Fibromyalgia (FM) is a disease which causes the sufferer to feel chronic pain in various soft tissues and muscles of the body. In some cases, the pain goes deep into the skeleton. As a result of which some experts categorize this disease by chronic musculoskeletal pain. Some other complications like memory loss, fatigue, mood-changing and sleeplessness also accompany this disease.
The condition is also referred as Fibromyalgia Syndrome (FMS). In those cases where a patient shows complications other than extreme pain. Symptoms of this disease can vary according to the patient’s mental health, medical history and environmental factors. FM is considered by many to be one of the most ‘mysterious’ medical conditions because much of the work around it is still based on theory rather than proven fact.
Patients with this medical condition may feel chronic pain; but often the body or muscles don’t give any outward indication (such as bruising or swelling). Sometimes the condition of the muscles doesn’t justify the pain described by the patient. These findings lead experts to believe that Fibro tempers the signals from the brain and intensifies the sensations of pain. This theory is leading many specialists to design treatments using psychological methods.
Some treatments are known to cure the symptoms, but still there is no single treatment method that can give guaranteed results. The cure of this medical condition depends a lot on the patient’s mental attitude and the support network around them. This article will unravel some mysteries that will not only help readers to understand this illness, but also assist them in fighting it.
History of Fibromyalgia
Medical literature indicates that experts began studying widespread chronic pain from the start of the 18th century. The evolution of different aspects of this disease followed unique paths.
Until the 1970s, doctors and scholars referred this medical condition by several names – including neurasthenia, muscular rheumatism, psychogenic rheumatism, and fibrositis. Dr P.K. Hench introduced the term “fibromyalgia” to describe the symptoms of widespread chronic pain in 1976. This term is derived from a Latin word fibra (fiber) and two Greek words mayo and algos meaning muscle and pain respectively. Researcher Mohammed Yunus adopted the term in his research paper, using it interchangeably with the existing term ‘fobrositis’. Other scholars then took the lead and embraced the new term.
In the early 1800s, before the widespread use of microscopes or the invention of x-ray, when physicians came across people suffering from persistent pain in various parts of the body, they naturally looked for visible signs of injuries.
One theory which gained popularity around this time was that this medical condition was due to a mental disorder. Though this theory wasn’t supported by evidence it did fit well with ‘common sense’ at the time and this early theory helped doctors to proceed forward in finding the cure. They named this disease as ‘muscular rheumatism’ and from that time doctors started to study the illness.
After almost ten years, in the early 1820s, Scottish doctor William Balfour described the ‘tender points’ of muscular rheumatism. These specific tender points helped doctors in diagnosing this disease for more than a century. Even now some doctors use tender points identification for the diagnosis of FM, although the chart of tender points has evolved through continuing research and observation.
In 1981, scientists published the first clinically controlled study into fibromyalgia, which validated many supposed symptoms, and confirmed the existence of ‘tender points’. In 1990, the first comprehensive guidelines were published to diagnose the disease. These guidelines were written by The American College of Rheumatology and they were based on a collection of scientific studies.
In 2005, the American Pain Society published a paper to guide doctors and patients for the treatment of FM; and in 2007 the FDA approved the first medication to treat the disease. The medication was not developed to eliminate the illness but to cure the symptoms.
Symptoms of Fibromyalgia
This chapter will tell you about all the different symptoms.
The most common symptom of FM is chronic pain. Fibro is categorized by pain in several parts of the body but it does not mean that every long-lasting throbbing pain is a symptom of FM. Some other diseases like osteoarthritis and joint pain also cause serious pain that lasts for a very long time. The difference between the pain of FM and other diseases is that in the case of FM the patient will feel pain all over their body.
According to the Arthritis Foundation, the patient feels pain, aching, gnawing, throbbing, burning, and soreness in the case of fibromyalgia. In some cases even light contact can cause the patient to feel extreme pain.
List of Symptoms
- Other symptoms of FM include
- Muscle spasms
- Tightness of muscles
- Loss of energy
- Muscle fatigue ranging from moderate to severe
- Insomnia or sleeplessness
- Difficulty in concentrating even on simple tasks
- Difficulty remembering things
- Abdominal pain
- Alternating constipation and diarrhea
- Migraine headaches
- Tenderness of jaw and face
- Sensitivity of bright light, odors, cold, noise, and some foods
- Numbness in the hands, arms, face, feet, and legs
- Frequent urination
- Loss of stamina
- Pain in muscles after simple exercises
- The feeling of swelling in the feet and hands without having real swelling
The existence of a number of ‘tender points’ throughout the body is a common indication of this condition. These tender points are sensitive to touch, which means if you press these points then the patient will feel pain. There are as many as 18 tender points, identified by different experts on different occasions. Some of the most common tender points are:
- Neck: front area
- Chest: top area
- Head: back side
- Hips: top and sides
- Elbows: outside pain
- Knees: inside pain
- Region between the shoulders
‘Fibro Fog’ can cause patients with this disease to forget important details and find concentration difficult. Fibro Fog affects both women and men who have fibromyalgia pain, though it tends to hit women more often. There is no conclusive evidence about why this happen to patients but there is a theory that sleeplessness leads to the disturbance of brain cells. Sometimes extreme pain also disturbs the chemical composition of the brain which creates several complications and memory fogging.
