Fibromyalgia
Therapeutic treatments
by Dr Banshari Mridha
Fibromyalgia is a pain condition most common among middle-aged women. Patients suffering from this condition complain of chronic sore muscles all over the body _ most commonly in the neck, shoulders, back and hips _ and feel too weak and exhausted to perform daily chores. They may also experience mental haziness due to memory and thought problems and inability to concentrate, leading to decreased cognition and overall functional status.
Cause
It may be genetically predisposed, as a positive family history is usually noted. Someone with fibromyalgia brain and spinal cord processes pain differently than a normal individual, making them experience pain more intensely.
Also, the sufferer has poor sleep quality, leading to limited stage-4 deep sleep during which muscles recover from the days wear and tear. This results in achy, sore and tender muscles that are unable to regain normalcy.
Stress, trauma or repeated injury may increase the pain.
Symptoms
Chronic muscle pain or flu-like aching, particularly at trigger points, distributed in the neck area, shoulder and back muscles.
Stiffness in muscle after prolong rest or sleep are also common features.
Headaches that seem like migraines.
Debilitating fatigue and tiredness all day long, even after adequate sleep and rest.
Poor sleep quality, resulting in waking up tired and lethargic.
Anxiety and depression.
Fibro fog, type of mental clouding, manifested by diminished concentration and memory loss which hamper performing everyday tasks.
Change in bowel and bladder habits.
Numbness and tingling in hands, arms, feet, and legs.
Painful periods in women.
Diagnosis
A simple way physicians may affirm this condition is to apply mild pressure to the tender points. If discomfort occurs at 11 or more of these points, one can be certain that the person has fibromyalgia.
However, the main symptoms of fibromyalgia _ pain, soreness and crippling fatigue _ usually overlap with many other conditions, making diagnosis quiet difficult. It can easily be mistaken for diabetes, hypothyroidism, depression, rheumatoid arthritis or other autoimmune diseases.
There are no simple blood tests or X-rays to confirm it; a multidisciplinary team of doctors needs to be consulted as it is a diagnosis of exclusion.
Treatment
Drugs- Antidepressants such as Duloxetine, NSAIDS (nonsteroidal anti-inflammatory drugs) such as Ibuprofen, anticonvulsant drug Pregabalin are the mainstay of treatment.
Physical therapy- Combination of therapeutic massage, heat waves, controlled supervised exercise and stretching painful muscles can be advantageous for optimal relief.
Hydrotherapy- Applying moist heat or ice packs to affected muscle groups can help bring some relief.
Tips
Exercising regularly - Gently introducing exercise to daily routine as much as a person can tolerate has shown to be most beneficial. Exercise causes endorphins release which is a natural painkiller and mood elevator. Aerobic exercise, fast walking or swimming are the best option.
Proper sleep- maintaining a regular sleep cycle by going to bed and waking up at the same time every day and following a healthy sleep routine (no laptop, TV or internet while trying to sleep) have shown to be effective.
Eating well- A balanced healthy diet, without too much artificial sweetener or stimulants like caffeine, is helpful.
Deep tissue massage- Stimulates blood circulation and releases chronic tension.
Deep breathing relaxation techniques- Helps to alleviate stress, which has shown to be a trigger factor.
Acupuncture- May improve pain tolerance level.
Other therapeutic treatments include meditation, yoga, heat applications, warm baths and stretching exercises that improve the range of movement and lower discomfort.
The writer is a doctor of Internal Medicine
