Once referred to as fibrositis or fibromyositis, fibromyalgia affects millions of people – about 80 percent to 90 percent of them women. "Fibromyalgia is a mysterious illness with a long name and a bad reputation," says Dr. Ian K. Smith, medical writer of Time magazine. But the reputation is undeserved. For years, patients who went to their doctors complaining of unexplainable pain, stiffness and fatigue were told that their symptoms were psychosomatic. Now, we know that fibromyalgia is a real medical syndrome. And it is being taken more and more seriously these days.
If you suspect you may have fibromyalgia, here’s how your doctor will go about diagnosing and treating your condition.
Besides pain and fatigue, you may also experience:
• Sleep disturbances. Most people with fibromyalgia wake up tired and feel unrefreshed, even though they seem to get plenty of sleep. Sleep studies suggest this is due to a sleep disorder called alpha-wave interrupted sleep pattern, a condition in which deep sleep (stage 4) is frequently interrupted by bursts of brain activity similar to wakefulness.
• Irritable Bowel Syndrome (IBS). About 40 to 70 percent experience constipation, diarrhea, abdominal pain and bloating – the hallmark of IBS.
• Chronic headaches and facial pain. About 50 percent have recurrent migraine or tension-type headaches, which may be related to tenderness in the neck and shoulders. As many as 90 percent experience jaw and facial pain which may be associated with tenderness in the muscles and ligaments around the jaw joint – often called TMJ (temporomandibular joint) syndrome.
• Sensitivity to environment. About 50 percent report being sensitive to odors, noise, bright lights, various foods and weather.
• Other symptoms. These include numbness or tingling sensations in the extremities, difficulty concentrating, pelvic pain, chest pain, morning stiffness, irritable bladder, dry eyes and mouth, and dizziness.
Sounds simple but it’s not. Part of the problem in diagnosing fibromyalgia is that the symptoms often mimic other conditions which must be excluded by medical testing. For example, between a quarter and a third of people with fibromyalgia experience depression. This may result from fibromyalgia or be a contributing cause. Some confusion persists, no doubt, because some of the symptoms of fibromyalgia – fatigue, sleep problems, and disturbances in mood and concentration – are also present in depression.
Depressed feelings that accompany fibromyalgia may be a reaction to the pain and fatigue that you deal with on a daily basis. What’s more, if your symptoms are misunderstood by your family or by your doctor, you may also have feelings of rejection and alienation, leading to a depressed mood. If you’re experiencing periods of depression along with fibromyalgia, you may benefit from treatment for depression, including counseling, medication or support groups. This treatment will help you learn how to cope with your chronic illness and enhance your own capacity to deal with your symptoms.
• Chemical changes in the brain. Studies suggest that some people with fibromyalgia have alterations in the regulation of certain brain chemicals called neurotransmitters – in particular, serotonin (which is linked to depression, migraine and gastrointestinal distress) and substance P (which appears to be elevated in the spinal fluid of those with fibromyalgia). Other studies show abnormal levels of a hormone called somatomedin C in the spinal fluid. This hormone may cause a heightened sensitivity to pain.
• Sleep disturbances. Some people theorize that disturbed sleep patterns may be at the root of many cases of fibromyalgia.
• Familial susceptibility. Studies indicate that you may be more likely to have fibromyalgia if your mother has the condition.
• Injury or physical trauma. An injury in the upper spinal region, for example, has been shown to trigger the development of fibromyalgia in some people.
• Infection with a virus or bacteria. Although some believe this may be a triggering event, no one has identified the Epstein-Barr virus, parvovirus, other viruses or bacteria as playing a role.
• Physical activity. Regular exercise is a must to ease muscles and improve range of motion, but begin slowly. Try stretching and low-impact aerobics such as swimming, water therapy, walking, or using a stationary bike. Keep up the exercise even on days when you’re tired and aching.
• Physical therapy. This may include massage, application of ice, heat and ultrasound, and posture and movement training.
• Sleep and diet. Establish regular sleep routines and balance work with regular rest periods throughout the day. Maintain a healthy diet low in animal fat and high in fiber. Include lots of fruits and vegetables. If you’re overweight, losing weight can significantly ease your pain.
• Medications. To boost your body’s serotonin levels and help improve your sleep quality, your doctor may prescribe low doses of antidepressants such as nortriptyline, fluoxetine (or a combination of these two), sertraline or paroxetine. To help with pain, you may try acetaminophen or non-steroidal anti-inflammatory drugs such as ibuprofen or aspirin.
• Stress management. These include meditation, deep breathing, and visualization techniques.
• Biofeedback. To help you train your muscles to relax.
• Acupuncture. To help reduce the pain.
• Music, humor and hobbies. Finding activities you enjoy will help you relax and focus on positive events.