Fibromyalgia

Fibromyalgia is an inflammation of the fibrous or connective tissue of the body which causes widespread muscle pain, fatigue, and multiple tender points.Fibrositis, fibromyalgia, and fibromyositis are a set of symptoms believed tobe caused by the same general problem. Fibromyalgia affects 3-6% of the population. It is more common in adults than children, and in women than men, particularly women of childbearing age. The cause of fibromyalgia is not known.Sometimes it occurs in several family members, suggesting that it may be inherited. The primary symptoms of fibromyalgia are muscle and joint pain, stiffness, and fatigue. Pain is the major symptom with aches, tenderness, and stiffness of multiple muscles, joints, and soft tissues. The pain moves from one part of the body to another and is most common in the neck, shoulders, chest,arms, legs, hips, and back. Pain is present most of the time and may last foryears, but the severity changes. Symptoms of fatigue may result from chronicpain and anxiety about the problem. The inflammatory process also produces chemicals that cause fatigue. Other common symptoms are tension headaches, difficulty swallowing, recurrent abdominal pain, diarrhea, and numbness or tingling of the extremities. Stress, anxiety, depression, or lack of sleepcan increase symptoms. Symptoms vary from gradual improvement to episodes ofrecurrent symptoms.

Diagnosis is difficult because symptoms of fibromyalgia are vague and generalized. Coexisting nerve and muscle disorders such as rheumatoid arthritis, spinal arthritis, or Lyme disease may further complicate diagnosis. There are notests to diagnose fibromyalgia. The diagnosis is usually made after ruling out other medical conditions with similar symptoms. In 1990, the American College of Rheumatology developed standards to help diagnose fibromyalgia. According to these standards, a person is thought to have fibromyalgia if he or shehas widespread pain in combination with tenderness in at least 11 of the 18sites known as trigger points, including the base of the neck, along the backbone, in front of the hip and elbow, and at the rear of the knee and shoulder. There is no cure for fibromyalgia. The goal of treatment is to manage the symptoms through exercise, proper rest, and diet. A patient's clear understanding of his or her role in the recovery process is imperative for successful management. Helpful treatments include heat and occasionally cold applications, a regular stretching program, and aerobic activities which increase the heart rate. Exercise programs need to include good warm-up and cool-down sessions, with attention to avoiding exercises causing joint pain. The diet should include a variety of fruits and vegetables which provide trace elements and minerals necessary for healthy muscles. Adequate rest is essential and avoidingstimulating foods or drinks (such as coffee) and medications like decongestants before bedtime is advised. If diet, exercise, and adequate rest do not relieve the symptoms of fibromyalgia, medications such as antidepressantdrugs, muscle relaxants, and anti-inflammatory drugs may be prescribed. People with fibromyalgia often need to see a rheumatologist (a doctor who specializes in disorders of the joints, muscles, and soft tissue) to decide the cause of the symptoms, to learn about fibromyalgia and its treatment, and to exclude other rheumatic diseases. Treatment programs must be individualized to each patient. Massage therapy and attention to mental health, including psychological consultation, may be important. Other alternative therapies include hellerwork, rolfing, homeopathic medicine, Chinese traditional medicine(both acupuncture and herbs), polarity therapy, and Western botanicalmedicine. Fibromyalgia is a chronic problem with symptoms that improve and worsen. There is no way to prevent fibromyalgia. Staying as healthy as possiblewith a good diet, safe exercise, and adequate rest is the best prevention.

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