Friday, April 9, 2010

Fibromyalgia

Fibromyalgia is a chronic disease, often debilitating, defined solely as a constellation of signs and symptoms characterized by diffuse pain, and fatigue. It is not contagious.

Fibromyalgia is seen in 3-10% of the general population, and is mostly found between the ages 20 and 50, in women more often than men. The nature of fibromyalgia is not well understood, and there is no western medical cure, though it can be managed. There are many complimentary and alternative therapies available including acupuncture, herbal medicine, and dietary therapies.

fibromyalgia symptoms

Not all patients display all symptoms of fibromyalgia. The primary symptoms include:

  • Widespread, diffuse pain, often including heightened sensitivity of the skin
    • This pain is seen both in the skin and muscles.
    • It is described as both aching and soreness.
    • Often times subtle stimulation to the skin such as the act of wearing clothing can cause extreme pain.
  • Achiness around joints
    • Unlike arthritis, fibromyalgia does not cause swelling.
    • Deformity in the joints is also not a sign of fibromyalgia. Rather, deformity of the joints would be indicative of osteoarthritis.
  • Nerve pain

Other possible fibromyalgia symptoms

Fibromyalgia CycleThese symptoms are often associated with fibromyalgia but may be due to other comorbid disorders. These symptoms include:

  • fatigue
  • irritable bowel syndrome (IBS)
  • genitourinary symptoms
  • dermatological disorders
  • headaches
  • symptomatic hypoglycemia

Although it is common in people with fibromyalgia for pain to be widespread, it may also be localized in areas such as the shoulders, neck, back, and hips.

Fibromyalgia symptoms may start as a result of trauma (such as a traffic accident) or illness, but there are no strong correlation between any specific type of trigger and the subsequent initiation of fibromyalgia.

Symptoms can have a slow onset, and many patients have mild symptoms beginning in childhood such as growing pains. Signs and symptoms of fibromyalgia are often aggravated by unrelated illness, or changes in the weather. They can become more tolerable or less tolerable throughout daily or yearly cycles.

Many people with fibromyalgia find that, at least some of the time, the disease prevents them from performing normal activities such as driving a car or walking up stairs. The syndrome does not cause inflammation as is presented in arthritis, nor are there any diagnostically abnormal laboratory findings.

Symptoms of fibromyalgia may present periodically or may be continual.

fibromyalgia diagnosis

When making a diagnosis of fibromyalgia, a practitioner would take into consideration the patients case history and the exclusion of other conditions such as endocrine disorders, arthritis, and polymyalgia rheumatica. There are also two criteria established by the American College of Rheumatology for diagnosis:

  • A history of widespread pain lasting more than three months. Widespread, as in all four quadrants of the body, i.e., both sides, and above and below the waist.
  • Tender points. There are eighteen designated possible tender points (although a person with the syndrome may feel pain in other areas as well). During diagnosis, four kilograms of pressure is exerted at each of the eighteen points; the patient must feel pain at eleven or more of these points for fibromyalgia to be considered. This technique was developed by the American College of Rheumatology as a means of confirming the diagnosis for clinical studies. It is also used in the United Kingdom. Unfortunately, while the vast majority of fibromyalgia patients express pain when these points are pressed, a few patients with a high pain tolerance may not feel exceptional pain during the test.

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