by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
Click here: Second Opinion Arthritis Treatment Kit
“Fibroid myalgia” or fibromyalgia as it is better known is a common condition characterized by generalized pain and fatigue. This condition has nothing to do with fibroids.
Fibromyalgia is considered a form of arthritis. The cause is unknown but theories implicating abnormal hypothalamic pituitary axis function or dysfunction of neurotransmitter pathways in the brain are currently popular.
Several studies have demonstrated different abnormalities in CNS functioning. Abnormal sleep studies showing alpha intrusion during delta (stage 4) sleep and a reduction of rapid eye movement (REM) sleep have been seen. In addition, abnormal SPECT scans have suggested lower blood flow to the thalamus and caudate nucleus in fibromyalgia patients.
Approximately 2 per cent of the population has fibromyalgia. About 80 per cent of patients with fibromyalgia are women. While fibromyalgia may occur as a primary condition, it is also a secondary condition, occurring in as many as 30 per cent of patients with systemic lupus erythematosus and rheumatoid arthritis.
Patients with fibromyalgia complain of generalized pain affecting both sides of the body and both the upper as well as lower part of the body.
Pain tends to be aggravated by weather changes as well as by stress.
While patients will complain of subjective joint swelling, objective swelling is absent. Here is a situation where magnetic resonance imaging which is able to detect minute amounts of synovitis that can help in the work up.
Sleep disturbance occurs in almost all patients. Complaints of chronic fatigue and non restorative sleep (feeling as if they haven’t slept) are common. Sleep apnea may confound the situation.
Tender trigger points are noted in all patients. A patient with 11 of 18 tender trigger points fulfills a major diagnostic criterion for the diagnosis of fibromyalgia. These trigger point tender areas are stereotypic meaning the same areas are tender in all patients with the diagnosis of FM.
Other symptoms include migraine headache, decrease in short term memory, cognitive dysfunction, blurred or double vision, hypersensitivity to sound and smells, shortness of breath, chest pains, palpitations, irritable bowel, irritable bladder, painful menses, painful urination, multiple drug allergies, multiple sensitivities to chemicals.
In fact, the types of symptoms a patient presents with may determine what type of physician that patient will seek out. For instance, patients with bowel symptoms may see a gastroenterologist. Patients with bladder irritability may see a urologist. Patients for whom depression is a problem may see a psychiatrist, and patient s who complain of migraine headaches may see a neurologist. Unexplained aches and pains will usually send a patient to see a rheumat5ologist or even an orthopedic surgeon.
Laboratory testing will not be diagnostic. However, laboratory testing will help to exclude other conditions such as polymyalgia rheumatica, hypothyroidism, rheumatoid arthritis, systemic lupus erythematosus, etc., that might masquerade as fibromyalgia. FM is a diagnosis of exclusion so it is imperative that other possible causes of aches and pains are ruled out.
Imaging tests may also be helpful in establishing the presence or absence of FM.
Treatment must be individualized. Most patients will respond to a combination of non impact aerobic exercise (swimming, stationary bike, elliptical trainer), cognitive behavioral therapy, and medication.
Medications that have been found to be helpful include tricyclic antidepressants in low doses, muscle relaxants such as cyclobenzaprine, also in low doses, and selective serotonin reuptake inhibitors (SSRIs)
Other medicines such as gabapentin and tramadol may also be helpful. A more complete discussion of FM may be found elsewhere.
More recently, drugs such as Mirapex have been used for their dopaminergic effect.
Get more information about fibromyalgia and related conditions as well as...
• Insider arthritis tips that help you erase the pain and fatigue of rheumatoid arthritis almost overnight!
• Devastating ammunition against low back pain... discover 9 secrets!
• Ignored remedies that eliminate fibromyalgia symptoms quickly!
• Obsolete treatments for knee osteoarthritis that still are used... and may still work for you!
• The stiff penalties you face if you ignore this type of hip pain...
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• And much more...
Click here Second Opinion Arthritis Treatment Kit
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