Charles E. Steiner, DO

               Muntean Health Care, 400 East State Street, Athens OH 45710, phone 740-592-4229

 

FIBROMYALGIA (FM)

DESCRIPTION

Fibromyalgia is a disorder of extra sensitivity to pain (in muscles, ligaments and tendons) and tiredness

(feeling exhausted for no apparent reason).  Persons with classic fibromyalgia have “tender points” in

muscles and tendons at specific places on the neck, shoulders, back, hips, arms & legs. Tenderness at 11

or more of the 18 points is defined as FM. 

 

FREQUENT SIGNS AND SYMPTOMS   These symptoms may vary with weather, poor sleep or stress.

• Trouble sleeping.            • Painful menstrual periods.                          • Anxiety.            • Fatigue.

• Headaches                       • Tingling or numbness in hands and feet.  • Mood changes  • Chest pain.

• Morning stiffness.          • Problems with thinking and memory (sometimes called “fibro fog”).

 

CAUSES

• The definition is not specific enough to allow finding causes statistically    • Multiple factors involved.

• Symptoms like fibromyalgia can be caused by not sleeping for 3 days.                   • Can occur spontaneously.

• STRESS and Failure to reach DEEP SLEEP are likely to be big factors                    

 

RISK INCREASES WITH

• Physically stressful or traumatic events, such as car accidents  • Repetitive injuries    • Obesity  

• Depression.   • Polycystic ovarian disease (PCOD)     • Irritable Bowel Syndrome        • Anxiety.

• Illnesses, especially rheumatoid arthritis, mononucleosis, Lupus.                  • TMJ dysfunction           

 

WHO IS AFFECTED BY FIBROMYALGIA?     

• 2 to 3 in 50 Americans.                 • Most persons with fibromyalgia are women.

• Although children can be affected; most persons are diagnosed in middle age.

 

EXPECTED OUTCOME

• Symptoms may vary, but they probably will never disappear completely. 

• Fibromyalgia is not progressive or life-threatening.

• The primary goal of treatment is to minimize symptoms & treat any identifiable disease or condition.

 

POSSIBLE COMPLICATIONS

• Depression     • Brain Atrophy   • Weakness  • Increased pain     • Stiffness that leads to falls & inactivity

 

TREATMENT

• It helps to help to get enough good sleep.               • Minimize mental and physical stress

• Warm showers followed by cool showers help to move fluid into and out of tissues may help.

• Work changes may be necessary.  • Do moderate exercise (or pain increases & muscles shrink)

• Gentle Osteopathic Manipulation may reduce contributing factors.  Acupuncture (by Francis

  Gander) and to a lesser extent, gentle massage, help to relax tissue to permit the body to repair.

• A team approach is often required, but Family Practice physicians often start treatment.

• Team members may include a pain clinic, rheumatologist (if you have rheumatoid or Lupus),

  psychotherapist or counselor (especially if you have or develop unresolved emotional issues).

 

MEDICATIONS

• Vitamin D3 at doses of 4000 to 5000 IU daily has been helpful for some persons

• Initial treatment starts with Antidepressants (like amitriptyline, Cymbalta, Effexor, etc.),

  Sleeping pills that produce deep (restorative) sleep, & possibly, Nonsteroidal Anti-inflammatories

  to reduce nighttime soreness (like Motrin, Ibuprofen, Mobic, Aleve or Naproxen)

• The next level of treatment includes nerve quieting medications, such as Gabapentin, or Lyrica  

  (Lyrica reduced pain by 50% in ผ of the patients tested at a dose of 75 mg twice daily.)

  Caution is required for all of these medications, since can cause “brain fog” and impair driving.

• The next level can include muscle relaxers (like Flexerilฎ, cyclobenzaprine), benzodiazepines

  (like diazepam) and Non-opioid pain killers (like tramadol).

• Eating darkly colored greens and brightly colored fruits or taking CoQ10 and Vitamin C and

  not smoking can decrease oxidizing chemicals in your blood.  Foods with high ORAC levels (oxygen

  radical absorbance capacity) can be helpful.

• Opioid medications are not considered to be a wise choice. Prolonged use of high doses of opioids

   will lead to increased pain sensitivity if taken long-term.  It can even hurt for wind to blow on you. 

 

ACTIVITY

Mild regular exercise.  Fibromyalgia gets much worse and you get weaker if you do not keep active.

 

YOU CAN GET MORE INFORMATION AT

The National Institute of Arthritis and Musculoskeletal and Skin Disorders (NIAMS), phone (free of

charge 301-495-4484 or 877-226-4267) or by e-mail at NIAMSinfo@mail.nih.gov        rev.  07/28/2012