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Fibromyalgia and General Health Care

 

Fibromyalgia is a chronic pain disorder which occurs in the muscles and soft tissues of the waist on both sides of the body. It is found that there is no medical condition behind this such as inflammation or injury. Unfortunately, in this disorder, no cure has been found, although intensive research is going on.

Though the person suffers from intense pain, with treatment, they can get back to their old lives and work again. But if the pain is not treated, then the person may not have any energy or may get depressed or have trouble sleeping.

The cause of such a disorder is unknown but experts have come up with a list which could be the possible causes of fibromyalgia:

  • Nerve cells may be too sensitive
  • Imbalance of brain chemicals (neurotransmitters)
  • Deep sleep phase may be disrupted thus affecting the amount of hormones that the body releases.

Some of the main symptoms of fibromyalgia are:

  • Deep or burning pain in the trunk region, neck, lower back, hips and shoulders
  • Certain regions in the body are tender and hurt when they are pressed

People with fibromyalgia also suffer from:

  • Anxiety and Depression
  • Sleep problems and Fatigue
  • Morning stiffness
  • Trouble while concentrating
  • Irritable bowel syndrome

In fibromyalgia, the pain and symptoms are inconsistent. That is, some symptoms may be present one day and absent the next day. Pain also waxes and wanes over time. Many patients have complained saying that their symptoms are worse in the cold and damp weather, or during times of stress, or when they exert too much. (Fibromyalgia – Topic Overview, 2015)

Treatment

Treatment for fibromyalgia includes managing symptoms, pain and other problems that the patient may suffer from. The goal is to decrease the body’s sensitivity towards pain and increase its energy to do physical activity.

The treatment is given based on 3 reasons, which are as follows:

  • How bad the symptoms are
  • If there is any disruption in the daily workings
  • What kind of changes the person is willing to and is able to make (Fibromyalgia – Treatment Overview, 2015)

Type of Doctors to Consult

  • Primary Doctor- The primary doctor is a general practitioner with minimum three years of additional training after medical school. They are someone who specializes in internal medicine and study of diseases in adults.

They can best assess the problems and give further referrals.

  • Rheumatologists- diagnose and treat arthritis and other diseases of the joints, muscles, and bones. This includes fibromyalgia, rheumatoid arthritis, osteoarthritis, gout, lupus, back pain osteoporosis, bursitis, and tendinitis.
  • Pain specialists- are usually board certified anaesthesiologists, neurologists, physiatrists, psychiatrists, or oncologists with additional training in pain management. They receive credentials from various professional organizations
  • Neurologists- diagnose and treat disorders of the nervous system. This includes treating common pain problems such as headaches, back pain, muscle disorders, fibromyalgia, neuropathy, and reflex sympathetic dystrophy (RSD).
  • Orthopaedists- specialize in the diagnosis, clinical treatment, and surgical repair of bone injuries. They also treat muscle problems and joint tissues — tendons, ligaments, cartilage.
  • Psychologists- diagnose and provide therapy for problems associated with pain, perception, depression, and anxiety. (Finding the Right Fibromyalgia Doctor for You, 2015)

Exercise

Exercise, for fibromyalgia patients, is one of the best ways to ensure movement of the body which would enable the person to get back to their daily activities. Exercises which would be suitable for these patients are mostly cardiovascular exercises especially pool exercises. But the person must ensure that they don’t over-exert, rather build up their exercise program. This would make sure that the person does not develop sore muscles which would demotivate them to continue exercising.  It would be helpful for the patient to work with a physical therapist who is familiar with fibromyalgia. (Fibromyalgia – Treatment Overview, 2015)

Medications

The main goal of providing medication to fibromyalgia patients is to reduce pain from the body. But not all medications work in the same manner. While some focus on easing the pain from the central nervous system, others target muscles to ease the discomfort.

Medicines do not directly affect or cure fibromyalgia but they do help the person in sleeping better, relaxing their muscles or relieving muscle and joint pain. The doctor could provide prescription medicines, which could be antidepressants, muscle relaxants, and anticonvulsants. Or non-prescription medicines which are mainly pain relievers.

