Truly, times are changing! Previously, we only used to bother about the joint pains and the lack of mobility suffered by our grandparents. But now, we are seeing so many middle-aged individuals with the same problem. More surprisingly, such symptoms of rheumatic disorders are even observed in children these days. People feel a body-wide pain and tender points in muscles, joints and other soft tissues for a long period. These symptoms are often accompanied by other issues like fatigue, sleep problems, and anxiety or depression, which can affect one's quality of life. If you are experiencing these symptoms, then there is a possibility that you are suffering from Fibromyalgia.
Fibromyalgia is a distinct and one of the three top rheumatic disorders, affecting about two percent of the population (usually middle-aged people but recently seen in children) with widespread pain or stiffness and tender points. Notably, there are no measurable findings on X-rays or lab tests. Researchers believe that, there is a familial aggregation (for example, fibromyalgia is found in about 25 percent of children with fibromyalgia mothers) and a significant linkage to a disease susceptibility gene to the human leucocyte antigen. Moreover, women are 10 times more likely to have fibromyalgia than men.
What are the Clinical Features of Fibromyalgia?
- Pain at rest, cold and humid weather. Fibromyalgia seems to get triggered with emotional stress or with poor sleep.
- Presence of tender points in specific locations in the body is the unique feature of fibromyalgia. There are 18 specific tender points detected.
- Fatigue is the second most common and a debilitating symptom of fibromyalgia. It is often associated with non-restorative sleep, awakening and problem falling asleep. A vicious cycle forms due to poor sleep pattern which worsens the pain and the pain in turn, disturbs sleep.
- Other symptoms include decreased concentration, headaches, irritable bowel syndrome, postural dizziness, endometriosis, pre-menstrual syndrome, restlessness and mitral valve prolapse (improper closure of valve).
Fibromyalgia has a poor prognosis, and a disability equal to that of rheumatoid arthritis. Depression is also associated with the duration of the disease.
What are the Causes of Fibromyalgia?
Till date the exact cause of fibromyalgia is unknown, but many theories suggest hormonal imbalances as a cause. The condition of fibromyalgia consists of changes in sleep patterns, sensory processing disturbances and neuroendocrine (Neuro Hormonal) dysfunction. There seems to be deficiencies of four main hormones:
- Decreased cortisol
- Decreased serotonin
- Decreased growth hormone
- Decreased autonomic response
Related to these, other alterations may occur and these include decreased CSF substance P and melatonin levels, decreased calcium metabolism and thyroid function, and increased prolactin level.
The Diagnosis of Fibromyalgia
There is no specific pathological or lab test to detect fibromyalgia, the diagnosis is purely based on the presence of clinical symptoms and the presence of at least 11 sensitive tender points out of a total of 18 such points.
The Management of Fibromyalgia
The treatment of fibromyalgia is symptomatic in nature. Along with medications, alternative medical approaches have also been found to be effective in the treatment of fibromyalgia.
Medication
The purpose of medication is to ease symptoms like pain, sleep disturbances etc. Some of the commonly used drugs are painkillers; tricyclic or tetracyclic antidepressants and hypnotics to treat sleep disturbances and depression; and Hormonal therapy and steroids to treat the hormonal imbalances.
Alternative Approaches
The most common and effective alternative approaches include:
- Exercises: Regular exercises have been found to be effective in managing most of the symptoms of fibromyalgia. Thirty minutes daily gentle aerobic exercises have positive effects on growth hormone, serotonin and androgen levels and on autonomic dysfunction. Regular exercises can improve the fitness level of an individual. Exercises have psychological benefits as well. There is a development of a sense of well-being and this further helps in relieving depression. Exercises like walking, cycling and aqua aerobics are good ways to start an exercise regime but an individual should keep him away from overdoing it.
- Relaxation Techniques: Meditation, yoga, music therapy, aromatherapy and massage are the most commonly and widely used relaxation techniques to treat back stress, fatigue and depression. Relaxation techniques have been found to be associated with the release of serotonin in the body, thereby restoring the neuro-hormonal balance in the body.
- Diet: Some studies have found that certain foods such as caffeine, aspartame and MSG (Monosodium Glutamate, a food additive) are known to trigger fibromyalgia symptoms. Avoiding such foods can substantially reduce the severity of the symptoms. Some foods like chilies, peppers and some herbs are believed to relieve pain and other symptoms.
- Lifestyle Modification: Leading an active lifestyle with sufficient amount of sleep, proper diet and regular exercises, avoiding strenuous activities and learning proper techniques to get de-stressed will allow individuals to cope up with the condition. Quitting smoking and the consumption of alcohol are also advised.
There is no specific protocol to treat fibromyalgia. Treatment is symptomatic and individualized. Treatment which suits one may not be suitable or effective for the others. But after the identification of the most effective treatment, the process becomes much faster and individuals can expect a better quality of life.
