Fibromyalgia: what it is, symptoms and treatment

What is fibromyalgia?

Fibromyalgia Is a chronic disease characterized by widespread pain that is often accompanied by fatigue, depression, sleep disturbances, cognitive impairments, and digestive and urinary disorders symptoms.

It is a poorly understood disorder in which pain signals processed by the brain appear to be exaggerated, increasing the sensation of pain in muscles and soft tissues. There are no tests for this disease, so fibromyalgia is diagnosed by excluding other possible causes.

Treatment may include over-the-counter pain relievers, antidepressants, physical therapy, nursing and prescribing drugs specifically approved for the treatment of fibromyalgia, such as lyrica (pregabalin).

Fibromyalgia symptoms

Fibromyalgia is an unusual and largely misunderstood disorder characterized by widespread common pain and weakness accompanied by fatigue, sleep problems, memory problems and problems gastrointestinal tract.

Since the many possible symptoms are so vast (and there is no consensus on how diagnose the disorder), many feel lost about what affects them and what to do with it. The most important thing to remember is that fibromyalgia may be misunderstood, but it is very real.

By learning more about the signs and symptoms of this condition and how it manifests, you can help your doctor. help you identify fibromyalgia and access treatment that can significantly improve the quality of your life.

Peculiarity

Fibromyalgia is a condition in which pain signals are abnormally processed by the brain in such a way that the sensation of pain increases (a condition called hyperalgesia).

Fibromyalgia is not the same as muscle pain (myalgia), joint pain (arthralgia) or even nervous pain (neuralgia).

Fibromyalgia causes chronic, widespread pain that can range in severity from mild to disabling. To be considered widespread, pain must occur on both sides of the body and above and below the waist.

Misinterpreted pain signals can cause different reactions in different people. In some cases, pain can travel in waves throughout the body or cause abnormal sensations such as tingling, burning, or itching, especially in the hands (called paresthesia).

Even irritants that usually do not cause pain (touch or temperature) can often lead to pain or burning sensations (called allodynia).

While fibromyalgia is characterized by widespread chronic pain, pain can often be localized around elbows, shoulders, knees, neck, hips, chest, lower back and back of the head. The pain in these areas may not be felt deeply, but rather just below the surface of the skin.

Fibromyalgia pain can alternately be described as acute, diffuse, severe, throbbing, or stabbing. While some people have fairly consistent levels of fibromyalgia symptoms, others may experience periods of low activity (remission) or sudden worsening of symptoms (flashes). Outbreaks and severe pain are often accompanied by heart palpitations.

Muscles and joints

Fibromyalgia is not a joint disorder like arthritis, but it can cause joint-related symptoms. Most and possibly all cases of fibromyalgia involve soft tissue, including muscle and connective tissue (such as tendons, ligaments, and fascia).

Symptoms may include:

• morning stiffness;
• muscle spasms or twitching (fasciculations);
• muscle weakness, especially in the legs;
• diffuse, non-inflammatory edema of the limbs, arms and legs;
• joint pain around the tendon inserts;
• disease of the temporomandibular joint (TMJ).

According to a study published in a foreign journal "Frontiers in Neuroscience", the symptoms of fibromyalgia are associated with an increased level of functional disability. High levels of this type of pain and stiffness, as well as other problems listed below, can result in loss of walking speed, stride, and balance at levels similar to those listed below. rheumatoid arthritis or osteoarthritis.

Cognitive impairment

«Fibrous fog", Also referred to as"brain fog"Is one of the most common symptoms of fibromyalgia. Many people living with this disorder will tell you that the symptoms of cognitive impairment are almost as debilitating as the pain itself.

Symptoms may include:

• forgetfulness;
• confusion, confusion;
• trouble concentrating;
• temporary loss of connection with the environment;
• violation of understanding;
• Difficulty pronouncing known words (dysphasia)
• difficulties with orientation of direction or space (topography);
• Difficulty processing information that a person hears (central auditory processing disorders)
• the complexity of processing numbers, inability to learn arithmetic (dyscalculia).

