Overview
Fibromyalgia is a condition characterized by widespread muscle pain and tenderness. The term "fibromyalgia" breaks down into "fibro" (fibrous tissue) and "myalgia" (muscle pain). It is often mistaken for arthritis, although patients with arthritis can also develop fibromyalgia. This condition predominantly affects women more than men and is commonly seen in individuals aged 20-50 years, although children can also be affected.
Causes
The exact cause of fibromyalgia is unknown. However, there appears to be a link to factors such as arthritis, traumatic events, and mental health. Patients with fibromyalgia have increased sensitivity to pain, which means even minor pressure or knocks can cause significant pain. Poor quality sleep is also a significant factor, as it can worsen or even cause pain. Stress, depression, and unhappiness can further affect sleep quality, exacerbating the condition.
Symptoms
- Widespread body pain: Pain in the arms, forearms, thighs, and legs that impacts daily activities.
- Tender or overly sensitive joints and muscles: General body stiffness.
- Fatigue: Persistent tiredness and low energy.
- Mood disturbances: Low mood and irritability.
- Cognitive disturbances: Forgetfulness and lack of concentration.
- Sleep disturbances: Impaired restorative sleep.
- Depression: About one-third of patients may experience associated depression.
Other Symptoms
- Chronic headaches
- Dyspepsia (gastric issues)
- Burning or pricking sensations in feet and hands
- Abdominal pain
- Chest pain and palpitations
- Irritable bowel syndrome (diarrhea/constipation)
- Dizziness
Diagnosis
Diagnosis of fibromyalgia is based on clinical symptoms and physical examination. It is important to exclude other conditions like arthritis, myositis, and metabolic bone diseases. Clinical questionnaires filled out by patients can be valuable diagnostic tools.
Management
Fibromyalgia does not cause tissue damage, and its symptoms can be effectively managed with a combination of medication, physical therapy, and behavioral techniques.
Medications
- Analgesics: Acetaminophen or NSAIDs for pain relief.
- Antidepressants: Help with sleep, fatigue, and pain.
- Anti-seizure drugs: Reduce pain symptoms.
Therapies
- Supervised, low-impact aerobic exercises.
- Occupational therapy: Improves daily activities like personal care and household chores.
- Medications: Improve sleep and relax muscles.
Behavioral Techniques
- Planning and pacing daily activities to avoid overexertion.
- Engaging in pleasurable activities like hobbies and socializing.
- Avoiding triggers such as emotional stress, poor sleep, overexertion, and exposure to damp/cold weather.
- Stress management: Behavioral health providers can offer techniques to manage stress and prevent distress.
- Seeking help for chronic anger, despair, and pessimism.
Tips for Better Sleep
- Maintain regular sleep habits. Try to get to bed and wake up at the same time every day—even on weekends and vacations.
- Avoid caffeine and alcohol in the late afternoon and evening. If consumed too close to bedtime, the caffeine in coffee, soft drinks, chocolate, and some medications can keep you from sleeping or sleeping soundly. Even though it can make you feel sleepy, drinking alcohol around bedtime also can disturb sleep.
- Time your exercise. Regular daytime exercise can improve nighttime sleep. But avoid exercising within 3 hours of bedtime, which actually can be stimulating, keeping you awake.
- Avoid daytime naps. Sleeping in the afternoon can interfere with nighttime sleep. If you feel you cannot get by without a nap, set an alarm for 30 minutes to 1 hour. When it goes off, get up and start moving.
- Reserve your bed for sleeping. Watching the late news, reading a suspense novel, or working on your laptop in bed can stimulate you, making it hard to sleep.
- Keep your bedroom dark, quiet, and cool.
- Avoid liquids and spicy meals before bed. Heartburn and late-night trips to the bathroom are not conducive to good sleep.
Disclaimer
This information is for patient education purposes and is not intended for medicolegal use or self-medication.
Dr. Praveen Kumar M, Consultant Rheumatologist