Fi­bromyal­gia: Pain that can’t be ex­plained

The Star (St. Lucia) - - LOCAL -

Fi­bromyal­gia is not a new dis­ease, but it only re­cently gained recog­ni­tion as a painful and de­bil­i­tat­ing con­di­tion. Its symp­toms of all-over body pain were first dis­cussed in the 1800s and fi­bromyal­gia was known as mus­cu­lar rheuma­tism. At that time no cause, re­lief or cure from symp­toms could be found; some doc­tors even be­lieved it was a dis­ease of the mind and the pain was man­i­fested by thoughts and ex­pe­ri­ences. It was not un­til 1904 that the med­i­cal pro­fes­sion re­alised it was not a rheumatic dis­ease; they re­named it fi­brosi­tis— be­liev­ing the pain was caused by in­flam­ma­tion. In 1976 the name changed again to fi­bromyal­gia, when it was dis­cov­ered that in­flam­ma­tion was not the cause of pain. Re­searchers now be­lieve that the way the brain per­ceives pain is al­tered and these sig­nals are am­pli­fied in the pres­ence of fi­bromyal­gia.

The name, bro­ken down: Fi­bra (Latin), mean­ing fi­brous tis­sues, i.e. ten­dons and lig­a­ments; myos (Greek), mean­ing mus­cle, and al­gos (Greek), mean­ing pain. It does not dis­crim­i­nate; both Mor­gan Free­man and Lady Gaga suf­fer from this painful con­di­tion. Lady Gaga is speak­ing out on Twit­ter to help raise aware­ness and con­nect with peo­ple who have it too.

Al­though fi­bromyal­gia is still un­der the um­brella of rheuma­toid dis­eases, this new un­der­stand­ing of what it is (and is not) has helped many with this con­di­tion fi­nally find some re­lief. As yet there is still no cure but in­creased knowl­edge has brought bet­ter treat­ments for pain re­lief and other symp­toms. So, what ex­actly is fi­bromyal­gia? Fi­bromyal­gia, which af­fects more women than men, de­scribes pain and ten­der­ness through­out the body along­side other symp­toms such as fa­tigue, mood swings, poor mem­ory and some­times in­som­nia. The cause is un­known; symp­toms may ap­pear for no rea­son, grad­u­ally in­creas­ing over time or some­times linked to trauma, surgery, in­fec­tion or high lev­els of stress.

The most com­mon symp­toms are: wide­spread pain, fa­tigue, poor mem­ory (known as brain fog) and in­som­nia. The less com­mon symp­toms are: tem­poro­mandibu­lar joint dis­or­der (TMJ), fre­quent headaches, ir­ri­ta­ble bowel syn­drome (IBS) and cys­ti­tis and painful blad­der.

Al­though more is known about fi­bromyal­gia, di­ag­nos­ing it can still be dif­fi­cult. There are no de­fin­i­tive blood tests, lab­o­ra­tory tests or sig­nif­i­cant signs. Di­ag­no­sis is based on hav­ing symp­toms for three months or more and rul­ing out any other patholo­gies or causes. Blood tests do not con­firm but rather dis­miss other con­di­tions with sim­i­lar symp­toms, such as rheuma­toid arthri­tis, thy­roid prob­lems or in­fec­tion. Treat­ment for fi­bromyal­gia can vary greatly be­tween in­di­vid­u­als and this has made it dif­fi­cult to find the per­fect so­lu­tion. Most of­ten a com­bi­na­tion of in­ter­ven­tions are sug­gested to man­age symp­toms:

• Self-care and lifestyle changes – An im­por­tant piece of ad­vice that is of­ten sug­gested is to re­duce stress. Just think­ing about re­duc­ing stress is enough to in­crease stress lev­els. It seems that these days stress is un­avoid­able, whether at work, at home or jug­gling both work and home; even sit­ting in slow-mov­ing traf­fic can be stress­ful. Man­ag­ing stress is far bet­ter than ig­nor­ing it or let­ting it con­trol us. There are so many ways to do this from writ­ing lists and pri­ori­tis­ing to learn­ing the art of med­i­ta­tion.

Go for a walk, get some fresh air and take in the sur­round­ings to un­wind af­ter a long day; get plenty of sleep and slow down. Feel­ing good to­day does not mean hav­ing to fit ev­ery­thing into one day!

• Med­i­ca­tion – Now that more is known about this con­di­tion, med­i­ca­tion is more ef­fec­tive. It may take time to find the right com­bi­na­tion but doc­tors have a clearer idea of med­i­ca­tions that are ef­fec­tive in treat­ing pain, in­som­nia and mood. Re­mem­ber, never take high doses of med­i­ca­tion with­out pro­fes­sional guid­ance; even over-the-counter med­i­ca­tion can have side ef­fects if not taken cor­rectly.

• Ther­apy – See­ing a phys­io­ther­a­pist can help to man­age and un­der­stand pain through a range of in­ter­ven­tions. Phys­io­ther­a­pists can of­fer a full as­sess­ment to iden­tify ar­eas of weak­ness and pain, and of­fer ad­vice on pain man­age­ment and ex­er­cise. Ex­er­cise can help re­lieve symp­toms. Re­mem­ber, ex­er­cis­ing in mod­er­a­tion re­leases en­dor­phins, the body’s very own happy hor­mones, as well as im­prov­ing cir­cu­la­tion, strength­en­ing mus­cles and boost­ing me­tab­o­lism. All of these can help re­lieve symp­toms. Oc­cu­pa­tional Ther­a­pists can ad­vise on man­ag­ing daily tasks and give ad­vice on mod­i­fi­ca­tions at home and at work. Coun­selling is also help­ful in recog­nis­ing stress and iden­ti­fy­ing strengths and weak­nesses. It is some­times help­ful to seek ad­vice on set­ting sen­si­ble goals and sug­gest­ing cop­ing strate­gies.

Kim Jack­son is a UK-trained phys­io­ther­a­pist with over 20 years’ ex­pe­ri­ence. She spe­cialises in mus­cu­loskele­tal pain and dys­func­tion in­clud­ing back pain and sci­at­ica, stroke and other neuro con­di­tions plus sports phys­io­ther­apy, hav­ing worked with lo­cal, re­gional and in­ter­na­tional ath­letes and teams treat­ing in­juries and analysing biome­chan­ics to im­prove func­tion and per­for­mance. She is reg­is­tered with the Al­lied Health Coun­cil and is a mem­ber of PASL. She cur­rently works at Bay­side Ther­apy Ser­vices in Rod­ney Bay, O: 458 4409 or C: 284 5443; www.bayside­ther­a­py­ser­vices.com

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