So you think you may suffer from Fibromyalgia (FM) and you’re trying to find out more information about this condition… but where do you start? Certainly you can “Google” the word “fibromyalgia” and spend the rest of the day, week, or maybe month reading about the symptoms, clinical signs, the many treatment options, and the different types of doctors who treat FM patients. You will certainly learn a lot! But you will still most likely remain confused as to what to do about it.
First, what is fibromyalgia? It is a chronic (long-standing) painful condition resulting in widespread pain throughout the body and it’s usually difficult to isolate a cause or reason for such significantly disabling symptoms. It is very common, affecting 3-6% of the general population (global) and 6-12 million Americans (2-4% of the United States population). Woman are affected more than men (75-90% are women), and it is typically diagnosed between 20-50 years of age. FM affects people physically, emotionally, and socially. The symptoms can fluctuate but they never completely disappears. The cause, though still debated, points to the central nervous system in which a “minor” pain signal reaching the brain is somehow magnified and perceived as more intense (this is called “central sensitization”). This makes the FM patient hypersensitive to normal stimulations like a hug or a when hitting a bump in the road with their car.
How is it diagnosed? Prior to 1987, FM was not recognized by the American Medical Association (AMA) as an illness or cause of disability. In 1990, The American College of Rheumatology (ACR) reported the initial criteria for diagnosing FM. There are no blood tests, x-rays, biopsies, EEGs, EMGs, or other tests for FM. Hence, a thorough history (frequently revealing fatigue, sleep problems, mental fog, depression, headache, and bowel problems) and examination ruling out other disorders is appropriate. Diagnosis includes a history of widespread, chronic pain and the presence of multiple tender points (at least 11 of 18) located all over the body.
What is the treatment? Pain management has been the primary focus of treatment and this can include medication, ice/heat, exercise, lifestyle adjustments, counseling when anxiety/depression are issues, dietary strategies, sleep management, but perhaps most important is education about FM and how to “live with it.” That is, learning how to “control it” since no one has found the “cure.” Exercise in short durations of time by walking or swimming (not too strenuous). Expect post-exercise soreness so don’t overdo it initially or you’ll be “convinced” you shouldn’t be exercising. Diet – avoid glutens/grains and emphasize fruits, vegetables, lean meats (grass fed chicken, beef, and fish), and consider nutritional support from a multiple vitamin, calcium/magnesium, fish oil (omega 3 fatty acids), vitamin D3, and Co-Q10. Find a good “team” of doctors – a chiropractic, family doc, and rheumatologist who, YOU are comfortable with and who will work together for you. Finally, don’t expect miracles as it may lead to disappointment.