I am sorry to mention incurable, but it’s the sad truth.
It is a syndrome affecting the muscles, soft tissues wherein the person suffers from widespread chronic pain (greater than 3 months duration), insomnia (restless sleep, disturbed sleep), fatigue, irritability, depression/anxiety and disturbed memory.
There are specific trigger points on the body where pain is typically felt.
The above image shows where are the tender points.
How do I know I am suffering from fibromyalgia?
Symptoms mentioned below occur in combinations or all together, never only one symptom
- Chronic Pain (greater than 3 months duration) widespread over the body especially over upper back around trapezius and scapular region, lower back region, multiple joint pains.
- Disturbed/ unfulfilled sleep and some suffer from insomnia.
- Easy fatiguability, evening fatigue even after not doing much of work.
- Depression or anxiety.
- Cognitive dysfunction ( difficulty thinking or remembering things)
- Previous history of trauma- mental and or physical can trigger this syndrome.
- Most common in young and middle aged females. But any sex at any age can suffer.
Can it be something other than fibromyalgia?
Fibromyalgia is a diagnosis by exclusion, that is, the doctor will exclude all other causes before labeling you as a fibromyalgia patient.
It was termed as a Rheumatoid variant (rheumatoid arthritis- multiple joint pains with swelling and inflammation leading to deformities of joints). But recent papers suggest that this is an independent syndrome.
- ESR/CRP/ASO titre/RA factor- to rule out rheumatoid arthritis or any seronegative arthritis.
- Vitamin B12 and Vitamin D3- low levels do cause tingling/numbness/disturbed cognitive functions and fatiguability/muscle pains respectively.
- Thyroid function tests.
- Iron and magnesium levels.
If all the above is normal then physical examinations by your doctor will reveal the tender points, which along with other symptoms can guide him to make a diagnosis of fibromyalgia.
There are guidelines provided by American College of Rheumatology (ACR) which according to various physical examination provides score to help diagnosis of fibromyalgia. (The guidelines are smudgy and does not accurately diagnose the condition- many false positive results. So not routinely used.)
What exactly goes wrong?
There are two main biological variants which are responsible
- Threshold for pain is reduced
- Pain response is maladaptive.
Add to the above emotional disturbance or negative mental influence and the combination results in FIBROMYALGIA. Patients who have negative self image, not happy with their work/ careers, problems in family, not appreciated by spouse/ friends/family/at work place are more prone to suffer.
Days of work are lost due to pain and fatigue. Patients mental and physical well being is disturbed due to chronic pain.
So is it for REAL or is my mind playing games?
Believe me- you and me both want it to be mind games. But its NOT.
There are various chemical substances which are released in our bodies like serotonin, endorphins which are inhibitory neurotransmitters which are reduced and substance P, glutamate, which are excitatory sensory inputs are in excess in patients suffering from fibromyalgia.
There is dysregulation of many other chemicals like dopamine, growth hormones, etc.
So the medical fraternity has recently recognized the existence of this syndrome named FIBROMYALGIA.
There are no treatments that can cure fibromyalgia but there are multiple ways by which you can keep in check the pain and other symptoms.
- Lifestyle modifications- Exercises which will keep you active. I would prefer my patients doing exercises which are fun. Be it good gym/ yoga/ swimming/ games/walk. Interactive and joyful environment is more beneficial.
- Eat healthy- fruits, vegetables, a nice balanced diet. Avoid greasy food and carbogenic drinks. Keep a food journal.
- Medicines- doctor’s will prescribe you medicines to help you sleep properly (as disturbed sleep is universal in fibromyalgia) and pain medicines. Both of which will be temporary. Also multivitamin and calcium supplements will be prescribed. anti anxiety and anti depression meds can also be prescribed. Physiotherapy- to some extent (IFT, SWD and Ultrasound therapy) helps in reducing pain and exercises will tone your core muscles.
- MOST IMPORTANT IS POSITIVE OUTLOOK IN LIFE. Without this all the above mentioned therapies will fail.
- Have a good social support group and talk to your doctor about any symptoms or feelings you find disturbing. Do not try to fight fibromyalgia alone- family and friends help to reduce the burden of this disease.