Fibromyalgia FM
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What is fibromyalgia?
What causes fibromyalgia?
What are the signs and symptoms of fibromyalgia?
Treatments for fibromyalgia
Acupuncture for fibromyalgia
Fibromyalgia Tender Points

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. 

  • Sleep disturbances. Some researchers theorize that disturbed sleep patterns may be a cause rather than just a symptom of fibromyalgia.

  • 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.

  • Infection. Some researchers believe that a viral or bacterial infection may trigger fibromyalgia.

  • 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.

  • 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:

  • 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.

  • 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.

  • Irritable bowel syndrome (IBS). The constipation, diarrhea, abdominal pain and bloating associated with IBS are common in people with fibromyalgia.

  • 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.

  • 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:

  • Depression

  • Numbness or tingling sensations in the hands and feet (paresthesia)

  • Difficulty concentrating

  • Mood changes

  • Chest pain

  • Dry eyes, skin and mouth

  • Painful menstrual periods

  • Dizziness

  • Anxiety

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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:

  • 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.

  • 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.

  • 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.

  • 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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