Fibromyalgia is a disorder characterized by diffuse musculoskeletal pain throughout the whole body. It is often accompanied by sleep issues, jaw pain, headaches, stomach problems, and depression. There is no special test, blood work, nerve or muscle test, or X-ray that confirms the diagnosis. Rather, diagnosis of Fibromyalgia is based on a patient’s history, medical exam, and the exclusion of other diseases that may cause similar problems.
Symptoms of Fibromyalgia
There are 2 core symptoms of fibromyalgia:
- Diffuse muscle pain
With diffuse muscle pain even a light touch of the skin produces pain. Typical locations of muscle pain include all four extremities, head and trunk. Muscle pain often interferes with sleep, and contributes to fatigue and depression. This constellation of problems is thought to be driven by an over-active nervous system, which is hypersensitive to sensory inputs.
Treatment of fibromyalgia is aimed at minimizing symptoms and maximizing function. People with fibromyalgia often greatly diminish activity and withdraw from normal interactions. A comprehensive strategy that teaches a person to understand the physical and mental aspects of the disease is often helpful. A multidisciplinary team that includes medical management, lifestyle, psychology, and physical therapy is one of the most effective strategies. Physical Medicine based pain clinics often coordinate such programs.
Medication management of fibromyalgia is aimed at modifying symptoms. There are 3 drugs now approved specifically for fibromyalgia. All these medications are considered neuropathics. They reduce the sensitivity of the nervous system so that stimuli are not perceived as intensely. Analgesics can be helpful when used judiciously, especially acetaminophen, anti-inflammatories, and occasionally tramadol. Symptom treatment for depression, and sleep management is also extremely important.
Fibromyalgia is a disorder that affects the whole body and every aspect of daily function. At this time, there is not a known cause and no definitive cure. Management of symptoms is the key to treatment. An experienced pain physician with a multidisciplinary team will often lead to the most beneficial personalized treatment strategy.
Thomas Cohn, MD
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