Fibromyalgia: mechanisms, symptoms, and clinical management

Fibromyalgia

The objective of this study is to examine the condition of Fibromyalgia. Toward this end, this study will conduct a review of current literature in this area of inquiry.

Fibromyalgia is a syndrome reported as common and one in which the individual has pain throughout their body as well as joint, muscle, tendon and soft tissue tenderness on a long-term basis.

Causes of Fibromyalgia

While the cause of Fibromyalgia is uncertain it has been linked to such as fatigue, problems sleeping, headaches, anxiety, and depression. Factors that are believed to be potential triggers of fibromyalgia include: (1) physical or emotional trauma; (2) abnormal responses to pain in areas of the brain; (3) disturbances in sleep; and (4) infection although no specific virus has been identified as being responsible for causing Fibromyalgia.

Occurrence of Fibromyalgia

Fibromyalgia is known to occur most in women ages 20 to 50 years of age. Conditions that may appear the same as Fibromyalgia include the conditions of: (1) chronic pain to the back or neck; (2) chronic fatigue syndrome; (3) depression; (4) hypothyroidism; (5) Lyme disease; and (6) sleep disorders. (Summary of Cochrane Review, 2012, p.1, Centers for Disease Control and Prevention, 2012, p.1)

Symptoms of Fibromyalgia

Pain is the primary symptom of fibromyalgia and ranges from mild to severe. The painful areas are referred to as "tender points" and are reported to be located in the soft tissue on the back of the neck, shoulders, chest, lower back, hips, shins, elbows, and knees. The pain spreads out from these areas and may feel such as a deep ache or shooting burning type of pain. In reality, the joints are not affected yet the pain appears to be coming from the joints of the individual affected by Fibromyalgia. (Summary of Cochrane Review, 2012, paraphrased)

There is a tendency for invidiously with Fibromyalgia to awaken with pain and stiffness in their body and in some individuals, the pain gets better during the daylight hours and then worsens again at night. For others, there is no relief since they suffer pain both day and night. Factors that tend to make Fibromyalgia worse include such as activity, weather that is cold or damp as well as suffering stress and anxiety. Nearly all individuals with Fibromyalgia experience fatigue, depression, and problems with sleeping and it is reported that it is difficult for those with Fibromyalgia to fall asleep and when they do fall asleep they have difficulty staying asleep and feel tired upon awakening. (Summary of Cochrane Review, 2012, paraphrased)

Additional symptoms of Fibromyalgia are reported to include: (1) irritable bowel syndrome; (2) problems with memory and concentration; (3) hands and feet tingling and feeling numb; (4) reduced ability to exercise; and (5) tension and migraine headaches. (Summary of Cochrane Review, 2012, p. 1)

Diagnosis of Fibromyalgia

Diagnosis of fibromyalgia requires at least three months of pain widespread in the individual's body and pain and tenderness in 11 of 18 areas of the body include those as follows: (1) arms (elbows); (2) Buttocks; (3) chest; (4) knees; (5) lower back; (6) neck; (7) rib cage; (8) shoulders; and (9) thighs, (Summary of Cochrane Review, 2012, p. 1) While blood and urine testing in those with Fibromyalgia are generally normal it is necessary to conduct these tests so that other conditions that are similar to Fibromyalgia can be ruled out.

Treatment of Fibromyalgia

The goal of treatment is to relieve pain and other symptoms associated with Fibromyalgia. (Summary of Cochrane Review, 2012, paraphrased) The first type of treatment involves (1) physical therapy; (2) exercise and fitness program; and (3) stress-relief methods including light massage and relaxation techniques. (Summary of Cochrane Review, 2012, p. 1) When these types of treatment are not effective an antidepressant or muscle relaxant may be prescribed. Medication is used to improve sleep and tolerance to pain and should be used in combination with exercise and behavior therapy. Medications that are used for treating fibromyalgia include: (1) anti-seizure drugs; (2) other anti-depressants; (3) muscle relaxants; (4) pain relievers; and (5) sleeping aids. (Summary of Cochrane Review, 2012, p. 1) Another therapy for treatment of fibromyalgia is cognitive behavioral therapy which assists the individual in coping with negative thoughts, in keeping a diary of pain and other symptoms of Fibromyalgia, recognition of what makes the symptoms of Fibromyalgia worse, seeking out activities that the individual enjoys and setting limitations for themselves. Support groups have been found to be of great assistance. Additional recommendations include consuming a well-balanced diet, avoidance of caffeine, practicing good sleeping routines, and acupressure and acupuncture. In the case of severe fibromyalgia, a referral to a pain clinic may be required.

Prognosis of Fibromyalgia

Fibromyalgia is a disorder that is long-term and that is characterized many times by improvement of symptoms. The pain may worsen at other times and be ongoing for months and even years.

Research Studies on Fibromyalgia

The work of Demirbad and Erci (2012) examined the effects of sleep and touch therapy on symptoms of fibromyalgia and depression. It is reported that there are various interventions practiced in the attempt to bring about a reduction in fibromyalgia symptoms. The study reported by Demirbad and Erci (2012) was conducted in the Physical Medicine and Rehabilitation Polyclinic in Trabzon Turkey between September 2009 and March 2011. The sample was comprised by 162 female patients with a previous diagnosis of fibromyalgia at least six months prior to the study. The sample contained two intervention groups and one control group containing 54 patients. A personal information form was used for collection of data as well as a Fibromyalgia Symptom Form and the Beck Depression Index. The study employed a pre-test/post-test control group design. A paired sample t-test was utilized to make comparison of the in-group scale points, the chi-square in the intergroup comparisons and the McNamer test in the in-group comparisons. Following the intervention it is reported that the depression levels in the touch-music-aroma therapy group "however a larger decrease (before: 22.01±5.3; after: 14.52±3.7) than in the sleep-music-aroma therapy group (before: 24.81±5.1; after: 20.16±4.9) and control groups (before: 23.73±4.4; after: 21.05±2.6). Symptoms such as restless sleep, headache, morning fatigue, exhaustion, feeling like crying and bowel complaints were also significantly reduced (P