By Faith Trussell, RN, BSN
Fibromyalgia is a common disorder characterized by chronic and widespread pain, sleep disturbance, fatigue, and, often, psychological distress. It is estimated that 2% of the population in the United States (roughly five million adults) are affected, 80-90% of those being women. The cause of fibromyalgia is not completely understood; however, sufficient biochemical abnormalities have been identified to substantiate the claim that it is not a subjective pain condition, but rather a physiological disorder of abnormal central processing of pain input.
Although no lab tests are available to definitively diagnose fibromyalgia, patients must first undergo thorough evaluation to rule out alternative diagnoses, such as hypothyroidism, lupus and chronic infections. When these and other possible disorders are ruled out, a person may be given the diagnosis of fibromyalgia, based on the presence of abnormal pain elicited by the application of pressure at 18 “tender points” (nine pairs) on the body, including the back of the head, elbows, shoulders, knees, hip joints and around the neck. While most people normally wouldn’t flinch, these areas are often extremely sensitive in fibromyalgia patients when light pressure is applied. Pain in 11 of the 18 points supports a diagnosis of fibromyalgia.
The pain associated with fibromyalgia is typically described as radiating over large areas of the body, predominantly involving the muscles and joints, although there is no inflammation or damage to the joints, muscles or other tissues. Besides the classic muscle and joint pain, fibromyalgia sufferers frequently report sleep disorders, dizziness, cognitive/memory impairment, chronic headaches, anxiety and depression, facial pain, fatigue, muscle twitches, weight gain and nausea.
Treating fibromyalgia with a multidisciplinary approach has been proven to be most effective, using a combination of psychological therapy (including aggressive depression treatment, relaxation training, cognitive-behavioral therapy, coping skills and distraction strategies), physical therapy (exercise/activity/conditioning, heat and massage) and medication (especially for depression and poor sleep; pain medications are minimally effective in fibromyalgia). Unfortunately, achieving a satisfactory clinical response to treatment for fibromyalgia is difficult. If you think you may suffer from fibromyalgia, ask your doctor about it.
Note: This column is provided by Senior Life Solutions, a program at Cedar County Memorial Hospital dedicated to addressing the emotional health of senior adults. Call 417-876-3656 for more information.