FIBROMYALGIA SYNDROME

FIBRO - (FIBRES)
MY - (MUSCLES)
ALGIA - (PAIN)

 

Fibromyalgia Syndrome (FMS) is a common illness, as common as rheumatoid arthritis and even more painful. The name Fibromyalgia is made up of as indicated above 'fibro' for fibrous tissues such as tendons and ligaments; 'my' indicative of muscles and 'algia' meaning pain. It is a chronic, critical condition which includes widespread pain, profound fatigue and an array of other associated symptoms. The muscle pain tends to manifest itself as diffuse aching or burning, often described as being felt from head to toe. It tends to fluctuate and can be more or less frequent at certain times. It may also change location, usually becoming more severe in the parts of the body most in use.

The fatigue ranges from feeling tired, to the exhaustion of a flu-like illness. It may come and go and people can feel drained of all energy - as if someone has 'just pulled the plug'.

MAIN SYMPTOMS OF FIBROMYALGIA

  • Widespread Pain

  • Chronic Fatigue

  • Non Restorative Sleep

Associated symptoms

  • Headaches - ranging from 'ordinary' to migraine

  • Poor memory/Concentration

  • Irritable Bowel Syndrome (IBS)

  • Restless Leg Syndrome (RLS)

  • Depression or Anxiety

  • Raynauds Phenomenon

  • Mitral Valve Prolapse (MVP)

  • Vertigo/Dizziness

  • Tingling/Burning Sensations

  • Dry eyes/Mouth

  • Heartburn/Reflux

  • Dysmenorrhea

  • Hypersensitivity

Hopefully you will not have all of these symptoms. If you develop something new e.g - tingling in your hands or feet check it out with your GP. Don't assume everything is fibromyalgia related. Unfortunately it probably will be. Many of the symptoms are shared by other illnesses so you need to rule these out.

DIAGNOSIS

Please do not use this list for self diagnosis but check it with your doctor. FMS is not new, but in recent times has been difficult to diagnose as the condition can not be identified in standard laboratory tests and x-rays. Many of its signs and symptoms are found in other conditions as well - especially Chronic Fatigue Syndrome (CFS) and Multiple Sclerosis (MS). GP's can diagnose fibromyalgia but if your GP is uncertain or unfamiliar with fibromyalgia you should ask for referral to a Rheumatologist for confirmation. Be aware that once fibromyalgia is diagnosed a Rheumatologist will rarely give you review appointments, it is your GP who will be treating you in the long term. Diagnosis is made by physical examination and from medical history.

Criteria for Diagnosis

Currently fibromyalgia cannot be diagnosed by any laboratory tests or by x-ray/mri scan. These are used to rule out other possible causes. Once other medical conditions have been ruled out, through testing, diagnosis depends on three main symptoms:

  • Widespread pain i.e pain in all four quadrants of the body (above and below the waist/ left and right side

  •  Pain in at least 11 out of 18 specified tender  points when pressed (these 'tender points', or spots of tenderness are rarely noticed by the patient until pressed).

  • Sleep disturbance

 

WHAT CAUSES FMS?

Although the true cause of fibromyalgia is unknown researchers are leaning towards a neurological background (to do with the nervous system,) rather than a rheumatic cause (joints and soft tissues).  It is known that most people with FMS are deprived of deep, restorative sleep. Current studies have found out how to improve the quality of sleep. Latest research has identified a deficiency of Serotonin in the central nervous system and a resulting imbalance of Substance P. The effect is Disordered Sensory Processing (the brain registers pain when others might experience a slight ache or stiffness). this has the effect of making those suffering with FMS, hypersensitive.

FMS is often found to develop after a trauma (physical or emotional) which appears to act as a catalyst e.g a fall, a car accident, a viral infection, childbirth or an operation. Sometimes the condition begins without any obvious trigger.

OUTLOOK

Although Fibromyalgia is a chronic syndrome it is not degenerative, (no detectable changes occur over time.) Worsening of symptoms is caused in the main part by a de-conditioning of the muscles due to the pain, which inhibits their use.