Energy and sleep

In fibromyalgia, fatigue is more than just fatigue; it is a constant emaciation that does not improve despite rest. Chronic fatigue not only exacerbates feelings of foggy and disorientation, but also contributes to high rates of depression in people living with the disorder.

It is not surprising that fibromyalgia is so closely associated with chronic fatigue syndrome, both of which have similar symptoms.

Fatigue is one of the most common symptoms of fibromyalgia, affecting four out of every five people with the disorder.

Fatigue associated with fibromyalgia often goes hand in hand with sleep problems, which are almost guaranteed to lead to exhaustion and malaise.

Symptoms may include:

• light or regularly disturbed sleep;
• flinching during sleep (hypnotic tremors);
• obstructive sleep apnea;
• restless legs syndrome;
• insomnia.

Sensorineural signs

Among the neurosensory symptoms are:

• headaches;
• chronic migraine;
• dizziness;
• fainting (syncope);
• sensitivity to temperature, humidity and atmospheric pressure;
• light sensitivity (photophobia);
• sensitivity to noise (hyperacusis);
• sensitivity to odors (hyperosmia).

Digestive and urinary system

Digestive problems are common in people with fibromyalgia. Half of the patients are diagnosed with symptoms irritable bowel syndrome (IBS). Like fibromyalgia, IBS is thought to result from an abnormal response from the central nervous system.

People with fibromyalgia also often have interstitial cystitis, a condition that causes chronic bladder pain.

Symptoms may include:

• bloating and gas;
• nausea;
• abdominal cramps;
• diarrhea;
• constipation;
• dyspepsia;
• difficulty swallowing (dysphagia)
• frequent urination;
• frequent need to urinate;
• pain when urinating (dysuria);
• bladder spasms.

Mental states

Fibromyalgia and depression closely connected. While it would be fair to assume that the long-term emotional impact of fibromyalgia may be underlying psychological symptoms (such as panic disorder), others are not sure.

Some scientists, in fact, believe that symptoms can be caused, at least in part, by the influence of fibromyalgia on the central nervous system, namely on dysregulation neurotransmitters.

According to research from the University of North Carolina, 86 percent of people with fibromyalgia will have episodes of depression at some point in their lives.

Besides depression, other symptoms may include:

• anxiety or panic attacks;
• generalized anxiety disorder;
• mood swings;
• unexplained irritability.

Reproductive system

Hormones are thought to play a causal role in fibromyalgia. On the one hand, hormones are thought to cause symptoms of the disorder (as evidenced by women who have flare-ups during their period).

On the other hand, fibromyalgia can cause hormonal imbalancecausing problems of the reproductive tract, mainly in women.

Symptoms may include:

• extremely painful periods;
• pain in the pelvic area;
• chronic vulvar pain (vulvodynia);
• premature menopause.

Although loss of sex drive, impotence and erectile disfunction Also common in people with fibromyalgia, they are thought to be associated with depression and anxiety rather than the disorder itself.

Fibromyalgia Causes

No one really knows exactly what causes fibromyalgia. It is associated with similar disorders such as chronic fatigue syndrome and irritable bowel syndrome, which are believed to be caused by an overreaction of the central nervous system to normal stimuli.

People with fibromyalgia tend to have unusually high concentrations of two chemicals known as substance P (pain substance P) and glutamate, in their body. Substance P and glutamate are involved in the transmission and regulation of pain information. With these elevated levels of substance P and glutamate, pain signals to and from the brain can be greatly exaggerated.

Likewise, a number of small studies have shown that people with fibromyalgia tend to have decreased blood flow to the thalamus, the section of the brain that acts as a pain perception center. It is believed that it can also enhance pain perception.

