Fibromyalgia – Symptoms, Causes, Diagnosis, and Treatment

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Introduction

 Fibromyalgia is a chronic rheumatic condition that affects muscles and joints all over the body.

Predisposing factors

It most commonly affects women more than men between the ages of 20 and 55. In the given age group, the cause of generalised musculoskeletal pain in most women is Fibromyalgia.

The risk of Fibromyalgia is higher if one has an existing rheumatic condition like rheumatoid arthritis. Genetics also play a major role.

Causes of Fibromyalgia

Fibromyalgia has no known cause or aetiology. It can be triggered or aggravated by multiple physical and emotional stressors. Certain studies have shown a genetic predisposition for Fibromyalgia.

Symptoms of Fibromyalgia

Widespread musculoskeletal pain –  Fatigue occurs both in the upper and lower halves of the body. The pain may initially be localised to the neck or shoulder, which later becomes widespread.

Fatigue – Fatigue is a cardinal symptom of Fibromyalgia, especially in the mornings. Even minor activities aggravate the pain and fatigue. Early morning stiffness is characteristic.  

Cognitive disturbances – Patients have difficulty focusing, being attentive and doing tasks requiring racing thoughts.

Other symptoms – Migraine-type headaches and vascular headaches are common. IBS (Irritable bowel syndrome) commonly co-exists with Fibromyalgia. Almost 30% to 50% of patients have anxiety or depression at the time of diagnosis.

Diagnosis of Fibromyalgia

Fibromyalgia usually requires a clinical diagnosis. There are no routine tests that are recommended for Fibromyalgia.  

Treatment of Fibromyalgia

Patient education is of prime importance. It is crucial for the patient to understand that Fibromyalgia is a real disease.  

Since physical and emotional stressors are major triggers for symptoms of Fibromyalgia, patients should learn relaxation techniques which will be a part of the formal stress reduction program.  

Patients should be encouraged to obtain treatment for sleep disorders since good sleep hygiene is an essential part of the management of Fibromyalgia.  

Exercise helps with pain, improves sleep and indirectly helps patients with Fibromyalgia.

Medications like antidepressants and anti-convulsants are prescribed for persistent symptoms.

Psychosocial interventions like cognitive behavioural therapy are beneficial in Fibromyalgia patients.

Prognosis of Fibromyalgia

Prognosis depends on a lot of factors. Compliance with all modalities of treatment is associated with a better prognosis.  

Patients continue to have long-term pain and fatigue.  

Female gender, low socioeconomic status, unemployment, obesity, depression and history of abuse had adverse effects on the outcome.

Conclusion

Fibromyalgia is a rheumatic condition that is chronic in nature and affects the joints and muscles. Exercise, medications and psychosocial treatments are done to manage Fibromyalgia.

FAQs

Is Fibromyalgia curable?

The symptoms of Fibromyalgia can be kept under control with long-term medication and other modalities of treatment.

What is the diet for Fibromyalgia?

Dietary changes are not part of any standard treatment for Fibromyalgia. Choose whole grains, fruits and vegetables, and healthy oils to keep the body weight under check because obesity can aggravate symptoms of Fibromyalgia.  

What are the current treatment options for Fibromyalgia?

FDA has approved pregabalin, duloxetine and milnacipran for the treatment of Fibromyalgia. And other symptomatic measures such as pain killers, antidepressants, and sleep hormones may be prescribed accordingly.
 Non-pharmacological measures such as physical therapy, yoga and relaxation techniques such as massage therapy have shown beneficial effects, according to various studies.

Is total relief of symptoms possible in Fibromyalgia?

Total relief of symptoms is seldom achieved in Fibromyalgia. Although symptoms, to a large extent, can be controlled with medication and other non-pharmacological measures, the symptoms do not lead to disability or shorten life expectancy.

Is Fibromyalgia life-threatening?

No, Fibromyalgia is not life-threatening. It can be managed.

Are dietary supplements recommended for Fibromyalgia?

There is no conclusive recommendation. However, Coenzyme Q and Vitamin D supplements can improve pain and quality of life in Fibromyalgia.  


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