 

CURRENT TREATMENT

At the present time treatment for FMS aims at reducing pain and improving sleep. In other words, some of the symptoms are being treated, rather than the condition itself. The most effective treatment is often through a multidisciplinary approach, using medications, complementary and supportive therapies, and lifestyle adaptations. The symptoms of Fibromyalgia are diverse and vary among patients, therefore, treatment programs must be individualized for each patient. treatment programs are most effective when they combine patient education, stress reduction, regular exercise, and medications. Your GP will be able to discuss possible medications, which will help. These can include pain killers and tricyclic drugs, used to treat depression, although doses for fibromyalgia are much lower than for depression. In some cases, these drugs will help both sleep and pain. Over the counter medications may help to relieve pain but severe pain may require the expertise of a pain clinic. Your GP can refer you to a pain clinic and other specialists eg. Physiotherapists, Clinical Psychologists. They can help you to develop coping techniques for dealing with pain. Recent studies have verified that the best outcome for each patient results from a combination of approaches that involves the patient in customization of the treatment plan.

 

ALTERNATIVE REMEDIES AND TREATMENTS

There are many different forms of alternative treatments available whether it be hands on Therapies such as Massage, TENS (Transcutaneous Electrical Nerve Stimulation), Cryotherapy (Cold Therapy), Heat Therapy or going to a Chiropractor. These, however, can become expensive and knowing which is going to be the most suitable for you is often just guess work. Personal recommendation from a fellow sufferer is often the best way to find good practitioner. Some of the aforementioned treatments can be practiced at home for example the benefits of heat and cold should not be underestimated. The use use of a hot water bottle, and taking hot baths or showers will help to reduce pain and banish morning stiffness. Soaking your hands and feet in hot water for a few minutes can ease aching and chill packs can also be beneficial to some.

Millions of people rely on alternatives remedies and treatments to help them with chronic conditions such as Natural herbs and supplements, Acupuncture or Acupressure and Aromatherapy.  This an prove expensive and finding what is beneficial to you can involve a lot of trial and error. Do not presume that natural herbs and supplements can not be harmful, most people never consider mentioning to their doctor that they are taking a herb or supplement. It is extremely important that you inform your doctor as some herbal remedies or supplements can interact with other medications you take, increasing or decreasing their effects.

MANAGING FIBROMYALGIA: HOW YOU CAN HELP YOURSELF

Exercise is the most common 'prescription' for FMS. Two kinds of exercise are of benefit: stretching and aerobic. Both should be done gently at first, for a few minutes at a time. As pain permits, exercise time can be increased gradually.

Effective stretching exercises can be recommended by a physiotherapist or found in books, on a DVD or a local yoga class. Tai Chi is extremely beneficial as the exercises are relatively easy to perform for people with muscle problems and can also help with relaxation in a meditative way.

Aerobic exercise should be the low impact type: walking or moving around in warm water are excellent. Aquatherapy in groups in a hydrotherapy pool can be very beneficial to retain mobility. Some gym clubs run aqua aerobics classes which are worthwhile attending as long as the pool is heated to a minimum of 28 degrees. Swimming is also very effective but again the pool must be heated to a minimum temperature of 28 degrees.

A healthy diet is important to provide the body with protein, vitamins and minerals. It is best ti avoid coffee, tea and alcohol. Some sufferers have a tendency to gain weight which can be distressing. Following a healthy diet could, in turn, help with weight control. As long as you are not allergic to diary products a glass of milk at bedtime not only helps the body tissues repair but can also assists in sleep.

Learning to pace yourself, with the addition of relaxation techniques works really well for almost everybody with FMS. It reduces tension in the mind and body almost immediately. The results are calming for all the symptoms, especially for the pain. Rest is vitally important so you must listen to your body when it tells you to slow down. It is important to pace yourself as overdoing it may simply make matters worse.

 

RECOMMENDED READING

Fibromyalgia for Dummies - Roland Staud, M.D and Christine Adamec: ISBN: 0-7645-5441-7

Self Management of Long-term Health Conditions: A handbook for People with Chronic Disease, Expert Patients Programme Community Interest Company (EPPCIC): ISBN: 978-1-933503-12-7

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