Fibromyalgia

Fibromyalgia Overview

spine-health — Tue, 11 Dec 2007 21:16:20 -0800

Definition of fibromyalgia

The condition called “fibromyalgia” is a myofascial pain syndrome (a muscular pain syndrome) that can result in generalized back pain and muscle pain, a feeling of general fatigue, and specific tender areas. The patient will have a normal neurological exam, but may have multiple spots that are tender to palpation, called "tender points".

Fibromyalgia: Aerobic Fitness for Fibromyalgia

spine-health — Wed, 02 Jan 2008 07:52:38 -0800

Aerobic exercise is considered an essential component of a comprehensive management program for fibromyalgia. In a review of fibromyalgia patients, it was found that more than 80% of the patients were physically "unfit" based on maximal oxygen uptake and the American Heart Association guidelines ⁴⁷.

Fibromyalgia: Alternative Treatments for Fibromyalgia (Non-Medicine Treatments)

spine-health — Tue, 11 Dec 2007 21:25:43 -0800

A wide variety of non-medicinal therapeutic modalities have been employed in an effort to alleviate the symptoms of fibromyalgia ⁵¹. While many fibromyalgia patients may respond to one or more of these treatments, few controlled studies have been performed to establish their efficacy.

One therapy that has been studied and found to be effective for fibromyalgia patients is EMG-biofeedback training.

Fibromyalgia: Management of Fibromyalgia

spine-health — Tue, 11 Dec 2007 21:25:43 -0800

Comprehensive approach to managing fibromyalgia
The precise pathophysiologic basis of fibromyalgia has yet to be clearly and convincingly illustrated. Fibromyalgia is known to be a chronic disorder, which means that there is no "cure" for fibromyalgia. Instead, treatment involves a coordinated management program to alleviate the symptoms.

The goals of a management program should include the following components:

Correct diagnosis of fibromyalgia
read more

Fibromyalgia: Differential Diagnosis of Fibromyalgia

spine-health — Tue, 11 Dec 2007 21:25:43 -0800

Obtaining an accurate diagnosis of fibromyalgia

With the exception of tender points, the physical examination may be unrevealing because the patient’s symptoms are common and non-specific (e.g. fatigue).

The diagnosis may be confused with other conditions, including myofascial syndrome, rheumatoid arthritis or osteoarthritis, among other conditions. An accurate diagnosis is critical because the treatments are very different.

Fibromyalgia: Patient Education for Fibromyalgia

spine-health — Tue, 11 Dec 2007 21:25:43 -0800

The foundation of an effective fibromyalgia management program is perhaps patient education. A patient who is well educated about fibromyalgia can have a sense of control and improved ability to manage the condition, which in turn can substantially alleviate symptoms of fibromyalgia.

First, patients should know that fibromyalgia is a common, non-progressive, non-deforming, and non-life threatening condition. Patients should be reassured that physical activity will not harm them and in fact can be helpful. Also, remissions can be expected from time to time ³⁹.

Fibromyalgia Condition Center References

spine-health — Tue, 11 Dec 2007 21:25:43 -0800

Wolfe, Fibromyalgia. Rheum Die Clin N.A.,16 (3) August 1990, 681-698.
Smythe, Non-Articular Rheumatism and Psychogenic Musculo-skeletal Syndromes, in Arthritis and Allied Conditions, Eleventh edition, Edited by McCarty, Philadelphia, 1989:1241-1254.
Bennett, Fibrositis, in Textbook of Rheumatology, Third Edition, Edited by Kelley, Philadelphia, 1989: 541-553
Schumacher, Primer on the Rheumatic Diseases, Ninth edition, 1988: 227-230.
read more

Fibromyalgia: Correct Diagnosis for Fibromyalgia

spine-health — Tue, 11 Dec 2007 21:25:43 -0800

The average duration from onset to diagnosis of fibromyalgia is approximately 5 to 8 years. Therefore, by the time a diagnosis is made, most patients have seen numerous different physicians and have undergone extensive testing. Still they are often left without satisfying answers.

Fibromyalgia Symptoms

spine-health — Tue, 11 Dec 2007 21:25:43 -0800

Fibromyalgia symptoms are quite common but non-specific. However, the constellation of symptoms can often suggest a diagnosis of fibromyalgia.

Fibromyalgia: Medications for Fibromyalgia

spine-health — Tue, 11 Dec 2007 21:25:43 -0800

Various classes of medications have been evaluated in the treatment of fibromyalgia, including:

Tricyclic anti-depressants

Muscle relaxants

Sedatives/hypnotics

Non-steroidal anti-inflammatory medications (NSAID’s)

Cortico steroids

Fibromyalgia: Specific Diagnosis of Fibromyalgia

spine-health — Tue, 11 Dec 2007 21:25:43 -0800

American College of Rheumatology Diagnosis Criteria

"The hallmark of the examination of a fibrositis patient is the lack of objective findings in relation to the plethora of symptoms. The only abnormal finding is the presence of numerous tender points".
Robert Bennett, 1988

Fibromyalgia: Sleep Enhancement for Fibromyalgia

spine-health — Tue, 11 Dec 2007 21:25:43 -0800

Unrefreshing or non-restorative sleep is reported in greater than 75% of fibromyalgia patients. One study reported abnormal stage 4 sleep patterns in fibromyalgia patients ³³. Furthermore, clinically induced sleep deprivations can induce a conditions like fibromyalgia in normal adults.

Fibromyalgia: Profile of Fibromyalgia Patients

spine-health — Tue, 11 Dec 2007 21:25:42 -0800

Clinical studies involving fibromyalgia patients

Recently, there have been a number of useful clinical studies to understand the profile of fibromyalgia patients. In a 1986 study that compared fibromyalgia patients with a control group, fibromyalgia patients were found to be in general better educated, wealthier, and more likely to be married. Additionally, they had greater use of the health care system, averaging 13 health care visits per year and 3 to 4 times the number of lifetime hospitalizations ¹³.

The average fibromyalgia patient profile comprises:

Fibromyalgia: Evolution of Fibromyalgia

spine-health — Tue, 11 Dec 2007 21:25:42 -0800

Until recently, the lack of a unifying etiology (the study of the causes and origins of the condition), and the lack of an accepted terminology, has hindered the understanding and recognition of fibromyalgia. Over the years, fibromyalgia has undergone a "conceptual evolution" ²¹.

Fibromyalgia: Defining Characteristics of Fibromyalgia

spine-health — Tue, 11 Dec 2007 21:25:42 -0800

Introduction to fibromyalgia symptoms, diagnosis and treatment

Fibromyalgia is a fairly common—although difficult to understand—syndrome. It is characterized by scattered musculoskeletal pain (involving the muscles and bone structure), tenderness in specific areas, generalized fatigue and a feeling of being tired after sleeping ^1-6.

Fibromyalgia is most common in relatively young, otherwise healthy-appearing individuals, and occurs much more often in women than in men. It is estimated that fibromyalgia affects up to six million people in the US (10).