MY STORY A plan for a frustrating health condition that confounds doctors and victims alike. You hurt all over. You feel constantly fatigued, but have trouble sleeping. Yet, despite countless tests your doctor finds nothing measurably wrong with you. It’s a familiar scenario if you’re affected by fibromyalgia.
A PHYSICAL CAUSE? Fibromyalgia is a puzzling syndrome that’s characterized by chronic pain(often described as a deep ache or burning sensation in the muscles and joints), fatigue, and tenderness throughout the body. It is a frustrating condition that may be compounded by the fact that it I shard to pin down. Some medical experts still question whether the condition is physiological or psychological. The cause of fibromyalgia is unclear. Before 1999 it was viewed primarily as a muscle disorder. Now it’s thought to involve a genetic predisposition and a triggering event such as an infectious illness, or physical or emotional trauma that leads to abnormal processing of pain signals.
A recent review from the University of Cincinnati College of Medicine cites evidence linking fibromyalgia may respond more to painful stimuli but may also experience pain from stimuli that are not normally painful, possibly due to reduced levels of the nervous system chemicals serotonin and norepinehrine. There’s some evidence of an imbalance of cortisol and other hormones as well. And, as noted above, chronic psychological or physical stress may initiate fibromylgia by increasing inflammatory substances, which set of a cascade of effects of the immune and nervous system.
Further complicating the picture, people with fibromyalgia often also have other conditions, such as irritable bowel syndrome, chronic fatigue, temporomandibular disorder (TMD), restless legs syndrome, migraines, and depression. Fibromyalgia does not damage or deform joints or muscles. But most people find it hard to deal with the frustrating condition that some doctors and others regard with skepticism.
DIAGNOSIS IS CRUCIAL
The majority of people who develop fibromyalgia are women, though men also can get it. Symptoms often begin between the ages of 25 and 55. Diagnosis is an important component of care, and is a turning point for many because thy can put doubts about the cause of their condition aside and focus on managing it. However, fibromyalgia is often challenging to diagnose because:
Symptoms vary widely from one person to the next There’s no gold-standard test that can confirm or rule out the condition Symptoms may resemble those of a host of other diseases such as various forms of arthritis, underactive thyroid, Lyme disease, sleep apnea, depression, multiple sclerosis or vitamin D deficiency.
If you think you may have fibromyalgia see your doctor (or a rheumatologist) who will evaluate you medical history with a physical exam and various tests that can help rule out other conditions that fibromylgia can mimic. Generally experiencing widespread pain lasting for at least three months and excess tenderness in at least 11 of 18 specific sites may signal a positive diagnosis for fibromyalgia.
CORNERSTONES OF CARE
Once fibromyalgia is recognized, a multipronged treatment approach often leads to enough symptom relief so that you can turn the focus of your life away from pain and back to the activities and relationships that you most enjoy. Successful treatment of fibromyalgia includes:
Education Learning more about how to manage its symptoms is an important step in bringing your symptoms under better control.
Watching what you eat Some people think certain foods and additives commonly wheat, dairy, citrus, sweets, alcohol, coffee, or MSG exacerbate their symptoms. You can try eliminating suspect foods to see if that helps, and then reintroduce them after two weeks to see symptoms worsen. In small studies, vegetarian diets helped some people with fibromyalgia.
Exercising This is likely to be difficult and painful initially, but increasing your fitness with low to moderate intensity aerobic exercise (such as brisk walking, cycling, or swimming) may help reduce pain and improve sleep and overall psychological well being. Your doctor or a physical therapist can help develop an overall exercise program.
Reducing stress Taking time each day to relax with meditation or deep breathing exercises, and learning to pace yourself.
Improving Sleep Sleep hygiene includes going to bed and waking at about the same time each day and avoiding exercise, alcohol, caffeine or nicotine within a couple of hours of bedtime.
People with fibrimyalgia may respond more too painful stimuli but may also experience pain from stimuli that are not normally painful
Cognitive behavioral therapy sessions These may help teach your how to manage anger, stress, negative thoughts and anxieties that may be contributing and may result from fibromyalgia symptoms, cope with the pain and fatigue.
Support groups You may find comfort and advice by joining a support group.
Complementary therapies Heat packs or hot baths, hypnosis, meditation, massage therapy, acupuncture and chiropractic therapy may all help relieve stress and reduce pain.
Drugs There are no medications approved specifically for fibromyalgia, but your doctor may prescribe drugs that influence brain chemistry and/or relieve symptoms in other ways, like antidepressants, muscle relaxants, and painkillers. Certain drugs for Parkinson’s disease may help reduce fibromyalgia pain and aid sleep if your also have restless legs syndrome.
Often, a trial of a drug or combination of drugs is necessary to see if it helps your symptoms and if you can tolerate its side effects. None of the many supplements touted for fibromyalgia including magnesium, zinc, ginkgo biloba, coenzyme Q-10, and kava are proven to work, and some may pose a risk. If you take any supplements, be sure to tell your doctor.
For some with less severe fibromyalgia symptoms, a few manageable changes can make a big difference in how they feel. Other may require a more comprehensive care program me. Your doctor may be able to recommend a chronic pain clinic. Most major hospitals (like Hinduja in Mumbai) have one.
Puzzing Symptoms In addition to chronic pain and fatigue symptoms of fibromyagia may include * digestive problems *headaches *mood changes *difficulty concentrating *facial pain *stiffness *numbness and tingling in the fingers and toes * sensitivity to odours, noise, bright lights and other stimuli. However, the list of symptoms may vary ad probably won’t follow a consistent pattern.