I understand fibromyalgia

Yes, I understand Fibromyalgia

As I understand it, Fibromyalgia (fi-bro-my-AL-ja) is a poorly-understood long-term painful condition of the muscles and established tender body-points with fatigue, depression, sleeping disturbances, "black-outs", panic attacks, life-style deterioration and many other problems that make living tiresome and frustrating for those afflicted with it. Usually, it remains with the victim throughout his/her life.

Demographics:

Affecting adults more than children and women more than men (4:1), this real illness can be stand-alone or accompany other connective-tissue disorders like rheumatoid arthritis and lupus (SLE). It affects all ethnic populations globally.

Symptoms:

It is a cyclical disease, with days of severe pain alternating with relatively better interval days. Pain is brought on by repetitive actions of the affected muscle groups. Marked by "trigger" points and "tender" points (there are 18 of these, and at least 11 must be affected to diagnose the disease) on the bodies of those afflicted, this illness is especially debilitating as its causes are not known and its treatment is, at best, a sort of amelioration of symptoms and not a definitive cure.

Children are often thought to be malingering when they lose "energy" or "stop" responding in class. They exhibit stronger symptoms of pain, loss of energy and depression. The illness can crucially affect the child's body image and self-esteem.

Treatment:

This includes the following tried and tested forms of intervention, not all of which can be explained scientifically:

a) Emotional support and counselling is the main form of therapy. An empathetic and caring physician can work wonders even without any drugs.

b) Use of sleeping medications, (esp. zolpidem) and low doses of tricyclic anti-depressants like amitryptiline. Narcotics like morphine and so on are used only in severely affected persons. Routine pain-killers are generally non-beneficial. Injection of local anesthetics (e.g. procaine) into the severely affected tender points has also been used with encouraging results.

c) Rotating physical activities so that repetitive movements are minimised.

d) Non-impact aerobics, at least 20 mins thrice a week.

e) Lifestyle improvement measures such as change of job, eating a balanced diet, avoidance of smoking, treatment of underlying illnesses (if any) and meditation and yoga are all helpful.

f) Alternative medicinal systems such as acupuncture have also been used, with significant results.

g) Use of stimulants like coffee (caffeine) should be generally avoided.

Outcome:

The extent to which patients succumb to the various effects of pain and fatigue are dependent upon many variables, e.g.their psycho-social support, financial status, childhood experiences, sense of humor and their self-determination to fight back.

References:

http://www.nlm.nih.gov/medlineplus/ency/article/000427.htm
http://www.nfra.net/
http://www.pediatricnetwork.org/booklet/page3.htm
http://www.pediatricnetwork.org/medical/q+a/bell/panicattacks.htm
http://en.wikipedia.org/wiki/Fibromyalgia

© Dr. Taher Kagalwala, May 2007.

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