Treatments Can Ease Severe Aches, Pain of Fibromyalgia

LEXINGTON, Ky. (Jan. 15, 2013) - The following column appeared in the Lexington Herald-Leader on Sunday, Jan. 13, 2013.

By Dr. Leslie Crofford

Everyday aches and pains are a part of life, but sometimes they can get so severe that it is almost unbearable and interferes with the ability to function normally. In that case, fibromyalgia may be to blame.

Fibromyalgia causes pain that can be felt in muscles, joint and even skin. Although it is the most common musculoskeletal condition after osteoarthritis, it is often misunderstood and misdiagnosed. It is characterized by all-over body ache that persists for at least three months, specific tender points on the body and severe fatigue. <?xml:namespace prefix = owc />

The muscles may feel like they are tired and overworked and may twitch, burn or have a deep stabbing pain. The condition can be accompanied by unrefreshing sleep, problems with clear thinking and feelings of anxiety or depression. Other medical conditions sometimes found in fibromyalgia patients are chronic headaches, irritable bowel syndrome and temporomandibular or facial pain.

It is estimated that more than 12 million Americans are living with fibromyalgia, and it is more common in women than in men. The cause of fibromyalgia is not known, but those with fibromyalgia may have a personal or family history of other painful conditions.

It is thought that one reason women are more likely to have the condition is that they have about seven times less serotonin in their brains than men do. Reduced serotonin or other brain chemicals may lead to the increased sensitivity to pain in patients with fibromyalgia.

Diagnosing fibromyalgia requires first making sure you do not have other conditions that have similar symptoms. Blood and other laboratory tests can rule out other serious illnesses. Your primary care physician may refer you to a specialist for further evaluation.

There is no cure for fibromyalgia, but a combination of medications, exercises and behavioral changes can treat symptoms.

Aerobic or conditioning exercises can relieve pain and the depression that may come with the condition. Regular exercise can normalize levels of the brain chemicals that are altered in fibromyalgia patients. Regular exercise can also improve sleep and reduce fatigue.

If you have trouble getting started with an exercise program, physical therapy also can be used to learn how to get started and how to avoid injury.

Anti-depressants are the class of drugs commonly prescribed to help with fibromyalgia pain and are used because they increase levels of serotonin and other brain chemicals that reduce pain.

Over-the-counter pain relievers like acetaminophen may also be useful but should be taken only as recommended.

Anti-inflammatory drugs such as ibuprofen and naproxen are not specifically helpful because there is no inflammation with fibromyalgia, but they may be useful for other types of pain that may worsen fibromyalgia symptoms.

A muscle relaxant taken at bedtime can help to provide a more restful sleep.

Alternative fibromyalgia treatments could also be beneficial for treating its symptoms, though research in these areas is minimal. Those treatments include yoga, tai-chi, acupuncture and chiropractic massage.

The medical community continues to seek the cause of fibromyalgia. There are genetic factors that place people at risk for developing fibromyalgia and related pain conditions. It is also known that fibromyalgia can be triggered or worsened by many types of physical and emotional stressors.

If you think you are suffering from fibromyalgia, contact your primary physician.

Dr. Leslie Crofford is chief of the Division of Rheumatology and director of the Center for the Advancement of Women’s Health at UK HealthCare.