The Challenge of Fibromyalgia

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"The Healthy Geezer" answers questions about health and aging in his weekly column

Question: My sister went through a nightmare of doctor visits before she finally found out she has fibromyalgia. Why did it take so long for her to get a correct diagnosis?

Answer: What your sister endured is common. It's not easy to diagnose fibromyalgia with just a laboratory test. Healthcare practitioners have to rely on symptoms to make a diagnosis.

Unfortunately, symptoms of fibromyalgia can vary, depending upon the person.  To further complicate matters, fibromyalgia imitates other conditions, including rheumatoid arthritis, multiple sclerosis and lupus.

The word fibromyalgia comes from the Latin term for fibrous tissue (fibro) and the Greek terms for muscle (myo) and pain (algia). Fibromyalgia is not a disease. It's a syndrome, which is a group of symptoms that doesn’t have a single cause. It is characterized by widespread pain, tenderness and fatigue.

Other symptoms of fibromyalgia may include cognitive difficulties (the so-called fibro fog); sleep disturbances; morning stiffness; headaches; irritable bowel syndrome; painful menstrual periods; numbness or tingling of the extremities; restless legs syndrome; and sensitivity to heat, cold, noise; and light.

About 5 million people in the United States have fibromyalgia. More than 80 percent are women. Most people are diagnosed during middle age.

While fibromyalgia is a chronic condition, it is not progressive. It is never fatal, and it will not damage the joints, muscles or internal organs. In many people, the condition improves over time.

The causes of fibromyalgia haven't been found. There is speculation that the syndrome may be caused by trauma or repetitive injuries. According to one theory, people with fibromyalgia may have genes that cause them to react strongly to stimuli that most people would not perceive as painful.

The American College of Rheumatology has established criteria for diagnosing fibromyalgia. A person must have diffuse tenderness and a history of widespread pain lasting more than three months. Pain is considered to be widespread when it affects all four quadrants of the body.

Fibromyalgia can be difficult to treat. Often, treatment often requires a team of healthcare professionals including a doctor, a physical therapist and others. There are clinics that specialize in fibromyalgia.

Antidepressants may be prescribed to people with the syndrome. They work by elevating the levels of brain chemicals that are associated not only with depression, but also with pain and fatigue. Increasing the levels of these chemicals can reduce pain in fibromyalgia sufferers.

People with fibromyalgia also may benefit from a combination of physical and occupational therapy; pain management and coping techniques; and a proper balance of rest and activity. Some people also report benefit from massage, movement therapy, chiropractic treatment and acupuncture.

Lifestyle changes can also minimize the effects of fibromyalgia. Getting enough sleep, exercising and making changes at work can make a difference. For example, some people cut back on the number of hours they work or switch to a less demanding job. Working with an occupational therapist to design a more comfortable work station may also help.

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All rights reserved © 2012 by Fred Cicetti