Fibromyalgia
“Fibromyalgia” is the name given to a complicated collection of chronic pain and other physical and behavioral symptoms. Although widespread pain is the primary symptom of fibromyalgia, the symptoms are not restricted to pain, and the condition is best characterized under the term of “fibromyalgia syndrome.” There is no definitive set of symptoms that all fibromyalgia patients exhibit, so there is a great deal of variability in the presentation of each patient. However, the most common co-occurring symptoms with fibromyalgia include sleep disturbances, fatigue, and joint stiffness. Some patients may also experience a range of other symptoms which can include headaches, irritable bowel syndrome, irritable bladder, cognitive and memory problems, temporomandibular joint disorder, pelvic pain, restless leg syndrome, sensitivity to noise and temperature, anxiety, and depression. Not surprisingly, fibromyalgia patients with their unique mix of these symptoms report decreased functioning over time. Fibromyalgia is thought to affect 2-4% of the US population, with the incidence in women exceeding that in men nine to one, and is most commonly diagnosed in patients between the ages of 20—50.
Fibromyalgia remains a controversial diagnosis in the medical community because the symptoms are so diverse, the cause of fibromyalgia is not known, there is a lack of objective diagnostic tests to confirm its presence, and because there are no clear boundaries between fibromyalgia and other recognized syndromes. While many researchers and treaters accept its existence, others are skeptical of its validity as a discrete clinical entity and about its usefulness as a clinical label, and view the array of symptoms that characterize it as responses to everyday life.
Among researchers who study fibromyalgia and who have generated theories of what causes it, there is support for the influence of genetics as there seems to be a high concentration of fibromyalgia in families; high levels of physical and environmental stress; aberrant immune response; dopamine dysfunction leading to amplification of pain signals; and abnormal serotonin production. There is no scientific consensus however and research into the causes and treatment of fibromyalgia is on-going.
While fibromyalgia is not fatal or progressive, it is persistent, with most patients reporting that their basic symptoms do not change over time. However symptom “flare ups” are reported most frequently from emotional distress, weather changes, sleeping problems, strenuous activity, mental stress, worrying, car travel, family conflicts, physical injuries and physical inactivity.
Just as there is no one accepted cause of fibromyalgia, there is no one universally accepted treatment for it either, and the treatment that is offered is directed at symptom relief. The range of commonly utilized treatments include behavioral therapy; pharmacological agents including antidepressants, anti seizure medication, and dopamine agonists; and physical treatment including exercise, heat application, or massage. Integrated treatment that includes patient education, medication, exercise and cognitive-behavioral therapy has been shown to be effective in controlling pain and symptoms and in increasing function. This is precisely the nature of the treatment offered at Centennial Rehabilitation.