Generalized aches and pains are very common and are often the reasons that young patients seek medical care. There are multiple medical conditions that can cause muscle pain, one of them is a condition called fibromyalgia. This condition is often difficult to diagnose and when diagnosed can be very confusing for patients and family members. Patients look well, there are no obvious abnormalities on physical examination, and laboratory and imaging studies are normal.
Fibromyalgia is a disorder characterized by muscle pain all over the body and it is accompanied by fatigue, sleep, memory and mood issues. People with fibromyalgia often describe their symptoms as a flu-like infection that won’t go away. Other symptoms that can occur due to fibromyalgia include digestive disorders, headache/migraines, depression and/or anxiety, tingling or numbness in hands and feet and in female’s painful menstrual periods.
Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress. However in most cases, symptoms gradually accumulate over time with no single triggering event. It is unknown what causes fibromyalgia, only that anyone can get it, including children. However, it is most common in middle aged women and is now considered to be the most common cause of generalized, musculoskeletal pain in women between ages of 20 and 55 years. In the United States and in other countries, the prevalence is approximately 2 percent.
For the diagnosis of fibromyalgia doctors have to base their decision on symptoms and physical examinations as there is no specific lab test to determine fibromyalgia. All other disorders as well as any primary mood or sleep disorders have to be ruled out with careful history/examination and appropriate laboratory tests. For the diagnosis patient’s must present with a history of widespread pain lasting more than 3 months and the pain must be present in both the right and left sides of the body as well as above and below the wrist. The other diagnosis factor is presence of tender points. The body has 18 tender points, and for fibromyalgia 11 of them should be found to be tender on examination.
Sometimes doctors can diagnose fibromyalgia without checking for the number of tender points if the patient has many areas that feel painful, and is bothered a lot by symptoms that are often caused by fibromyalgia. There is no cure for fibromyalgia, but there are medicines and strategies to help with the symptoms. Treatment often requires a healthcare team which includes a doctor, physical therapist and possibly a professional trained in mental health like a counselor or psychologist or psychiatrist.
Treatment options include pain management, sleep management and psychological support. Pain management includes medication prescribed by a doctor to achieve pain relief and range from over the counter medications such as acetaminophen to non-narcotic antidepressant. Some of these medicines are normally used to treat depression or seizures but they may help as they work on the brain areas that deal with pain. Sleep management includes getting the right amount of sleep at night and maintaining regular sleep habits.
Patients should avoid caffeine and exercise close to bedtime as they are stimulating and can keep the patient awake. Finally, working with a professional trained in mental health will helps the patient in staying positive and maintaining a positive outlook towards life. Other treatment strategies that can benefit are light exercising such as walking, swimming, or riding a bike and yoga. It is also important to stay positive throughout. The patient’s outlook and beliefs plays an important role on how they feel pain.
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