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Fibromyalgia: the facts
Tuesday 16 August 2011
Local (i.e., South Australian) newspaper the Sunday Mail recently highlighted Fibromyalgia in the paper's lift-out health section, Body + Soul:
It's one of the most-searched health terms on the internet, but what exactly is fibromyalgia?
Can you imagine having aches and pains from head to toe with no discernable cause and no cure? As many as one in 20 Australians suffers from fibromyalgia, a condition that causes chronic pain in the muscles, ligaments and tendons all over the body.
Fibromayalgia is a controversial condition. Up until five years ago, it was not widely acknowledged as a physical condition, but rather viewed as a psychosomatic disorder (a manifestation of emotional distress), says rheumatologist Dr Daniel Lewis. "Now we understand the nuances of the pain system better, we know that people with fibromyalgia process pain in an abnormal way," Dr Lewis says.
While the incidence of fibromyalgia is not rising, Dr Lewis says it is an under-recognised condition in the medical community, which can delay diagnosis. "It can take a long time, up to several years, to be diagnosed."
Women most at risk
There are no definitive causes of the disease but women, especially those between the ages of 35 and 55, are more likely to contract fibromyalgia than men, and certain personality types are more at risk, says Dr Jaimini Raniga from Sydney's Royston Clinic.
"Fibromyalgia tends to affect high achievers," she explains. "Stress, exercise and nutrition are all factors and high achievers are more likely to ignore these things."
Recent research has also shown obesity is a possible link. A study of fibromyalgia patients in the US found that most, but not all, were overweight or obese. Those who were carrying extra weight had reduced strength, less flexibility and increased sensitivity to pain, especially in the lower body. The study authors also suggested that weight loss could improve symptoms in obese sufferers.
Decoding the symptoms
Pain is the predominant symptom of fibromyalgia, with severity ranging from a mild ache to a stabbing or burning in the muscles. Other symptoms include sleep disturbance, poor concentration and increased sensitivity to heat or cold.
"People with fibromyalgia may also have gut problems such as irritable bowel and 90 per cent of sufferers also suffer from fatigue," Dr Raniga says.
An illness such as fibromyalgia also increases your risk of developing anxiety and depression.
There are no specific tests for fibromyalgia, so it is a process of elimination that eventually leads to a diagnosis.
"Other possible causes of soft-tissue pain, like thyroid or other hormone deficiencies, are excluded first," Dr Raniga explains.
Your doctor may also check for increased tenderness on certain points of the body, including the shoulders, chest, neck, elbow, hip and knee.
Treatment for fibromyalgia depends on the individual's set of symptoms, but often takes a holistic approach, Dr Raniga says.
"Depending on the factors at play for the individual, strategies may involve stress reduction, exercise, improved nutrition, massage and acupuncture, as well as conventional therapies such as pain medications, antidepressants and correction of hormone imbalances, if necessary," she explains.
In recent years, meditation has emerged as an effective way to manage patients' pain. Dr Lewis runs meditation courses for people living with fibromyalgia and other conditions.
"Meditation is a practice which is now a feature of most pain-management programs and research now confirms a brief daily meditation practice can dramatically reduce the experience of pain," he explains. "Meditation has been shown to dampen down the nerve activity in the brain centres that register pain."
There is currently no medication allowed to be prescribed specifically for fibromyalgia in Australia. In the US, the drug pregabalin has been licensed for fibromyalgia treatment for the past two years. It is available in Australia, but is only licensed to treat neuropathic pain, Dr Lewis says.
"Australian licensing requires research to have been done in Australia, and there's been minimal local research done so far," he says.
Dr Lewis says even if medication were available, it should only be used as the icing on the cake. "The fundamental thing is management. We can't cure fibromyalgia, so people have to deal with their lifestyle issues."
Read our fact sheet on Fibromyalgia.
"I couldn't hold a telephone or feed myself"
Helen Longhurst, 50, was diagnosed with fibromyalgia at 48, after years of suffering.
"It is as though your muscles are bruised and someone is poking them or, on bad days, like someone has attached a vacuum cleaner to your bruise to keep the pain constant.
"At first it was regular headaches and a bit of lower-back pain, which I put down to stress. My doctor ordered a blood test, but it didn't show up anything, so she told me to exercise and go for a massage.
"The headaches became migraines. I had to take time off work and my boss suggested I see a company doctor. I had a lot of tests, including an ultrasound and MRI, but nothing could explain the extreme pain.
"At my lowest I was sitting on the lounge, my arms on pillows because they were too heavy to keep by my side, and my husband had to feed me. I couldn't even hold a telephone and I was dosed up on painkillers and sleep medication.
"The diagnosis was a relief. I was referred to a rheumatologist and went weekly to a specialist clinic. I had hydro sessions with a physio and learned tips and exercises from a psychologist and occupational therapist.
"I've learned to live with the condition but I wish I had been diagnosed earlier. There were times I thought I'd never go anywhere or do anything again. Now I go to the gym at least twice a week and I'm planning a holiday in Europe."
The above, with comments, originally appeared here.
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