The patients may or may not benefit from the medicines. It is also possible that the medicines which seemed to be helping your symptoms, may not work as well over time. The doctor may have to try different medicines on the person, and they have to communicate if they are getting relief or not. (Fibromyalgia – Treatment Overview, 2015)

Pain

  • Serotonin and norepinephrine are two chemicals in the brain which reduce pain-related messages. Medications try to increase the dosage of these two chemicals
  • The muscles and tissues of the body which hurt send signals to the brain which are interpreted as pain. Certain drugs slow down these signals and reduce its impact. The person would then interpret this as reduction of fibromyalgia pain. These drugs also help in sleep problems
  • Another symptom of fibromyalgia is having tight and knotted muscles. Medications help in relaxing these muscles
  • Dopamine, a brain chemical, helps in easing pain in the body. But in fibromyalgia this chemical is not released. Dopamine-enhancing medication is usually taken by fibromyalgia patients to ease their pain

Sleep

  • Most of the fibromyalgia patients have complained of having sleep problems. Doctors prescribe insomnia medicines to improve the quality of sleep
  • One-third of fibromyalgia patients suffer from restless legs syndrome which is the movement of the limbs during sleep. Treatment of this syndrome will decrease their sleep problems

Fatigue

  • Fibromyalgia patients place fatigue as their second worst symptom. Fatigue prevents them from continuing normally with their daily activities and impacts the person’s quality of life
  • Fatigue could be due to low thyroid hormone which can be easily tested. This can be resolved by taking thyroid hormone supplements
  • Taking drugs which increases serotonin alone reduces fatigue to an extent (Treatment, n.d.)

Counselling

The best counselling treatment for fibromyalgia is CBT, or Cognitive-behavioural therapy. This method challenges the person’s thinking, especially negative thoughts. It helps the person in changing their views on pain and how to handle to it. Other counselling methods include relaxation therapy, pain management, biofeedback etc. Counselling not only helps fibromyalgia but also with depression, anxiety, sleep problems etc. (Fibromyalgia – Other Treatment, 2015)

Complementary and Alternative therapy

Patients with fibromyalgia usually go for alternative therapy. These therapies usually help in treating symptoms such as relieving stress, ease of muscle tension, and help the person feel better and healthier. Most of these therapies help people to an extent and there has been evidential proof of it, but there are some therapies, such as tender point injections, which cannot be proved if they help the person or not.

Complementary and alternative treatments that have been used to treat fibromyalgia include:

  • Acupuncture.
  • Chiropractic therapy.
  • Massage therapy.
  • Meditative movement, such as tai chi and qi gong.
  • Relaxation techniques such as yoga, meditation, or prayer.
  • Reflexology. This is the practice of applying pressure to points on the body that benefit other parts of the body.
  • Transcutaneous electrical nerve stimulation (TENS).
  • Vitamins, dietary supplements, and herbal products. (Fibromyalgia – Other Treatment, 2015)

Diet

Certain foods act like triggers which makes the symptoms worse for some people. Gastrointestinal issues, such as irritable bowel syndrome, sometimes accompany this syndrome. This can be reduced by eating a balanced diet and avoiding the aggravators.

Common aggravators may include:

  • Caffeine
  • Fried foods
  • Foods high in sodium (Healthline Editorial Team, 2014)

Self- Help

The patient must be alert of the changes that the body is going through. For instance, sleep problems, moodiness etc. They must convey these changes to a caregiver who could be a doctor or a friend. They must try to relieve their pain and stiffness how much ever they can using medicines and heat.

Identify the triggers that make the symptoms worse. This could be weather, a certain activity, stress etc. These triggers must be avoided or reduced.

Patients must also keep in mind a symptom called “fibro-fog”, in which the person feels they are not thinking clearly or are forgetting something. Memory enhancing techniques or mnemonics can be used to increase memory. (Fibromyalgia – Treatment Overview, 2015)

References

Fibromyalgia – Other Treatment. (2015). Retrieved from WebMD: http://www.webmd.com/fibromyalgia/tc/fibromyalgia-other-treatment

Fibromyalgia – Topic Overview. (2015). Retrieved from WebMD: http://www.webmd.com/fibromyalgia/tc/fibromyalgia-topic-overview

Fibromyalgia – Treatment Overview. (2015). Retrieved from WebMD: http://www.webmd.com/fibromyalgia/tc/fibromyalgia-treatment-overview

Finding the Right Fibromyalgia Doctor for You. (2015). Retrieved from WebMD: http://www.webmd.com/fibromyalgia/guide/finding-right-fibromyalgia-doctor-fibromyalgia-specialist

Healthline Editorial Team. (2014, October 6). Fibromyalgia Prevention. Retrieved from Healthline: http://www.healthline.com/health/fibromyalgia-prevention#Overview1

Treatment. (n.d.). Retrieved from Fibromyalgia Network: http://www.fmnetnews.com/fibro-basics/treatment/medication-options