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Fibromyalgia

What is fibromyalgia?

Fibromyalgia is a condition that is characterized by widespread musculoskeletal pain and fatigue. It affects approximately 2% of the US adult population. There are roughly 6 million diagnosed cases making fibromyalgia the third most common rheumatologic disorder. It is usually a chronic condition that is a multi-system disorder. Fibromyalgia is often classified as a syndrome meaning there are frequently a host of symptoms that are common among sufferers. In addition to widespread pain and fatigue, patients who have fibromyalgia also complain of sleep disturbance, headache, dizziness, irritable bowel, genitourinary symptoms, depression, abnormal skin sensations such as numbness and tingling (paresthesia), predisposition to allergic reactions, morning stiffness, ocular sensitivity, and loss of balance (poor proprioception). Talk to your health care provider about other symptoms that you are experiencing as they may be related to the syndrome. Although the exact etiology (origin of the condition) is unknown, there are certain factors that are often attributed to the cause. These include disrupted sleep pattern, history of trauma or infection, immune abnormality, endocrine aberration, reduced blood flow to muscles, and/or altered serotonin levels. It is important to remember that fibromyalgia may be secondary to an underlying disease state; it is important to discuss this with your doctor making him or her aware of all of the symptoms you are experiencing.

How is fibromyalgia diagnosed?

Currently there are no tests that definitively diagnose fibromyalgia; research is being conducted in order to determine biochemical markers that detect metabolic anomalies. Additionally, there are several preliminary studies that indicate that brain imaging studies may support the diagnosis; however, neuroimaging is not yet widely accepted. Generally the condition is diagnosed via clinical examination (based on history, physical examination and palpation) performed by a qualified health care provider.

What are the options for treating fibromyalgia?

Effectively treating fibromyalgia requires a multimodal approach. When at all possible, find a treatment plan that is minimally invasive without drugs or surgery. More invasive options should only be entertained after the conservative methods fail to produce the desired result. Our clinic offers an evidence based treatment strategy that consists of exercise programs, soft tissue techniques, physiotherapy, massage, behavior modification counseling, nutritional counseling, and joint adjustments (also known as joint manipulation). Acupuncture is an alternative treatment method not provided in our clinic. On the more invasive end of the spectrum are pharmacotherapeutic options such as muscle relaxants (cyclobenzaprine), antidepressants (amitriptyline and nortriptyline), selective serotonin-reuptake inhibitors, benzodiazepines and analgesics. Certain individuals may experience temporary reduction in pain from trigger point injections. Talk to your health care provider about the strategy that will best suit your needs. The best approach to treating fibromyalgia is one that is individualized.

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