Symptoms: Specific to women
There are some symptoms of FMS that only present in women. The most common of these is pain during periods. It is common to feel a small level of pain during the menstrual cycle but if the pain is at a mild or high level this may indicate a problem. This condition is not limited to fibro because other diseases like endometriosis also cause this kind of pain.
Another symptom specific to women, is Irritable bowel Syndrome (IBS). In this condition, the patient feels a frequent urge to urinate, stomach cramps, diarrhea, constipation, and bloating. These conditions in women are associated with hormonal disturbance and it is not clear why fibro causes these symptoms.
People with this illness can be sensitive to many stimuli, including light, temperature, voices, and odour. Sometimes patient finds it hard to eat some foods. The type of sensitive food varies with the patient. Doctors are still struggling to find out why patients of FM show this kind of behavior.
The most common of these sensitivities is to temperature, and as this is not commonly associated with other conditions it can be a reliable indication of Fibromyalgia.
Although the symptoms are now well documented, the actual cause of Fibro is still uncertain. Often these symptoms appear after serious psychological stress, physical trauma, infection, injury, or surgery – however sometimes they can appear gradually without any obvious trigger.
There are, therefore only theories and no reliable scientific evidence for the causes of Fibromyalgia.
Serotonin, also known as 5-hydroxytryptamine, is one of several chemicals in the human brain. It performs the function of neurotransmitter: which means it carries signals from one part of the brain to another. The main purpose of this chemical is to reduce anxiety. Some experts suggest that reduction in the serotonin level can decrease the patient’s ability to bear the pain. This lower threshold of pain is another symptom of fibro.
Endorphins are one of the body’s natural defences against pain. When endorphin levels decrease it reduces our body’s natural ability to cope with pain. Similarly, ‘Substance P’ is a chemical that amplifies pain signal so that we can take appropriate action in time. For instance, when we touch something hot we feel pain long before the burning of skin so that we take some action before our skin gets damaged. The increased level of Substance P amplifies the pain signals to such a high level that patient feels pain even on touch.
It has been theorised that some genetic mutation might lead to this disease or increases in the chances of a person having this disease. Genes define lots of our bodily behavior. Some doctors believe that there might be a gene that determines the behavior of the body toward pain – which normally remains inactive but through some serious injury, illness, or trauma becomes activated and symptoms of FM start to appear.
Some critics of this theory suggest that it is lifestyle that plays a vital role in deciding the intensity of pain that the sufferer feels.
Other causes of Fibromyalgia are:
All these possible causes affect the brain in one way or another; however scientists don’t consider ‘mental status’ as a core cause of this diseases. Rather, mental status may change the situation of this disease. For instance, a person with a better mental health condition might be less susceptible to pain than the one with poor mental health.
These diverse theories suggest that Fibromyalgia is caused by several factors. Nothing can be said with certainty but it gives physicians some indication about the nature of this disease and it can help experts in the diagnosis and treatment of this illness.
Diagnosis of Fibromyalgia is a difficult task due its large number of symptoms many of which can also be found in other diseases like lupus and rheumatoid arthritis. There are different ways to differentiate fibro from other diseases and doctors select them according to their ease and available facilities.
Testing of Tender Points
Diagnosis of FM depends on the technology available in the health care center. In developed countries, almost every hospital has the modern equipment for different tests but there are large numbers of health care centers that don’t have hi-tech facilities. In this case doctors will examine the 18 tender points to check how many of them are in pain.
It can be a very efficient way to proceed, but doctors in the modern clinic don’t recommend this kind of diagnosis because it causes extreme pain to the patient. In this scenario, doctors may ask the patient if they have suffered ‘widespread pain for more than three months’. If the answer is yes then this can be seen as an equivalent to the presence of tender points.
Another important factor that can help doctors to diagnose this disease is the medical history of the patient and their family. If any member of the family is suffering from fibro then there are very high chances for the patient to have this disease too. This test is just an indication because it can’t be said with 100% certainty that the other family member is suffering from FM not from any other disease. If several people in the family and extended family of the patient are showing the same symptoms of widespread chronic pain then it can be said with fair confidence that the patient has fibromyalgia.
Diagnosis and Gender
Women are more likely to be affected by this disease. Between 80% and 90% of patients with the symptoms of Fibro are women. This huge difference suggests that this disease has something to do with those genes and hormones that are specific to women. There are lots of diseases that affect women only but fibromyalgia is different because it also affects men. The ratio of men with FM is small but still there are lots of men who are suffering from this disease. It makes this disease more mysterious and this kind of uneven gender distribution also makes it difficult for doctors to diagnose this disease.
