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What
is Fibromyalgia?
Fibromyalgia is a chronic condition
characterized by widespread pain in your muscles, ligaments and tendons, as well
as fatigue and multiple tender points ！ places on your body where slight
pressure causes pain. Fibromyalgia is more common in women than in men.
Previously, fibromyalgia was known by other names such as fibrositis, chronic
muscle pain syndrome, psychogenic rheumatism and tension myalgias.
Although the intensity of your
symptoms may vary, they'll probably never disappear completely. It may be
reassuring to know, however, that fibromyalgia isn't progressive or
life-threatening. Treatments and self-care steps can improve fibromyalgia
symptoms and your general health.
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Causes
It's likely that a number of factors
contribute to the development of fibromyalgia.
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Sleep disturbances. Some
researchers theorize that disturbed sleep patterns may be a cause rather
than just a symptom of fibromyalgia.
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Injury. An injury or trauma,
particularly in the upper spinal region, may trigger the development of
fibromyalgia in some people. An injury may affect your central nervous
system, which may trigger fibromyalgia.
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Infection. Some researchers
believe that a viral or bacterial infection may trigger fibromyalgia.
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Abnormalities of the autonomic
(sympathetic) nervous system. Part of your autonomic nervous system ！ the
sympathetic, or involuntary, system ！ controls bodily functions that you
don't consciously control, such as heart rate, blood vessel contraction,
sweating, salivary flow and intestinal movements. It¨s thought that
sympathetic nervous system dysfunction occurs in people with fibromyalgia,
particularly at night, which leads to fatigue, stiffness, dizziness and
other signs and symptoms associated with the condition.
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Changes in muscle metabolism.
For example, deconditioning and decreased blood flow to muscles may
contribute to decreased strength and fatigue. Differences in metabolism and
abnormalities in the hormonal substance that influences the activity of
nerves may play a role.
Psychological stress and hormonal
changes also may be possible causes of fibromyalgia.
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Signs
and symptoms
Signs and symptoms of fibromyalgia
can vary, depending on the weather, stress, physical activity or even the time
of day. Common signs and symptoms include:
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Widespread pain. Fibromyalgia is
characterized by pain in specific areas of your body when pressure is
applied, including the back of your head, upper back and neck, upper chest,
elbows, hips and knees. The pain generally persists for months at a time and
is often accompanied by stiffness.
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Fatigue and sleep disturbances.
People with fibromyalgia often wake up tired and unrefreshed even though
they seem to get plenty of sleep. Some studies suggest that this sleep
problem is the result of a sleep disorder called alpha wave interrupted
sleep pattern, a condition in which deep sleep is frequently interrupted by
bursts of brain activity similar to wakefulness. So people with fibromyalgia
miss the deep restorative stage of sleep. Nighttime muscle spasms in your
legs and restless legs syndrome also may be associated with fibromyalgia.
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Irritable bowel syndrome (IBS).
The constipation, diarrhea, abdominal pain and bloating associated with IBS
are common in people with fibromyalgia.
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Headaches and facial pain. Many
people who have fibromyalgia also have headaches and facial pain that may be
related to tenderness or stiffness in their neck and shoulders.
Temporomandibular joint (TMJ) dysfunction, which affects the jaw joints and
surrounding muscles, also is common in people with fibromyalgia.
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Heightened sensitivity. It's
common for people with fibromyalgia to report being sensitive to odors,
noises, bright lights and touch.
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Other common signs and symptoms
include:
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Treatments
In general, treatment for
fibromyalgia includes both medication and self-care. The emphasis is on
minimizing symptoms and improving general health.
Medications
Medications can help reduce the pain of fibromyalgia and improve sleep. Common
choices include:
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Analgesics. Acetaminophen
(Tylenol, others) may ease the pain and stiffness caused by fibromyalgia.
However, its effectiveness varies. Tramadol (Ultram) is a prescription pain
reliever that may be taken with or without acetaminophen. Your doctor may
recommend nonsteroidal anti-inflammatory drugs (NSAIDs) ！ such as aspirin,
ibuprofen (Advil, Motrin, others) or naproxen sodium (Anaprox, Aleve) ！ in
conjunction with other medications. NSAIDs haven't proved to be effective in
managing the pain in fibromyalgia when taken by themselves.
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Antidepressants. Your doctor may
prescribe antidepressant medications such as amitriptyline, nortriptyline (Pamelor)
or doxepin (Sinequan) to help promote sleep. Fluoxetine (Prozac) in
combination with amitriptyline has also been found effective. Sertraline
(Zoloft) and paroxetine (Paxil) may help if you're experiencing depression.
Some evidence exists for a newer
class of antidepressants known as serotonin and norepinephrine reuptake
inhibitors or dual uptake inhibitors, which regulate two brain chemicals
that may transmit pain signals. Studies have found that duloxetine (Cymbalta)
may help control pain better than placebo in people with fibromyalgia. Small
trials of venlafaxine (Effexor) suggest the same, though more study is
needed to confirm these findings.
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Muscle relaxants. Taking the
medication cyclobenzaprine (Flexeril) at bedtime may help treat muscle pain
and spasms. Muscle relaxants are generally limited to short-term use.
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Pregabalin (Lyrica). Pregabalin
may reduce pain and improve function in people with fibromyalgia. Pregabalin,
an anti-seizure medication that's also used to treat some types of pain, is
the first drug approved by the Food and Drug Administration to treat
fibromyalgia. Studies show pregabalin reduced signs and symptoms of
fibromyalgia in some people. In one study, about half of the participants
taking the highest doses of the drug reported at least a 30 percent
improvement. Side effects of pregabalin include dizziness, sleepiness,
difficulty concentrating, blurred vision, weight gain, dry mouth, and
swelling in the hands and feet.
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Acupuncture
for Fibromyalgia
In Chinese medicine,
pain is caused by the stagnation of the qi and blood flow along the meridians
where the muscles are affected. For fibromyalgia, the underlying problem is qi
deficiency that causes energy flow blockage so that the muscles are less
responsive and muscular metabolism is impaired. Most FM patients experience
sleeping problem. They always complain of difficulty to fall asleep or wake up
during sleep by muscle pains and stiffness.
What acupuncture
does in FM treatment is not only to relieve the pain but also to improve the qi
flow and balance the function of internal organs which are always involved.
After patients' deep sleep is improved, they start to have better feeling during
the day, for they feel more refreshed and energized. By inducing release of
endorphins in the brain, acupuncture is also effective for depression and
fatigue related to pain.
Acupuncture and
acupressure have actually shown to relieve pain symptoms caused by fibromyalgia.
In a recent study performed by the Mayo Clinic, fibromyalgia acupuncture
treatment was shown to reduce pain and depression. Acupuncture for fibromyalgia
was also shown to increase energy and reduce fatigue. Other studies have
illustrated that acupuncture remains effective for up to one month after
treatment.
Another recent
acupuncture trial has also shown that stimulation in certain areas of the body
is particularly helpful for relieving fibromyalgia pain. In the study, a needle
was inserted into the trapezius muscles (near the back and shoulder) of both
fibromyalgia patients and healthy controls. The needles helped to increase blood
flow in fibromyalgia patients to a much greater degree than in the healthy
controls. this increased blood circulation helped to reduce the number of tender
points and increase muscle health.
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Fibromyalgia
Tender Points
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