Free Essay


In: Other Topics

Submitted By bosanka78
Words 2200
Pages 9
Fibromyalgia Fibromyalgia has been shown to be genetic. It frequently becomes evident after stressful events. The stressful events may be emotional (such as a traumatic life event), physical (such as a motor-vehicle accident), or medical (such as certain infections). The chronic pain of rheumatoid arthritis, systemic lupus erythematosus, and other autoimmune diseases can trigger the development of fibromyalgia.
The manner in which the brain and spinal cord process pain sensations is abnormal in fibromyalgia. The threshold at which stimuli cause pain or discomfort has been proven to be lower in fibromyalgia. The pain felt is more intense because the pain is amplified by the abnormalities in the central nervous system and in pain processing. Because of this, things that are not normally painful may be painful for someone with fibromyalgia. In addition, fibromyalgia causes the pain from any given cause to be worse. For example, a patient with fibromyalgia may find a massage painful instead of pleasant. In addition, back pain that someone without fibromyalgia experiences as moderate may be experienced as severe by someone with fibromyalgia, because the pain is amplified by abnormalities in pain processing by the central nervous system.
The defining feature of fibromyalgia is chronic widespread pain. This means pain in multiple areas of the body, most commonly in muscles, tendons, and joints. The pain is generally above and below the waist, on the left side of the body and on the right side of the body but can be localized, often in the neck and shoulders or low back, initially. The pain is chronic, which means it is present for more than three months. Patients commonly feel as if they "hurt all over" or as if they have the flu, or are about to develop a cold or the flu. It is common for some days to be worse than others, and many patients report "flare-ups" where their pain and other symptoms are worse for several days in a row or longer.

Fatigue is the other universal symptom of fibromyalgia. It is most noticeable upon awakening, but it may also be marked in the mid-afternoon. It is very common to wake up in the morning not feeling refreshed, even after sleeping through the night. Patients commonly feel they sleep "lightly" and may have multiple nighttime awakenings with difficulty returning to sleep. While widespread pain, fatigue, and sleep disturbances are the defining symptoms of the syndrome, fibromyalgia is associated with many other symptoms. Disordered thinking (cognitive disturbances) is often referred to as "fibro fog." Patients describe difficulty with attention and completing tasks, as well as a general sense of being in a fog.

Myofascial pain syndrome

Myofascial pain syndrome is characterized by muscle pain, tenderness, and spasm. Myofascial pain syndrome usually involves muscle in body areas that are asymmetric or focal, whereas fibromyalgia is typically a diffuse and symmetric muscle pain syndrome that involves both sides of the body

The cause of myofascial pain syndrome is unknown. Nevertheless, prior injury, poor sleep patterns, stressful life situations, and depression are common underlying conditions that may play a role in inciting and exacerbating myofascial pain syndrome. It is currently felt that risk factors such as these may lead to a change in the ability of the brain to properly process pain perception (referred to as central pain processing).

Myofascial Pain Syndrome vs.Fibromyalgia Syndrome

Many patients are labeled with fibromyalgia simply because they have chronic soft tissue pain. But it is important, at least for the sake of correctness, that not all chronic soft tissue pain be called fibromyalgia.
In fact, localized or regional pain is often due to myofascial pain syndrome (MPS), a rather common condition which affects certain muscle areas. MPS is often present in the fibromyalgia patient, but not all MPS patients also suffer from fibromyalgia.
MPS generally involves pain in the neck, shoulders, hips, back, jaw and head. This pain is often accompanied by stiffness or tightness. It is important that the doctor listen to the patient to learn where the pain is most intense. And because MPS is not diagnosed with a lab test or x-ray, it is important that the doctor carefully examine the patien

