Fibromyalgia is, unfortunately, a common condition that causes widespread chronic pain. As many as 1 in 25 people is thought to possibly suffer from it. More women than men seem to be affected from it (or, at least, are diagnosed with it), and it seems indiscriminate about age.
It is not life-threatening, progressive or degenerative, but it can be life changing. It doesn’t cause permeant damage to muscle, bones, organs, or joints, but it can and does cause severe pain. One consolation that can be taken from the diagnosis is that, although very painful, it’s not causing any long-term damage or changes to your body in any way, and it is not related to any autoimmune disease, either.
The general cause is thought to be centred around how pain is processed by the CNS (central nervous system) and the brain itself, but the how or why is unclear.
It’s a condition that causes a variety of symptoms alongside widespread chronic pain, and these can vary from person to person, and even from day to day:
- Pain within the muscles, tendons, and ligaments
- Lack of energy
- Sleeping disorders
- Mild Depression & Irritability
- Forgetfulness or Poor Concentration
- Increased Sensory Sensitivity (to cold, knocks, bumps, touch, pressure, etc)
- Poor circulation
- Feeling an urgent need to urinate
Symptoms can be continuous or flare up at various intervals. It can be can be continuous with extra flare ups that intensify the symptoms further. The intensity of symptoms and general pain can vary person to person and day to day. Even between times of day. It can be worse in on or several areas, or universal throughout the body. No two cases will be exactly the same, but they will all share the same key symptoms: Constant long-term pain, sleep deprivation, and fatigue.
The fatigue is often cited as the worst symptom. It is reported by many sufferers that this is the worst symptom because you can’t think clearly or remember things – the colloquially-known Fibro-Fog.
Because there is no obvious injury or cause, and sufferers can look “perfectly well”, Fibromyalgia is an invisible illness.
Some people may have difficulty understanding the pain, fatigue, and difficulty people with the condition experiences – but that doesn’t make it anything to feel guilty or ashamed for. The condition is real, as is the pain and other symptoms experienced.
Diagnosis & Treatment
Diagnosis is difficult. The symptoms vary and they mirror the symptoms of other conditions. There is no specific test that can be done – this is a condition of non-diagnosis and elimination.
It is in the absence of positive test results and with the anecdotal information given by the patient regarding their symptoms, the diagnosis of Fibromyalgia is made.
Tests should be carried out to rule out anything more troubling. If, when, they then come back negative, Fibromyalgia can be safely diagnosed – rushing to this conclusion may mean missing a different diagnosing a different condition, so it is important for this to be a diagnosis of elimination, after tests have been made to rule out everything else.
Effective treatment can just as complicated and elusive as the diagnosis. There are many different options and levels of effectiveness, from drugs to alternative therapy:
- Neuropathic drugs – pregabalin and gabapentin are used to treat neuropathic pain
- Opiate Drugs – strong painkillers such as codeine, tramadol, buorenorphine, or fenatyl patches
- Capsaicin gel or NSAID gel – non-steroidal anti-inflammatory gels for pain and inflation in particularly painful areas
- Physiotherapy – helps improve posture, stretch and relax muscles, and advise about relaxation techniques
- Occupational Therapy – this can help with managing everyday things without increasing your pain or wearing yourself out by offering practical advice on ways of working and what tools or contraptions can assist in doing it
- Gentle Exercise – yoga as been shown to help some people, as has swimming, walking and cycling
- Complimentary medicine – massage, acupuncture, and osteopathy may temporarily ease the pain
- Getting Proper Sleep
- CBT – cognitive behavioural therapy can be helpful in developing coping skills in learning how to live with longterm chronic pain
Cause and Effect
As of yet, no one really knows what exactly causes it. It people have reported varying problems directly preceding the onset, such as excessive stress and anxiety, bereavement, depression, physical or mental trauma, and viral infections. It can be a combination, or it can be none. Some people simply don’t seem to have a clear trigger at all.
Whatever the trigger or cause, what does seem to be the case is that it seems to develop a problem with the way the brain and nervous system perceives and processes pain. There may be no physical injury causing the pain, yet the pain is still as real as if there was. The problem with this is that there is no obvious way to treat or heal the pain, and it therefore cannot be stopped.
This is the reason that fibromyalgia is a long term, chronic condition.
Long-term studies have been made with this condition, and a better understanding has been accomplished from them. It is believed that it is related to the way the brain processes pain, and specific brain scans (fMRI scans, to be precise) have shown these processes are altered in people with fibromyalgia, proving its existence to doctos
Despite no specific evidence as yet as to quite what fibromyalgia is, researchers do know what it is not: It is not damaging, inflammatory, autoimmune, progressive, nor structure changing.
More research is continuing to be undertaken and new developments will continue to be uncovered as time goes on. Experts in rheumatology, neuro-imaging, psychology, neuropharmacology, neurosciences, and orthopaedic surgery are focusing on research trials such as the MUSICIAN study into chronic widespread pain, which includes fibromyalgia.