While fibromyalgia is now recognized as a syndrome by the medical community, it is still unclear if it is a purely somatic (physical) disorder. Fibromyalgia symptoms are clearly affected depression, anxiety, sleep problems, and stress, which can either increase pain perception or directly affect neurological function.

Little is known to the researchers at this point. However, scientists believe that certain following risk factors may increase the likelihood of fibromyalgia:

• Women are nine times more likely to have fibromyalgia than men. It has been suggested that estrogen decreases during menstruation and around the time climax.
• Age is also a factor. Although fibromyalgia is most commonly diagnosed in postmenopausal women, it is diagnosed between the ages of 20 and 50, although symptoms usually develop several years before. Children can also have fibromyalgia.
• Stress, appears to hasten the symptoms of fibromyalgia. When accompanied by sleep problems, the perception of pain is further enhanced, as is the risk of fatigue and depression.
• Genetics is also considered a factor. Research shows that having a parent or sibling with fibromyalgia significantly increases your risk of developing fibromyalgia.

Diagnostics

Fibromyalgia is difficult to diagnose. Because so little is known about it, there is no clear consensus on what measures can or should be used to validate it. Moreover, even if there are signs of a disorder, including chronic widespread pain and fatigue, available laboratory and imaging techniques often look perfect fine.

The only way to make a diagnosis is by exclusion.

This can be a painstaking process in which the doctor looks at and treats many other possible causes of the symptoms. Only when these causes are excluded can a diagnosis be made.

Possible excluding reasons may include:

• Addison's disease (insufficiency of the adrenal cortex);
• alcoholism;
• generalized osteoarthritis;
• Guillain-Barré syndrome;
• hypothyroidism;
• hyperparathyroidism;
• lupus;
• Lyme disease;
• malignant tumors;
• multiple sclerosis;
• myasthenia gravis;
• polymyalgia rheumatica;
• post-traumatic stress disorder (PTSD);
• rheumatoid arthritis;
• Schwarz-Yampol syndrome;
• systemic scleroderma.

The problem with diagnosing fibromyalgia is that other conditions can often coexist with fibromyalgia and have similar or overlapping symptoms. For example, if arthritis or sleep apnea is diagnosed, the diagnosis may explain some of the key symptoms you are experiencing, but not others.

Thus, you need an experienced doctor who can make subtle distinctions.

Fibromyalgia treatment

There is no cure for the disease at the moment. And since no two cases of the disorder are exactly the same, there is no single treatment that can relieve the symptoms of the disorder. Instead, treatment should be multifaceted and tailored to the types and severity of symptoms the person is experiencing.

Therapy may include over-the-counter and prescription drugs, physical and supportive therapy, reducing stress, lifestyle changes and additional treatments to reduce pain and restore quality of life sick.

Medications

As a defining feature of fibromyalgia, pain is the main focus of treatment. To this end, doctors turn to a variety of over-the-counter and prescription drugs, some of which are approved for the treatment of fibromyalgia and others are misused.

The goal of therapy is to treat often varied symptoms using as few drugs as possible to achieve the greatest clinical benefit. These can include analgesics, antidepressants, anticonvulsants, muscle relaxants, and other types of oral medications.

Analgesics.

For the treatment of mild pain in fibromyalgia Tylenol (acetaminophen) can provide adequate relief of acute symptoms with few side effects, if any. While non-steroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen) and Alive (naproxen) also have analgesic effects, it is important to remember that fibromyalgia is not inflammatory disease and that regular use of most NSAIDs may increase the risk of gastric bleeding stomach ulcers, cardiovascular and renal diseases.

Prescription NSAIDs such as Celebrex (celecoxib) or Voltaren (diclofenac) also carry the same risks as their over-the-counter counterparts, but may be suitable for short-term relief if taken in the lowest effective dose possible.

Antidepressants.

Antidepressants are often used to help manage fibromyalgia, as these drugs able to treat multiple symptoms, relieving pain, fatigue and depression, helping sleep and lifting mood.