Trauma is a common cause of MPS, in the form of muscle strain or ligament and tendon sprain; or as a result of chronic trauma due to repetitive work injury, or altered posture due to poor exercise. An example of the former is whiplash from an auto accident. An example of the latter is an individual who works at a computer all day, and subsequently develops MPS involving the muscles of the upper back and shoulders; such individuals often develop tension headaches. Of course, more than one area may be involved, and this can make distinguishing between MPS and fibromyalgia all the more difficult.
MPS can occur with a variety of medical problems, including spinal disc disease, or inflammatory illnesses. And like fibromyalgia, MPS symptoms can be made worse due to stress, depression, fatigue and vitamin deficiencies, to name a few.
It is important for the doctor to identify all other illnesses in an individual patient so that therapy can be most effective and accurate.
As there is no cure for fibromyalgia, so there is no cure for MPS. The goals of treatment should obviously include pain relief and improvement/restoration of mobility and functionality. It is important to identify any other accompanying conditions, and give treatment to these also. Perhaps most importantly, the patient needs to be educated on how to best manage chronic pain, so that life can be lived as normally as possible.
Just because there is no cure for MPS, do not think there is no treatment. Treatments include physical therapy and stretching exercises, massage therapy, trigger point-injections, and medications such as anti-inflammatories, muscle relaxants, anti-depressants, and anti-seizure drugs (for example, gabapentin).
But I believe that education is the most important component of the treatment regimen. Patients must be taught and encouraged to perform home exercises. Patients must be vigilant about appropriate posture, and assuring that the workplace has the best ergonomics. Patients also benefit greatly from practicing biofeedback techniques which assist in stress reduction, which in turn reduces the tension in the muscles that contributes greatly to the pain a patient experiences.
And while the treatment for MPS sounds awfully similar to that given to our fibromyalgia friends, let us not forget the key differences between these two chronic pain syndromes:
1. MPS has more localized or regional pain versus the diffuse pain of fibromyalgia.
2. MPS patients have "trigger points" which can cause pain at a distant location when pressed, whereas fibromyalgia patients suffer from "tender points".
3. MPS has a better prognosis, as the pain often resolves with treatment or the rectification of the offending stimulus (such as the ergonomically incorrect office desk); the pain of fibromyalgia has a much higher chance of being chronic.
Unfortunately, both MPS and fibromyalgia are frequently not diagnosed properly. This in turn leaves many with chronic pain which is not being treated properly.
In a way, I don't really care whether a doctor gets MPS confused with fibromyalgia, or vice-versa. What I do care about is that we have doctors who understand the importance and the necessity of giving those patients with widespread pain all the help available, just as those with regional pain deserve all the treatment available to ease their suffering.
Chronic pain by definition is always there, but that does not mean it always must be there with the same intensity.
Definition of myofacial pain syndrome
Myofascial pain refers to pain caused by muscular irritation. The large upper back muscles are prone to developing myofascial pain that radiates from sensitive points, called trigger points throughout muscle tissue. Muscular irritation and upper pain back is due to muscle weakness and repetitive motions.
A common myofascial pain is the soreness and aching in muscles associated with poor posture. Because the upper back pain is related to large muscles in the shoulder area, most rehabilitation programs will include a great deal of stretching and strengthening exercises.
Manual treatments such as chiropractic manipulation, massage therapy, and acupuncture are effective in treating myofascial pain.
Definiton of FMS disease primarily indicated by extensive tenderness and pain affecting muscles, tendons, joints, and soft tissues; can develop as a singular condition or concurrently with other conditions like rheumatoid arthritis or lupus
Fibromyalgia symptoms • Chronic muscle pain, muscle spasms, or tightness • Moderate or severe fatigue and decreased energy • Insomnia or waking up feeling just as tired as when you went to sleep • Stiffness upon waking or after staying in one position for too long • Difficulty remembering, concentrating, and performing simple mental tasks ("fibro fog") • Abdominal pain, bloating, nausea, and constipation alternating with diarrhea (irritable bowel (syndrome) • Tension or migraine headaches • Jaw and facial tenderness • Sensitivity to one or more of the following: odors, noise, bright lights, medications, certain foods, and cold • Feeling anxious or depressed • Numbness or tingling in the face, arms, hands, legs, or feet • Increase in urinary urgency or frequency (irritable bladder) • Reduced tolerance for exercise and muscle pain after exercise • A feeling of swelling (without actual swelling) in the hands and feet

