FIBROMYALGIA

Fibromyalgia is a generalized body pain disorder that lasts more than 6 months. It is characterized by the pressure sensitive tender spots, trigger points and accompanying systemic and neurological symptoms. It is seen twice as much in women and in 2-8% of the society.

Fibromyalgia pain may manifest as:

  • Generalized body pain
  • Head-neck pain
  • Back, low back pain
  • Joint pain

Complaints that can be seen alongside pain in patients with fibromyalgia are:

  • Sleep disorders
  • Waking tired in the morning
  • Fatigue that does not improve with rest
  • Brain fog (Fibro fog)
  • Concentration loss, reduced attention span
  • A deceleration of performance, inability to multitask
  • Memory problems
  • Migraines and headaches
  • Dizziness
  • Frequent urination, hyperactive bladder symptoms
  • Painful menstruation, premenstrual syndrome
  • Numbness of hands and feet
  • Restless legs syndrome (RLS)
  • Jaw pain, temporormandibular disorders, teeth grinding
  • Augmented sensitivity
  • Sensitivity to light and sound
  • Sensitivity to cold
  • Sensitivity to touch
  • Allodynia (pain with non painful stimuli)
  • Hyperalgesia (augmented pain with painful stimuli)
  • Sensitivity to odours
  • Multiple chemical and drug sensitivity
  • Joint pain and morning stiffness
  • Irritable bowel syndrome; Gastrointestinal symptoms (abdominal pain, diarrhea, constipation)
  • Vertigo, light headedness
  • Orthostatic intolerance

A physician can make a diagnosis of fibromyalgia by taking a detailed history and examining you. Tender points, tender areas and trigger points may be found during the examination.
Fibromyalgia is caused by a combination of genetic and environmental factors. There is augmented central sensitization, inflammation, neuro-inflammation, oxidative stress and problems of the serotonin and dopamin metabolisms. Fibromyalgia sometimes starts after physical trauma, surgery, a severe infection or major psychosocial stress; while in some patients it becomes evident over the years without any significant triggers.

Risk Factors for fibromyalgia are:

Disorders associated with fibromyalgia are:

  • Chronic fatigue syndrome
  • Sleep disorders
  • Migraines
  • Tension-type headache
  • Interstitial cystitis (painful bladder syndrome)
  • Obsessive compulsive disorder
  • Depression, anxiety
  • Post traumatic stress disorder
  • Restless legs syndrome
  • Rheumatic diseases
  • Thyroid metabolism disorders
  • Infections

The following diseases should be kept in mind for differential diagnosis:

  • Rheumatic diseases
  • Hypothyroidism
  • Vitamin D deficiency
  • Iron-deficiency anemia

 

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