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LOTS OF INFORMATION ABOUT FIBROMYALGIA (FMS)
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WHAT IS FMS?
Fibromyalgia (or FMS shortened) is a type of rheumatism which affects the muscles and ligaments of the body. In fibro - my - algia the fibrous tissues (fibro) and muscles (-my) are affected by pain (-algia) and tenderness. It is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and multiple tender points. Fibromyalgia Syndrome is a painful and debilitating condition which affects 5 percent of the population - mainly women as women outnumber men as much as 20:1 (this is in dispute currently, as more men are now seeking treatment). The main symptoms are "pain all over" the body and debilitating fatigue. It is an "invisible" illness and most sufferers appear fit and well, which adds to their problems. These aches and pains can come from almost anywhere in the body, and can include one or two or ten or twelve different areas depending on the person. Each person can differ in severity. While technically not damaging to the body, it is painful, sometimes debilitating. One sufferer may feel no more than annoyed by mild pain, another may be disabled by the severity of pain. The range is so wide that some people with FMS carry on with normal lives managing their pain with over the counter analgesics (and enjoy frequent remissions) while others find themselves in such constant, unrelenting pain that they must give up jobs and require narcotic therapy to simply function, so severe it interferes with personal, family life and daily activities. Fibromyalgia is not fatal, and most people are relieved to know what they have and that it isn`t some serious bone cancer or other fatal ailment. FMS is not consistant as you may hurt one place one day and not the next. Because there are no outward signs, other people may not realise the pain and extreme tiredness you are suffering. People with fibromyalgia often look well and feel awful. FMS is most common in middle aged women from 30 - 50 years. But there are lots of cases of men, children, teenagers, and adults out of the age bracket having it too. As I am one of them and so is my sister.
WHAT IS THE CAUSE OF FMS?
Although the cause of fibromyalgia is unknown, researchers have several theories about causes or triggers of the disorder. Some scientists believe that the syndrome may be caused by an injury or trauma. This injury may affect the central nervous system. Fibromyalgia may be associated with changes in muscle metabolism, such as decreased blood flow, causing fatigue and decreased strength. Some believe that it may be a Growth Hormone Deficiency, or maybe Less Serotoin Level In The Brain. Others believe the syndrome may be triggered by an infectious agent such as a virus in susceptible people, but no such agent has been identified. Some believe that it may be a underlying syndrome, Disease or Illness. Whilst others believe it could be genetics as various cases have siblings (like me and my sister) or mothers and daughters with it. Some kind of genetic or heriditory condition. WHO KNOWS?
WHAT ARE THE SYMPTOMS OF FMS?
*Pain, Wide spread with tender points
*Aches, Flu-like overall body aches that change intensity
*Extreme fatigue or constant exhaustion that occur day after day, even when you haven't done anything.(Chronic fatigue)
*Overall weakness
*Morning muscle stiffness
*Frequent or constant trouble sleeping
*Numbness, swelling, tingling (subjective)
*Soft tissue swelling
*Arthritis (osteoarthritis or and rheumatoid).
*Chest Wall Pain
*Mental malaise and confusion, often referred to as fibro fog. Included also would be difficulty concentrating, forgetfulness, and or attention difficulties.
*Headaches (migraine or tension) or and Temporomandibular Joint Syndrome.
*Complaints of swollen glands
*Irritable bowel syndrome or spastic colon.
*Restless legs.
*Paresthesia - pins and needles that primarily affect the legs, hands, or feet
*Heightened sensitivity to odors, noises, bright lights, medications, changes in the weather and or various foods.
*Abnormal anxiety
*Painful periods
AGGRAVATING FACTORS:
Changes in the weather, stress, depression, cold or drafty places, anxiety, hormone fluctuations.
HOW IS FMS DIAGNOSED?
For many years doctors had no idea of what this group of symptoms actually was. It was often diagnosed as muscular rheumatism or fibrositis. People suffering did not show up anything in a blood test or x-rays. Fibromyalgia is difficult to diagnose because many of the symptoms mimic those of other disorders. Be aware that trained physicians initially may diagnose Fibromyalgia when, in reality, it is another problem, or the very opposite could happen - sometimes a diagnosis of another medical condition is given when its actually Fibromyalgia that you are suffering from. Even harder to diagnose is the person who has Fibromyalgia but also has one of the other conditions as well. The physician reviews the patient's medical history and makes a diagnosis of fibromyalgia based on a history of chronic widespread pain that persists for more than 3 months. Pain in all four quadrants of the body: Right side, left side, above the waist, below the waist. Pain that occurs in at least 11 of the 18 "tender" points that are specified in a Fibromyalgia exam. Pain defined, in this context, as discomfort when 8 pounds of pressure are applied to the tender point, these must all be present. No single test can detect fibromyalgia, however there is at least one telltale sign on physical exam: a pattern of specific "tender spots"- muscles and tendons that are painful when touched. They cannot be located in any single anatomical distribution, must be present for at least three months and must include 11of 18 defined locations (figure 1). Proper diagnosis requires a specialist with expertise in neuro-musculoskeletal medicine. There is a device called an Alogometer that can be used to measure just how tender the sites involved are (figure 2), however the majority of specialists rely upon their physical exam skills to determine this.
figure: 1
figure: 2
WHAT OTHER CONDITIONS/DISEASES MIMIC SYMPTOMS OF FMS?
