Written By: Shraddha Rupavate | Updated : May 22, 2014 11:11 AM IST
Khyati, a 43 year old female, had just recovered from minor injuries after she met with an accident. She had never felt energetic since then. She always complained about dull pain in the neck and the shoulder region. Gradually the pain extended to her limbs and her back down the spine. Occasionally, she took pain killers for relieving headache but that relief would last only for a few hours. Slowly the pain started interfering with all her daily activities. 'I can't walk anymore; my legs are numb,' she told her husband once after walking a few steps. She visited several doctors and took hundreds of tests but could not understand what was happening to her.
Khyati was suffering from a chronic disabling condition called fibromyalgia. Although fibromyalgia is rarely found, it is one of the most common pain disorders that people may suffer from. Two main characteristic features of fibromyalgia are chronic pain and extreme fatigue. A person with fibromyalgia experiences long-term pain in the joints, muscles and tendons, which is not associated with any other cause. That's why it is considered a syndrome rather than a disease.
What causes fibromyalgia?
The exact cause of fibromyalgia is still unknown. But scientists now report that fibromyalgia has something to do with nerve fibres of the palm. According to a study published in the journal Pain Medicine, patients with fibromyalgia had more sensory nerve fibre within the blood vessels of their skin covering their palm. The blood vessels in the limbs help in regulating blood flow throughout the body and interference caused due to nerve fibre may lead to pain.
Here are some factors that are known to trigger fibromyalgia
What are the symptoms of fibromyalgia?
Fibromyalgia is associated with many other conditions like
The main symptom of fibromyalgia is moderate to severe pain in tender points. Tender points are the areas having soft tissues on the back, neck, shoulder, chest, hips, elbows, chin and knees. The pain may be localized at one point or may be felt like a deep ache, burning sensation or shooting, throbbing pain. Patients may also complain about:
Rare symptoms include tension headache, poor concentration, tingling sensation in the hands and feet.
When should you see a doctor?
There are about 18 known tender points (9 pairs) where your pain may be localized: Back of the neck, elbows, hips, thighs, shoulder blades, lower back, knees, chest and front of the neck. If you have pain in these tender points you should either see a pain specialist, rheumatologist or neurologist who could help you in diagnosing the condition properly.
How is fibromyalgia diagnosed?
There is no definitive test that can confirm fibromyalgia because the exact cause is not known. But the diagnosis of the condition is based on how long you have been suffering from the symptoms. Generally a patient suffering from chronic pain and fatigue over a period of 3 months is suspected to have fibromyalgia. If the patient is experiencing pain in at least 11 points out of the 18 known tender points, then the doctor will most certainly diagnose fibromyalgia. These tender points should include soft tissues in the elbow, chest, knees, lower back, neck, shoulder and thighs.
Can fibromyalgia be cured? What are the treatment options for fibromyalgia?
No. Fibromyalgia cannot be cured as of now. The goal of treatment is to relieve symptoms and improve the quality of life of patients.
Medication: Currently, duloxetine, pregabalin and milnacipran are three key drugs used in treatment of fibromyalgia. All three drugs help reduce muscle pain and stiffness. Your doctor may prescribe muscle relaxants and pain killers for reducing pain initially. Antidepressants maybe prescribed if stress acts as a trigger for inducing pain or if your pain makes you depressed. Sometimes the doctor may also give you sleeping pills if you're unable to sleep because of pain.
Physical therapy: Physiotherapy and some exercises may improve flexibility in patients who have muscle stiffness. Physical therapy helps the patient to manage the symptoms on their own.
Cognitive behavioural therapy: It is an important part of treatmentin patients with fibromyalgiabecause they are likely to get depressed and lose hope after finding out that their condition cannot be cured. Cognitive behavioural therapy helps patients to keep negative thought away and encourage them to involve themselves in activities they like with proper management of symptoms.
Read more about causes, symptoms, diagnosis and treatment of fibromyalgia.
References:
Clauw DJ. Fibromyalgia: an overview. (www.ncbi.nlm.nih.gov)
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