Blood Tests & X-rays
Many doctors associate fibro with unexpected alteration of hormones, which can be checked by blood test. If tests show normal hormone levels then it is an indication that the patient is most probably not suffering from FM, although it doesn’t rule it out completely.
X-Rays also play an important role in the diagnosis of this disease. In FM, the patient feels extreme pain in tender points but these points do not show any kind swelling or fracturing. If the patient is not suffering from FM and had any other disease like arthritis then x-rays will show the deformation of bones and will help doctors to rule out the possibility of FM.
All these methods of diagnosis have evolved with the passage of time, and work continues to develop more accurate, reliable, and less invasive tests. Moving from pressing the 18 tender points to just asking the some critical questions shows that we are heading in the right direction.
Treatment of fibromyalgia depends on both personal care and medication. Since the root causes of this disease are unknown it is not possible yet to eliminate this illness. In fact, there is no test has been developed yet that can testify that this disease has been cured. The main aim is to treat the symptoms and improve the general health of the patient. There are lots of different symptoms of this disease and every symptom have its own treatment methods, therefore, it is very difficult to cure all the symptoms. Some of the most popular methods to treat this illness are listed here.
Humans have struggled with this disease for almost two centuries and they have developed several methods to relieve the pain without the assistance of doctors or medication. Indeed until just a few decades ago the health care system was not well established and people tried to cure their illnesses on their own. Some of those successful home remedies can also help fibro patients even in this modern age.
Sufficient sleep is vital for sufferers of Fibro because sleeplessness can cause serious disturbance in the hormone levels. Patients with FMS find it hard to fall asleep, and so assigning a ‘quiet room’ where they can find peace and relaxation may help. The main aim is to provide maximum relaxation to the mind and body.
Another home remedy that can be used for the treatment of this disease is gentle massage. Massaging the tender points can decrease the pain to a great extent. Even self-massage of the neck, back, head, shoulders, hips, thighs, lower back, and arms can bring relief.
Electronic massagers are also available in the market but they may be less effective in this case as they are typically designed to deliver deeper tissue massage.
Some of the most commonly prescribed medication for the symptoms of Fibro include:
- Naproxen sodium
All these medications are listed here just for the purpose of sharing information. PLEASE CONSULT YOUR DOCTOR before taking any medicine. Some of these drugs are painkillers while others are anti-depressants. The excessive use of these medicines can cause some health complications; therefore, it is better to ask the doctor to explain everything about the medication.
Another unique but controversial treatment for FM symptoms is medical marijuana. Some pharmaceutical companies claim that this medicine has positive results for people who are suffering from severe pain and depression. However, there are lots of doctors and experts who believe that this drug has negative effect on the mind of the patient. They also accept that this drug can reduce the pain but suggest that in the process, it can damage the brain cells.
Lifestyle and Therapy
Lifestyle changes may be vital in addition to medication in overcoming the symptoms of FMS. Eliminating stress as far as possible can have highly positive results.
There is a direct link between stress and FM. Lots of psychologists suggest that stress is not related to the situation of the person but it is related to the perception of the person about certain situations. For instance, lots of people consider problems as the opportunities to find new solutions and discover new possibilities. For those people, problems do not create depression and stress. On the other hand, some people consider problems as hurdles and they take the stress of these problems which result in the depression.
It is recommended to visit a psychologist if you are suffering from this disease. A psychiatrist can help you to improve your behaviors which can help you in curing several symptoms of FM like anxiety, depression, and mental stress.
It is also recommended for fibro patients to exercise regularly.Whilst this might cause severe pain at the start, after some time the pain will reduce and the patient will find it easy to perform different physical activities. You don’t need to do extreme exercises to remain physically active. Some of the most appropriate exercises in this condition are biking, walking, and swimming.
Importantly, patients should take a regular amount of exercise each day, regardless of their degree of pain. If you manage, for example, 30 minutes walking on a ‘bad day’ then take the same 30 minute walk even on a ‘good day’.
All these treatment methods have already helped hundreds of people all over the world. The main factor that decides the pace and efficiency of treatment is the commitment of the patient and the support from their loved ones.
Symbols of Fibromyalgia
The purple ribbon is used as a symbol of fibromyalgia, and is used to raise awareness of the condition, its symptoms and its patients.
The butterfly is not the official symbol of Fibromyalgia but lots of people use the butterfly to represent this disease. There is a well thought philosophy behind selecting the butterfly as a symbol of this disease. The butterfly is a small insect with almost but still it leave a serious impact in the mind of people. FM also leaves a serious impact on the lives of patients and their surrounding people.
National Health Services UK – Fibromyalgia
WebMD Health Center – Fibrolmyalgia
Wikipedia on Fibromyalgia