Since fibromyalgia mimics other illnesses/diseases, many people who experience chronic pain and fatigue do not know that they have fibromyalgia, or they think that they have something else. Bloodwork is commonly done to rule out most of the other possible diseases. Fibromyalgia mimics other diseases/conditions such as rheumatoid arthritis, osteoarthritis, polymyalgia rheumatica, idiopathic inflammatory myopathy, Lyme Disease, hepatitis C, myofacial pain syndrome, connective tissue disorders such as lupus, neurological disorders like multiple sclerosis or early Parkinson's disease, hypothyroidism, and malignancy. Even Gulf War Syndrome has many of the same symptoms as FMS.
HOW IS FMS TREATED?
Overall it is worth facing up to the fact that fibromyalgia can be severe and can last for several years. You can help yourself by finding out what helps you. You must be prepared for setbacks, and for the fact that treatments will be very painful and very long. Waiting lists take months, and things you try may not work. Remember too that what helps one person with FMS might not work so well for another. It is a vicious cycle but there's nothing stopping you trying things such as:-
*Excersise progressively, don`t over do it. Stretching excersises may not ease the pain but might strengthen your muscles and joints.
*Relaxation, learn to take time out for yourself. Reduce muscle tension and stress by learning to relax your mind and body, playing an audio tape may help some people.
*Herbal medication.
*Anti-depressant drug even if there is no depression. Some of the older anti-depressants (e.g- Amytryptyline) have been found to be effective for chronic pain. The benefit may not be immediate, so it is worth trying it for at least a couple of months before deciding if they are helpful.
*Sleeping in a soft collar helps some people sleep better.
*Some painkillers (like paracetamol) and non-steroidal anti-inflammatory drugs (like ibruprofen) may help a little.
*Treatments like massage, accupuncture, physiotherapy and manipulation from a chiropractor or osteopath can all soothe pain and improve morale, but the benefits may not be long lasting. Only you can decide wheather the benefits if any are worth the pain, time and expense.
*A steroid injection in the affected area may help if one or two places are particularly painful. But the effect of injections is temporary.
*Hot baths help most people. Whilst there in the bath the hot water gives a soothing pain relief, but again only temporary whilst your in the bath. However they are tough to get in and out of if your pain is extreme. So you could also soak in a shower. Just put a plastic chair in the shower and sit there and aim the hot water at your pains.
*Hydro-pools can also help some people. They are special swimming pools with the temperature higher.
*Other prescription tablets are available, muscle relaxants and pain killers. But not may people with FMS have said that these tablets work. Some help a little but the side effects may not be worth the little effect they have. It depends on the individual.
*Guaifenesin is a drug that is new to people with fibromyalgia. It is not leagalised yet though. It makes you alot worse for a couple of months to start with. But then some symptoms get better in some FMS sufferers, in several months of taking it. Any benefits that guaifenesin brings can be blocked by the presence of salicylates (e.g-asprin) in your body. If you wish to try this product you`ll need to eliminate salicylates from your diet. Talk to your doctor to get more information.
*Diet, eat healthily and keep your weight down
ALSO YOU CAN COMBINE MEDICATION WITH TREATMENTS. YOU DON`T JUST HAVE TO TRY ONE TREATMENT TO HELP. TRY AS MANY AS YOU LIKE. YOU MIGHT FIND A BIT OF RELIEF. (take care to some treatments as each individual has different problems and a different collection of symptoms. Especially be careful if your fibromyalgia is accompanied by other conditions. As specified treatment paths for one condition can deteriate the other condition symptoms. Please see a professional who knows about each of your conditions thoroughly)
Try to keep your spirits up. Try to not get too down hearted, as although depression is not the cause of Fibromyalgia, it will make you feel worse and more fatigued. Learn about fibromyalgia. Get as much information and knowledge as you can find. There are lots of books, and the internet is a great sorce of information. Find out if there is a local support group in your area. Sharing the frustration of having this condition and knowing that other people out there have similar problems can help enormously. Ask your family to read infrormation on FMS and talk to them about your condition. Their lives have changed too.
WHAT IS THE PROGNOSIS OF FMS?
Because few are thought to completely recover from fibromyalgia, the syndrome is considered to be a chronic condition. Although current studies do not agree about the prognosis of people with fibromyalgia. For example, results from some specialized treatment centers show a poor prognosis, whereas community-based treatment programs show remissions in 24 percent of patients and symptom improvement in 47 percent. These mixed findings may be to do with the fact of the misdiagnosis's of fibromyalgia. People may improve if they did not suffer from it in the first place, and vice-versa. That is why results are not 100 percent relyable. Fibromyalgia is a common and chronic problem. The symptoms sometimes improve. At other times, the symptoms may worsen and continue for months or years. The key is seeking professional help which includes a multi-faceted approach to the management and treatment of the disease. Some kind of lifestyle modification is generally required for all fibromyalgia sufferers but there is no proof that fibromyalgia syndrome results in an increased death rate.
Fibromyalgia is getting more and more recognised around the world. (especially in the united states, and its more recognised than it was a couple of years ago here in the united kingdom.) There are more and more doctors, specialists and physiotherapists who know about it. However there are still plenty who speculate and have their own theories on FMS, but that will always be the case until more is researched and more answers are found.
Is FMS the new name for CFS/ME?
Is there such a condidion as FMS or is it an UNDERLYING condition with mimicing and overlapping symptoms of other conditions/diseases?
Is FMS hereditory?
Do specialists fob off patients with a FMS diagnosis?
Plus many more unanswered questions still to be answered!
ONLY THE FUTURE CAN ANSWER THESE QUESTIONS FOR SURE!
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FIBROMYALGIA, HYPERMOBILITY SYNDROME & CHRONIC FATIGUE SYNDROME / M.E
