Fibromyalgia is difficult to describe and even harder to diagnose. Dr. Hodges explains that it's a syndrome causing widespread muscle pain and fatigue that affects both sides of the body, above and below the waist. The disorder affects approximately 5 to 12 million people, predominately women between the ages of 20 and 50.
The pain associated with fibromyalgia is often described as a constant dull ache and tends to get worse with a sudden increase in physical activity, Dr. Hodges explains. "Patients with fibromyalgia cannot have sudden increases in physical activity without a worsening of their symptoms," she says.
Some people also experience a hypersensitivity to touch and don't like to be hugged or even have their children sit in their laps because their pain will grow worse in those areas for hours or even days afterward. Twenty-eight percent of patients with fibromyalgia are reported to have co-existing depression, but Dr. Hodges suspects that number is probably higher. "Wouldn't you be depressed if you were tired and hurting all the time?" she asks.
Fibromyalgia is also characterized by additional pain when firm pressure is applied to specific areas of the body, called tender points. Some of these areas include the back of the head, between the shoulder blades, the top of the shoulders and front sides of the neck.
Dr. Hodges says some patients also experience something called the "fibro fog," which some describe as feeling like their brain is wrapped in cotton wool. This is likely due to difficulty sleeping associated with the disorder. Some people with fibromyalgia report that their sleep is not restful and that they feel just as tired when they get out of bed in the morning than they did the night before.
There is no test for fibromyalgia, and diagnosis can be tricky because symptoms come and go. Your doctor first needs to figure out whether what you're experiencing really is fibromyalgia, Dr. Hodges explains, or if your symptoms are caused by something else such as thyroid problems, sleep disorders, connective tissue disorders (i.e. polymyalgia rheumatic or lupus), or even depression. If a secondary cause is detected, that should be treated first and may resolve the issue. Fibromyalgia is diagnosed if no other medical explanation for the widespread, chronic pain can be found.
There is no cure, but there are available treatments that can control the symptoms to allow people who have fibromyalgia to live more normal lives, Hodges explains. Several drugs are known to help ease and control symptoms but the treatment that works best depends on the individual.
In addition to these treatments there are other means of controlling and minimizing pain including gentle exercise. "Yoga, Pilates, tai chi and other forms of activity that employ gentle stretching are mandatory for patients who want good disease control, in my opinion," Dr. Hodges says. "Achiness worsens with inactivity, just as it does with too much sudden activity." She sends all of her fibromyalgia patients for a consult with a physical therapist to design an individual exercise plan, adding that it is important to pick a therapist who understands fibromyalgia and is used to working with these patients.
Along with reducing stress, getting enough sleep and eating a healthy diet (all important for symptom management), it is also helpful to make sure spouses and household members understand the disease, Dr. Hodges suggests, so that they can be supportive but not enabling. "Lying in bed is not the answer, though it can temporarily feel like it is."
For more information you can visit the National Fibromyalgia Association.
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