There are two antidepressants approved for fibromyalgia, both of which are serotonin and norepinephrine reuptake inhibitors. They work by preventing the reabsorption of serotonin and norepinephrine by cells, and thus provide a greater concentration of these “tactile” neurotransmitters in the body.

• Simbalta (duloxetine): starting dose 30 mg per day, maximum dose 60 mg per day.
• Savella (milnacipran): starting dose of 12.5 mg taken once daily, increased to 50 mg, taken twice a day (in severe cases, the total maximum daily dose may be used 200 mg).

Side effects may include nausea, dry mouth, constipation, decreased appetite, drowsiness, increased sweating, sexual problems, and arousal.

Other antidepressants commonly used off-label to treat fibromyalgia, including SSRIs such as Citalopram, Escitalopram, Paroxetine, and Sertraline.

While older generation tricyclic antidepressants are used less frequently, lower doses of Elavil (amitriptyline) has been shown to be effective as a sleep aid in helping to relieve chronic pain and depression.

Anticonvulsants.

Although scientists are unsure how they work for fibromyalgia, anticonvulsants commonly used to treat seizures and epilepsyhave been shown to be effective in the treatment of fibromyalgia.

Lyrics (pregabalin) is the first anticonvulsant drug approved for the treatment of fibromyalgia. If prescribed, treatment begins with lower doses until a maximum daily dose of 450 mg is reached (taken once a day). Common side effects include dizziness, drowsiness, and weight gain.

Other anticonvulsantssuch as Neurontin (gabapentin) have a similar mechanism of action and may work just as effectively.

Muscle relaxants.

Muscle relaxants also seem to help in some cases, and scientists are not entirely sure why. Because medications can cause drowsiness, they are usually taken at night before bed.

Since poor sleep is a common symptom of fibromyalgia, it has been suggested that restoring normal sleep patterns may reduce a person's sensitivity to pain. On the contrary, sleep deprivation, lack of sleep, is known to cause often deep pain symptoms.

Two muscle relaxants commonly used to treat fibromyalgia are Flexeril (cyclobenzaprine) and Zanaflex (tizanidine). Side effects may include dry mouth, dizziness, nausea, and blurred vision.

Complementary treatments

In addition to medications, your doctor may refer you to specialists to help overcome any physical or emotional problems you may have.

While we tend to think of fibromyalgia as a nerve disorder, it is actually a multidimensional disorder in which depression, anxiety, and poor health play a role.

For this purpose, you can use the services of the following specialists:

• Psychologists can provide counseling and apply cognitive behavioral therapy (CBT) to increase happiness by altering dysfunctional emotions, behavior, or thoughts.
• Psychiatrists can help if you suffer from depression, panic attacks, and anxiety disorders, such as PTSD, commonly seen in people with fibromyalgia. It is necessary to ensure close coordination with the attending physician to avoid overlap or contradiction between medicinal products.
• Physiotherapists can improve strength and well-being by teaching you how to exercise in a way that does not worsen symptoms. They can also offer therapeutic treatments to relieve pain and improve posture for more efficient muscle work.

Diet recommendations for fibromyalgia

Some people report that they feel better when they follow a certain diet or avoid certain foods. But research hasn't proven that dieting improves symptoms of fibromyalgia.

If you are diagnosed with fibromyalgia, try to eat a balanced diet overall. Nutrition is important to help keep your body healthy, prevent symptoms from worsening, and provide yourself with constant energy. Should:

• Eat fruits and vegetables, as well as whole grains, low-fat dairy products, and lean protein.
• To drink a lot of water.
• There is more vegetation than meat.
• Reduce the amount of sugar in the diet.

Living with fibromyalgia

Living with fibromyalgia is challenging. Work with your doctors and alternative therapists to find treatments that work for you. Each person is different, and what works for one person may be of little benefit to another. If you find yourself feeling lonely or unable to cope with your condition, look for a local or online support group. Connecting with other people who understand what you are going through can be incredibly rewarding.