Tender points of fibromyalgia

There are 18 possible tender points associated with fibromyalgia, which are located on the back of the head, shoulders, elbows, hips, buttocks and knees, according to Healthline. Tender points feel sore when pressed and are one factor physicians use to diagnose fibromyalgia.
Tender points are very small, superficial areas of sensitivity just under the skin, explains WebMD. They are localized areas of tenderness about the size of a penny found around joints but not in the joints themselves. Symptoms of widespread pain must be present for at least three months in order for a diagnosis of fibromyalgia to be rendered.
Other symptoms of fibromyalgia include deep muscle pain, headaches, jaw pain, fatigue, insomnia, depression and irritable bowel syndrome. Confusion, trouble concentrating on mental tasks, and other cognitive difficulties are known as fibro fog. The effects of pain on the brain or lack of oxygen to the brain tissues possibly causes these common symptoms, states Healthline.
Symptoms can occur gradually over time with no causal event, or they can begin after a physical trauma such as surgery or infection, explains Mayo Clinic. Psychological stress can trigger fibromyalgia. Women are much more likely to develop fibromyalgia than are men. While no cure exists, medications, diet, exercise, stress reduction and relaxation methods can help control symptoms.
Fibromyalgia consists of symptoms that are also found in many other conditions. A doctor must rule out these other conditions before making the diagnosis of fibromyalgia. There is no simple test to diagnose fibromyalgia. Many people go from doctor to doctor without receiving a medical diagnosis for their fibromyalgia symptoms. Many wonder if their painful symptoms are simply imagined.

In the past, millions of fibromyalgia patients were misdiagnosed as having depression, inflammatory arthritis such as rheumatoid or lupus, chronic myofascial pain, or chronic fatigue syndrome. There are, of course, a few similarities between fibromyalgia and chronic fatigue syndrome and between fibromyalgia and arthritis. But fibromyalgia is different. It is a distinct condition that needs an accurate diagnosis and appropriate treatment.


Most laboratory tests are not very useful by themselves for diagnosing fibromyalgia. There is a blood test -- called FM/a -- that identifies markers produced by immune system blood cells in people with fibromyalgia. One study showed the test can also help distinguish fibromyalgia from other conditions that can have similar symptoms, such as rheumatoid arthritis or lupus.

Your doctor will often make a diagnosis after doing a physical exam and discussing your symptoms with you. The reason for this is that a diagnosis to large extent is based on the way you feel. For instance, even though your doctor may notice tender points during the physical exam, you still need to tell him or her about the pain you feel in .

Therapeutic treatment
Certain medications as Naproxen sodium, acetaminophen and ibuprofen, including Advil and Motrin IB, are pain killers that are available over the counter. Off-the-shelf pain relievers include tramadol, such as Conzip and Ultram. Anti-seizure drugs, such as Gralise, Neurontin and Lyrica, as well as antidepressants, including milnacipran (Savella) and duloxetine (Cymbalta), can reduce fatigue and pain.

Therapeutic non prescribtion

Patient who suffer from fibromyalgia should stay active, meditate or do deep-breathing exercises to lower stress, advises Mayo Clinic. Additionally, the patient should maintain good posture, undertake stretching exercises and engage in activities moderately. Walking, swimming, cycling and other correct exercises can reduce the symptoms. Sleeping and waking up routinely and avoiding to sleep in the daytime may help treat the condition.
In addition to reducing depression and anxiety, massage may also ease movement in joints, trigger natural pain relievers, rest the muscles and slow the heart rate, explains Mayo Clinic. Yoga and acupuncture can also reduce pain and fatigue and relax the body. A counselor may teach the patient to believe in his abilities and stress-reducing technique

Work cites
-fibro welnes people

Anisa Finto
Cybertex Institue of Techology

Jose Blanco
Killeen Texas

Similar Documents