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  • Get Facts: Do you hear about Fibromyalgia?

    Post by : expatree

Fibromyalgia is a condition characterized by widespread body aches and pain. It is accompanied by other key symptoms such as fatigue, non restorative sleep cognitive problems and somatic complains.
 
The patient usually described a history of generalized pain, a constant dull ache that spreads over the body lasting more than 3 months, and other general physical symptoms including fatigue, morning stiffness, sleep disorders, waking unrefreshed, and cognitive (memory or thought) problems where patient have difficulties to focus, pay attention, and concentrate on mental tasks. There are often other pain complains associated, which can includes muscle knots, headaches and cramps.
 
Very often, these patients have seen many physicians and could not get a diagnosis to their symptoms as the investigations performed are essentially normal. They are stressed and drained both mentally and emotionally, often wondering if all the pain and symptoms are from their mind or own imagination.
 
Fibromyalgia affects 2-4% of the population, mostly women. There causes of fibromyalgia is unclear. There is often some triggering factor that sets off the symptoms of fibromyalgia such as an infection, surgery, emotional or physical trauma. There is hypersensitivity of the nervous system and the brain processes pain signals in an amplified manner.
 
The diagnosis of fibromyalgia is describe by the 1990 American College of Rheumatology criteria based on the presence of widespread pain for at least 3 months combines with at least 11 of 18 tender points sites on digital palaptation.

This is then revised in 2010, which eliminated the tender point examination and replaced by widespread pain index. A widespread pain index is a count of the number of body regions reported as painful by the patient.
 
The characteristic symptoms of fibromyalgia (fatigue, non-refreshed sleep, cognitive problems and the extent of somatic symptoms reporting) are also taken into consideration using a symptom severity scale. It is also important during history taking to review the medications that the patient is on as some medications such as HMG-CoA reductase inhibitors, carbimazole, amiodarone and interferon can cause myopathies and arthralgia.
 
A complete physical examination should be done, including an orthopedic and neurological examination.
 
While there is no investigation that can be done to diagnose fibromyalgia, blood test and diagnostic imaging are often ordered to exclude other conditions that can present with widespread pain such as Polymyalgia rheumatica, rheumatoid arthritis, connective tissue disorders, hypothyroidism and hypercalcaemia.
 
Patients with fibromyalgia should be screened for anxiety and depression, as well as for other conditions such as irritable bowel syndrome, headaches, temporomandibular disorder, irritable or overactive bladder.
 
While there is no cure for fibromyalgia, medications from the class of anti-convulsants and anti-depressants can help control symptoms. The U.S Food and Drug Administration have approved Pregabalin and Duloxetine for the treatment of fibromyalgia.
 
Besides using medications, other recommended adjuvant and supportive treatment to help managed the symptoms include cognitive behavioral therapy, mindfulness relaxation, acupuncture, pacing and gradual step-up physiotherapy to strectch and condition the muscles. Getting enough sleep may also help to minimize the impact of fibromyalgia.

Dr. Wilson Tay
Consultant Pain Specialist
Date:2015-10-10 22:18:19
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