FIBROMYALGIA-The Irritable Everything Syndrome

By: Dr. Abhishek Kumar Pandey, Asstt. Editor-ICN

LUCKNOW:Fibromyalgia is frequently considered to be a stress-related disorder. It is common and chronic syndrome that causes widespread pain and mental distress.

Females are most affected than males with the ratio of 9:1. Cause of fibromyalgia is unknown. It is a combination of psychological, genetic, neurobiological, and environmental factors. It is associated with “Functional somatic syndrome and depressive disorders”.

SYMPTOMSPain which appears to result from a neurochemical imbalance, debilitating fatigue, sleep disturbances, and joint stiffness.

  • Some people report difficulty in swallowing, bowel and bladder dysfunction, numbness.
  • Pain may be localized especially in the areas like shoulder, neck, low back, hips etc.
  • A patient with fibromyalgia has a lower threshold of pain because of the increased reactivity of the pain-sensitive nerve cells in the spinal cord or brain.
  • Chronic fatigue syndrome, post traumatic stress disorder, irritable bowel syndrome, and depression are common stress related conditions experienced by a person.
  • Smoking, lack of physical activity, obesity may increase the risk of fibromyalgia.

DIAGNOSIS-1. Complete blood count.

  1. Erythrocyte sedimentation count.
  2. Thyroid function tests.
  3. Vitamin D levels.
  • Fibromyalgia can be diagnosed when a person has had widespread pain for more than three months with no underlying medical conditions that can cause the pain. 

TREATMENT- Incorporates medication, patient education, aerobic exercise, and cognitive behavioral.

  • Cognitive behavioral therapy- It effect in reducing the symptoms of fibromyalgia.
  • PHARMACOTHERAPY- Anti depressant like Duloxetine and milnacipran; Tricyclic Antidepressants like Amitriptyline and Anti-seizure medications like Gabapentin and Pregabalin. Combination of tramadol and paracetamol is most efficacious in treating the disease.
  • NSAIDs ARE NOT RECOMMENDED AS FIRST- LINE OF THERAPY.
  • A combination of Antidepressants and antiepileptic’s taken for a period of 3-4 months.

EXERCISE1. It may help with depression and sleep disorders.

  1. Cardiovascular and aquatic –based exercises is effective.

FIBROMYALGIA is a long term or chronic disorder associated with widespread pain in the muscles and bones, along with general fatigue. There is no cure for the disease. A combination of medications, exercise, lifestyle changes and stress management may ease the symptoms associated with fibromyalgia.

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