Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain and spinal cord process painful and non painful signals. It affects 2 to 4 percent of people, women more often than men.
Pathophysiology of Fibromyalgia
This condition is characterized by subjective symptoms and lacks unique pathophysiological characteristics. Patients with fibromyalgia have a lowered mechanical and thermal pain threshold and altered temporal summation of pain stimuli. Thus, these individuals feel pain more intensely than normal individuals.
There is a disturbance in the secretion of certain chemicals in the central nervous system that control the pain sensation. Normally the human body has an endogenous analgesic system (that alleviates pain). But in individuals with fibromyalgia this is altered leading to a heightened pain sensation.
In patients with fibromyalgia, levels of several neurotransmitters that facilitate pain transmission are elevated in the brain, and levels of several neurotransmitters known to inhibit pain transmission are decreased.
Fibromyalgia is triggered with various environmental triggers that may be involved in the pathophysiology of fibromyalgia. These include mechanical/physical trauma or injury and psychosocial stressors. Physical traumas include acute illness, physical injury, surgery, and motor vehicle accidents. Also, few psychosocial triggers like chronic stress, emotional trauma, and emotional, physical, or sexual abuse may precipitate this condition.
There is strong evidence that psychological and behavioral therapy, especially cognitive behavioral therapy (CBT), is effective in FMS. Randomized controlled trials of CBT with longitudinal data over 6 to 30 months found decreased pain severity and improved function in FMS. Systematic reviews have confirmed that CBT improved pain, fatigue, mood, and function in FMS.
Lifestyle management in Fibromyalgia
Physical activity is known to have a beneficial effect in almost all cases. Many trials have shown a greater improvement in the exercise groups vs control groups in aerobic performance, tender-point pain pressure threshold and improvements in pain. One can alter & autoregulate the intensity of the workouts based on the severity of the pain experienced.
Chiropractic spinal manipulation and soft-tissue massage decreased tenderness in patients with FMS. Connective tissue manipulation and massage has produced positive results by reducing depression, pain intensity, and amount of analgesics used. Mindfulness - a non-spiritual meditation practice that cultivates present moment awareness also helps relieve the pain associated with this condition.
Apart from the above measures, one can follow the below mentioned self-care tips:
- Finding some time to relax each day. Deep-breathing exercises and meditation will help reduce the stress that precipitate the symptoms.
- Setting a regular sleep pattern. Good sleep helps in recovery both physically and mental. Nicotine is a stimulant, so those fibromyalgia patients with sleep problems should stop smoking.
- Nationally recognized organizations like the Arthritis Foundation and the National Fibromyalgia Association are great resources for information. Seeking the right information & sharing it with family, friends and co-workers can help spread awareness.
References:
- Clauw, D. J., Arnold, L. M. and McCarberg, B. H. (2011) ‘The Science of Fibromyalgia’, Mayo Clinic Proceedings, 86(9), pp. 907–911. doi: 10.4065/MCP.2011.0206.
- Fibromyalgia - American Family Physician (no date). Available at: https://www.aafp.org/afp/2007/0715/p247.html (Accessed: 14 April 2022).
- Fibromyalgia (no date). Available at: https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Fibromyalgia (Accessed: 13 April 2022).
- Goldenberg, D. L., Burckhardt, C. and Crofford, L. (2004) ‘Management of Fibromyalgia Syndrome’, JAMA, 292(19), pp. 2388–2395. doi: 10.1001/JAMA.292.19.2388.
- Mountz, J. M. et al. (1995) ‘Fibromyalgia in women’, Arthritis & Rheumatism, 38(7), pp. 926–938. doi: 10.1002/ART.1780380708.
- (PDF) The Fibromyalgia Impact Questionnaire (FIQ): A review of its development, current version, operating characteristics and uses (no date). Available at: https://www.researchgate.net/publication/7494026_The_Fibromyalgia_Impact_Questionnaire_FIQ_A_review_of_its_development_current_version_operating_characteristics_and_uses (Accessed: 14 April 2022).
- Wolfe, F. (1990) ‘Fibromyalgia’, Rheumatic Disease Clinics of North America, 16(3), pp. 681–698. doi: 10.1016/S0889-857X(21)00895-4.
