It is never a good feeling to experience physical discomfort ranging from a headache when waking up to a sore, balky knee after power walking. While some of these aches and pains can be traced back to a particular source, there are other instances when this is not the case. For others, it is all an unresolved mystery.
One mystery is a medical condition known as fibromyalgia.
Fibromyalgia is defined as a complex chronic pain disorder that may occur body wide or migrate throughout the body. Deconstructing the word, it means “pain in muscles, ligaments and tendons.” Approximately 10 million Americans (2-4%) suffer from fibromyalgia with a female to male ratio of about 8 to 2. It occurs in people of all ages, including children.
The actual causes are unknown, but it most likely involves a variety of factors working together. These may include:
- Genetics – Since fibromyalgia tends to run in families, there may be certain genetic mutations that make a person more susceptible to developing the disorder
- Infections – Some illnesses appear to trigger or aggravate the condition
- Physical/emotional trauma – fibromyalgia can be caused by a physical trauma, such as a car accident. Psychological stress may also trigger the condition
Symptom presentations vary. Other than strong pain, the following are the most common to be reported:
- Fatigue – The fatigue experienced is much more than being tired after a particularly busy day or sleepless night. It is an all-encompassing exhaustion that can interfere with occupational, personal, social or educational activities
- Sleep disorders – Some with the medical condition have an associated sleep disorder. During sleep, affected individuals are constantly interrupted by bursts of awake-like brain activity, limiting the amount of time they spend in deep slumber
- Other signs, symptoms, and overlapping conditions include: Irritable Bowel Disease (IBD) and irritable bladder, headaches, migraines, restless legs syndrome (periodic limb movement disorder), impaired memory and concentration, skin sensitivities and rashes, dry eyes, anxiety, depression, dizziness, vision problems, Raynaud’s Syndrome, neurological symptoms, and impaired coordination
Management of fibromyalgia requires a multidisciplinary team effort from health professionals. Pharmacologically management seeks to simply reduce intense pain to allow for better sleep. Common medicines include:
- Pain relievers – Over-the-counter pain relievers, such as acetaminophen ibuprofen or naproxen sodium, may be helpful. A doctor might suggest a prescription pain reliever such as tramadol. Narcotics are not advised because they can lead to dependence and may even worsen the pain over time
- Antidepressants and others medications – Duloxetine and milnacipran may ease the pain and fatigue associated with fibromyalgia. A muscle relaxant, cyclobenzaprine, may be prescribed to help promote sleep. Gabapentin and pregabalin, both of which are anti-seizure medications, have been efficacious as well.
The emotional toll of fibromyalgia may be substantial. Affected patients can experience greater psychological distress and impact on quality of life than those with other conditions. About half of all patients have difficulty with routine daily activities. Moreover, patients with fibromyalgia can lose jobs, possessions, and support from friends and family due to chronic symptoms.
Certain studies have shown that fibromyalgia symptoms remain stable over the long term, while others report an improvement in pain symptoms over time. Those with a significant life crisis, or who are on disability, have a poorer outcome, as determined by improvements in the patient’s ability to work, their own feelings about their condition, pain sensation tolerance, and levels of disturbed sleep, fatigue, and depression. Although the condition is lifelong, it is considered not fatal.
Krishan Jeyarajasingham MD is an individual who is planning to continue medical studies abroad in Australia. Global health, Human Rights, Education, & Poverty Alleviation are important to him.