THE BASICS OF FYBROMYALGIA
What is fybromyalgia? If you have the syndrome, you know only too well the symptoms and the debilitating effect they have on your daily life. Fybromyalgia is characterized by pain, stiffness of the muscles, tender points in the muscles, joints, and tendons, chronic fatigue, sleep problems, depression, anxiety, and disturbances in the bowel function. Fybromyalgia is sometimes referred to as a syndrome and abbreviated FMS. In the past, this condition was called fibrositis.
Even though fybromyalgia is one of the most common diseases affecting the muscles, the causes behind this disorder is unknown at this time. What is most unusual is that a patient’s tissues experience the pain with fybromyalgia without tissue inflammation. Therefore, the patient does not develop body damage or deformity. This condition does not cause damage to internal organs like so many other rheumatic diseases.
THE CAUSES OF FYBROMYALGIA
Although the cause of fybromyalgia is not known, researchers have found a nerve growth factor in the spinal fluid of patients and have noticed elevated levels of a nerve chemical signal, called substance P. There are also low levels of the brain chemical serotonin. These and other studies suggest that the central nervous system of the brain is supersensitive. Furthermore, there seems to be a diffuse disturbance of pain perception in patients with fybromyalgia. And patients show an impaired non-rapid eye movement sleep phase. This may be part of the reason why patients wake from sleep but still feel very tired. You need a good night’s sleep. Without it, you cannot function at your best. Fybromyalgia has also been associated with trauma, psychological distress, and infection.
WHO IS AFFECTED?
It seems that FMS tends to affect women more than men. In fact, about 80% of the cases of fybromyalgia are women between the ages of 35-55. The rest is a combination of men, children, and the elderly. This syndrome is found in many countries. In Sweden and Britain, 1% of the population is affected with the disease. Here in the United States, about 4% of the population is affected. Fybromyalgia can occur independently or in association with another disease like systemic lupus or rheumatoid arthritis.
SIGNS AND SYMPTOMS OF FYBROMYALGIA
The most prevailing symptom of fybromyalgia is pain. This pain, as mentioned earlier, is not caused by inflammation of the tissues but rather a super sensitivity to sensory stimuli and an unusually low pain threshold. Minor sensory stimuli that would ordinarily not cause pain in a normal individual can cause severe, even disabling pain in the fybromyalgic patient. This body pain can be exacerbated by changes in the weather, stress, and noise.
The pain of fybromyalgia is widespread and usually involves both sides of the body. The shoulders, buttocks, arms, chest, neck, and upper back are most commonly affected. Patients also have tender points that are localized areas of the body that are tender to the touch. These tender points, or pressure points, are most commonly found around the elbows, knees, hips, shoulders, hips, back of the neck, and the sides of the breastbone.
Fatigue is the number two symptom of fybromyalgia. Most patients experience this symptom because they do not achieve the REM (rapid eye movement) realm of sleep. Sometimes the quality of sleep means more than the number of hours a person sleeps. With fybromyalgia, patients frequently wake up feeling like they have been working out all night. They feel tired, achy, and in need of more rest. Fatigue affects about 90% of the people with fybromyalgia.
Symptoms such as mental or emotional disturbances occur in about 50% of the patients. These disturbances include poor concentration, forgetfulness, and memory problems. Patients can also experience mood changes, depression, anxiety, and irritability. Since there are no real tests for fybromyalgia, many patients are misdiagnosed with depression as their underlying problem.
Other symptoms of the disease include migraine and tension headaches, numbness or tingling at different parts of the body, irritable bowel syndrome, and irritable bladder. It is important to remember that each person with fybromyalgia is unique and may experience these symptoms intermittently and in different combinations.
Because the symptoms of fybromyalgia vary from patient to patient, it is important that a treatment plan be customized for the individual. Normally, a plan that includes exercise, stress reduction, pain medications, and patient education is recommended.
Patient education is a number one priority for patients. Understanding the disease will help patients cope with the varied symptoms of fybromyalgia. The local chapters of the Arthritis Foundation and Community Hospital support groups offer a good foundational education for people with fybromyalgia.
Stress reduction is another important way to minimize symptoms. The plan must be customized to the patient. Several techniques include biofeedback, relaxation tapes, psychological counseling, and support among family members, friends, and doctors.
Exercise that is low impact, such as swimming, cycling, walking, and stationary cross-country ski machines can really help control the symptoms. An exercise regimen performed in the mornings, every other day seems a wise choice. One result of exercise is better REM sleep.
Medications for fybromyalgia are diverse. Some are antidepressants. Others block nerve pain. More recently, drugs that simultaneously increase the amount of two brain transmitters, serotonin and norepinephrine, have been approved to treat fybromyalgia in adults.
Whatever treatments you receive, fybromyalgia can be controlled and the pain reduced. Education is key and commitment imperative to maintaining the symptoms of fybromyalgia at controlled levels.