Fibromyalgia is a mysterious pain syndrome which afflicts four million Americans and is characterized by…
- Chronic flu-like pain in the muscles, tendons and/or ligaments.
- “Tender points” areas of great sensitivity to touch.
- Restlessness, numbness and/or tingling in the arms and legs.
- Sleep problems thought to be caused by pain and/or persistent leg twitching that makes deep, restful sleep impossible.
- Chronic fatigue. Many fibromyalgia sufferers feel tired even after a full night’s sleep.
Some patients also report headaches, abdominal bloating and/or irritable bowel syndrome. To learn more, we spoke with the nation’s leading fibromyalgia researcher, Dr. Robert M. Bennett.
An emotional problem
For decades, doctors considered fibromyalgia an emotional problem. The consensus was that anxious or depressed individuals unwittingly “created” their symptoms.
Since the mid-1970s, several studies have proved this theory false. As it turns out, most fibromyalgia patients do not have emotional problems. In those who do, the problems are now believed to be the result of having to live with chronic pain not the cause of the pain.
Fibromyalgia seems to be associated with chronic fatigue syndrome (CFS) another disorder that has at least some connection with emotional problems. Up to 80% of CFS patients also have fibromyalgia.
Some researchers speculate that CFS and fibromyalgia are simply different terms for the same condition. Since neither syndrome is well understood, however, it’s hard to know for sure.
How fibromyalgia starts
While some cases begin with a flu-like infection, most start with lower back pain, whiplash or another localized pain. This pain then spreads to other parts of the body.
Why does the pain persist? What makes it spread? The culprit seems to be subtle changes in the central nervous system possibly the result of abnormally high levels of certain neurotransmitters that make people more sensitive to pain.
Because the disorder tends to run in families, researchers also suspect that there is a hereditary component.
The good news and the bad
The good news is that fibromyalgia is neither crippling nor degenerative. It certainly isn’t fatal.
Unfortunately, there is no cure. Most patients learn to manage their symptoms, but the pain may continue to flare up in response to injury, infection or stress.
Even worse, few doctors know much about the syndrome. That means it can be hard to get an accurate diagnosis. If you think you have fibromyalgia, your best bet is probably a rheumatologist.
Drug therapy
Conventional arthritis drugs, including aspirin, do not seem to be particularly effective against fibromyalgia. Drugs that do seem effective include…
• Amitriptyline
Amitriptyline (Elavil) and other tricyclic antidepressants. Taken at low doses (10 to 25 milligrams [mg] instead of the 100 to 200 mg prescribed for depression), tricyclics help to reduce pain and promote sleep.
• Zolpidem (Ambien)
This short-acting sedative can help fibromyalgia sufferers get much-needed sleep. However, because of the danger of dependency, Zolpidem should be taken no more than twice a week.
• L-dopa and carbidopa (Sinemet)
Very low doses of this drug used mainly to treat Parkinson’s disease relieve restless legs syndrome, a common problem for fibromyalgia patients.
• Procaine orlidocaine
These local anesthetics are injected into tender points. Injected properly, these drugs bring relief lasting several months.
• Tramadol (Ultram)
Relatively new non-narcotic drug.
Lifestyle issues
Since emotional stress can trigger pain, fibromyalgia patients must learn to pace themselves. Physical and occupational therapists can demonstrate less stressful ways to move and suggest job modifications to make your work environment more comfortable. It’s particularly important to avoid long stretches of typing or other repetitive motions.
• Exercise
Although too much or too little exercise exacerbates fibromyalgia symptoms, gentle stretching or massage (including acupressure) and moderate exercise are essential. Shoot for 20 minutes of aerobic exercise three times a week.
• Relaxation
Since fibromyalgia pain isn’t caused by muscle tension, deep breathing and other relaxation techniques aren’t likely to reduce symptoms. But learning to relax can keep tension from exacerbating the pain. Patients who know how to relax via relaxation tapes, rhythmic breathing, hot baths, etc. are better able to keep the problem in perspective.
• Support groups
As with many chronic diseases, fibromyalgia seems to be helped by active participation in a support group. To find a group in your area or to obtain more information on fibromyalgia contact the Arthritis Foundation.
