Last week one of the members of our practice expressed appreciation for my writing a column about anxiety, mentioned the fact that a friend of hers has been diagnosed with fibromyalgia, and asked if I would write on the subject. In doing research for this week’s column, I decided to present the side of the subject as seen by some medical professionals as well as some personal experience with patients who have had the diagnosis. Please realize that the issue of fibromyalgia is a controversial one in that it has been referred to by some as a “wastebasket diagnosis,” meaning that some believe that fibromyalgia is diagnosed only if doctors don’t know what is really wrong with you. Those who have the diagnosis would beg to differ. Either way, people are finding help with the problems associated with the disorder.
Fibromyalgia is a syndrome, or a condition which includes a pattern of symptoms which must be present in order for a diagnosis to be made. It is characterized by the presence of certain symptoms for three months or longer. These symptoms include widespread muscle tenderness and pain. Widespread is described as being both above and below the waist and on both sides of the body. There are eighteen specific trigger points that are tested, and pain must be present in at least eleven of these eighteen in order for there to be a diagnosis of fibromyalgia. Sleep disturbance is also a symptom of the disorder. This can include tossing and turning, waking frequently during the night, and awaking from a night’s sleep without feeling rested. Another symptom in the syndrome is any unusual joint or muscle stiffness that will not go away once one gets up and begins to move around.
While it is not classified as a psychological disorder, fibromyalgia has as part of the syndrome a major psychological component. Anxiety and depression are present as part of the diagnosis, and the presence of any emotional upset and stress actually cause exacerbations, or flare-ups in the condition. Many doctors prescribe antidepressants as treatment for the condition of fibromyalgia. There is no cure for the disorder, no diagnostic tests other than trigger point tenderness to confirm diagnosis, no defined cause of the disorder, and no specific drugs to prescribe for treatment. The only thing doctors can do is to treat the symptoms of the syndrome individually. There is no blanket prescription available to treat fibromyalgia as a disease.
The best treatment for the disorder is exercise, but this creates somewhat of a catch-22 for sufferers. To exercise hurts. Not to exercise makes the problem worse. The main thing to be aware of is that consistent home treatment must be fit into the daily routine. Sometimes this calls for drastic lifestyle changes. The degree to which one can get better depends upon the degree of commitment to take an active role in home treatment. Medications are used by some doctors to aid sleep and to reduce the aches and pains of muscular tension. Antidepressants might be used to improve sleep, relieve depression, and possibly relieve pain. Strong narcotic drugs are not usually used in treatment of fibromyalgia because they are ineffective for this particular disorder and because they are addictive.
Taking medications can actually become part of the problem due to the fact that no medication comes without its side effects. In addition to this, there is no proof that the use of drug therapy is effective in the long-term treatment of fibromyalgia. The syndrome itself has not been blamed for any damage to the muscles, organs, or tissues of the body, so not medicating is not going to cause any harm. There are support groups available for those who have been diagnosed with fibromyalgia. If you are interested in such groups, ask your doctor for more information.
There is much talk about CAM, or complementary and alternative medicine, in the medical arena today. This includes chiropractic among other things. Chiropractic has been used very successfully in the treatment of fibromyalgia. Case in point: a 40 year old woman came to our office suffering with the symptoms of fibromyalgia for the past 7 years. It was affecting her work and family life. After a thorough case history, examination, and necessary x-rays, a course of treatment was started. Within a month, the woman began to report that she didn’t feel as tired or as physically sore as she did prior to treatment. After two months of care, she reported that she could perform more of her daily duties than before and not feel exhausted at the end of the day. Today she is living a normal, healthy lifestyle without the array of antidepressants and muscle relaxers that she once felt she needed.
The body will store stress in many ways. It helps to get to the bottom of any unresolved emotional issues and, amazingly, physical conditions improve. It is almost impossible to have a negative physical response to a positive mental outlook. The mind/body connection is undeniable. Explore the possibilities that there might be some emotional baggage to free yourself from and pay attention to how your body responds. Get physical treatments to help your body process the emotional stuff. Massage, chiropractic, exercise in as large a dose as you can handle, and generally treating your body with respect will make an enormous difference in your overall well-being. Make some calls and explore your options. Help is out here, and taking an active role in your own care is the very first step to freedom from fibromyalgia and a host of other disorders. Treat your body and your spirit well.