Fibromyalgia (FM) is a very common and painful condition involving multiple tender points in specific parts of the body and discomfort in the muscles, joints, tendons and other soft tissues. It is often called the “invisible illness” because the main symptom in pain, yet the there is no apparent underlying reason to explain the pain. In the United States, 3.7 million people suffer from FM, which is more prevalent in females. Fibromyalgia is associated with sleep disturbances, chronic fatigue and irritable bowel syndromes. According to the American College of Rheumatology, there is a major disturbance in the process of analyzing painful stimulations in the central nervous system of patients with FM.
The cause of Fibromyalgia is not known, although it may develop after a trauma to the body such as after a motor vehicle accident, surgery or following an infectious disease. There are a number of theories for FM, and central to all of them is a disturbance in restorative sleep and lack of full relaxation of muscles that should occur during sleep. Additionally, alteration of neurohormonal activity that should occur during a restorative sleep is also paramount in the pathogenesis (development) of FM. This hormonal dysfunction results in altered levels of the growth hormone and cortisol which is a hormone necessary for the body to cope with stressful conditions. Functional MRI reveals evidence of an abnormal exaggeration of pain processing and pain perception in certain areas of the brain in patients with FM.
FM may be a challenging disorder when it comes to its diagnosis. In addition to pain, patients with FM usually have associated disorders such as fatigue, mood alterations, headaches, depression, anxiety and forgetfulness, which are also symptoms of other illnesses. Because there is not a standard, objective lab test that confirms a FM diagnosis, people often suffer for years while every other possibility is ruled out. Although there is currently not a specific test for FM, there are investigational tests that are becoming more widespread and can point physicians in the right direction. In particular are tests that check hormone levels because we know that many people with FM do not produce these hormones due to the absence of restorative sleep, thus leading to a vicious cycle of increased sleep disturbance, greater hormone imbalance, pain and distress.
Management of FM starts with educating the public and the health care providers as to the existence of this malady as a real medical condition. Prognosis is dramatically improved with early intervention. Treatment involves a multidisciplinary approach to pain management and should be focused on regaining a normal restorative sleep cycle and include pharmacological interventions, psychological support, and reconditioning of the muscles by a step wise physical therapy regimen to increase functional activity.
For more information about Fibromyalgia treatment and diagnoses, you may contact your local Dr. Benjamin Taimoorazy at Beverly Hills Migraine and Pain Management Institute, Located in Bloomington Illinois and Newport Beach California.