis is based on the symptomatology and a physical exam. There are 18 specific tender points on the body and a person with fibromyalgia is expected to be tender in at least 11 of those points.
Patients with fibromyalgia may experience sleep disturbances, wide distribution of areas of tenderness, and soft tissue pain. Recent research shows that patients have an altered sleep pattern and brain chemistry. Many sufferers report waking repeatedly during the night and not feeling refreshed after awakening. The more the sleep is disturbed the more severe the symptoms.
One third of patients with fibromyalgia have low insulin growth factor levels. Some of these also have elevated levels of neurotransmitter cerebral spinal fluid substance P. This substance is associated with enhanced pain perception. Patients also have low production of the steroid cortisol. The current theory is that the pain isnít associated with inflammatory damage but instead with a central defect in the processing of the perception of pain.
Fibromalgia treatment options include medications, exercise programs to stretch and strengthen the cardiovascular system, relaxation techniques to ease tension and anxiety, low dose anti-depressants, acupuncture, psychotherapy, behavior modification therapy, chiropractic care, massage therapy, physical therapy and education programs. Your doctor, with a qualified physical therapist, can design a tailored fibromalgia treatment.
Hypothyroidism can also mimic fibromyalgia. Patient with fibromyalagia will sometimes also present with myofascial pain, migraine headaches, irritable bowel syndrome, depression and temporomandibular Joint syndrome.
Pharmacological fibromyalgia treatment appears to be effective in some patients while worsening the symptoms in others. In most patients aerobic exercise and strength training activities are associated with significant improvement in pain, tender points, and disturbed sleep. Maintaining an aerobic regimen is difficult because of the pain. Patients may find it helpful to have a partner or strategy to stay motivated.
Acupuncture sessions in a fibromyalgia treatment program may vary widely but appear to improve the quality of life of patients. Patients with severe pain, and for whom other therapies are not effective use a chronic opiod analgesic medication. NSAIDís are not effective in a fibromyalgia treatment program.
Behavior modification training in a fibromyalgia treatment program, including coping skills, relaxation exercises and self-hypnosis may provide relief. Muscle relaxants, which might appear to be useful in a condition whose primary symptom is soft tissue pain, are used by some with varied results. A number of topical, non-narcotic pain creams have been found effective. Menastil is one; Corprofen another.
In a study published in Pain, 2004 researchers found that patients who had the best fibromyalgia treatment outcomes had an increased sense of control over the pain, believed they were not disabled, believed the pain does not indicate damage, had a strong exercise program, sought support from others and used coping self-statements. In another study reported in the American Journal of Physical Medicine and Rehabilitation 2003 researchers found that 78 participants in a 1.5 day multidisciplinary treatment program reported significant improvement in their lives one month later.
While fibromyalgia can be debilitating and painful it appears that patients who take control of their condition, as opposed to the condition taking control of them, fare better, have less pain and are more functional. Fibromyalgia treatment programs help sufferers to face their days with more hope and less pain.