Fibromyalgia - It's Not in Your Head!
Jim brought his wife of ten years into the office saying "Doc, at night I feel like a football during a kickoff. Betty kicks and moves her legs when she is asleep, and doesn't even know it! Then, in the morning I wake up with bruises all over my body." My immediate thought was, "Betty, the Eagles football team can use a new kicking specialist," but I knew this was a much more serious problem.
I spoke at length with Betty, and was saddened to hear that she had seen a handful of physicians and received just as many opinions. She read me the list of conditions she was told she had: lyme disease, lupus, depression, arthritis, irritable bowel syndrome, and the most bothersome to her, "it's all in your head." This last one made her both sad and angry. She knew the muscle pain and stiffness that had been a part of her life for several years was real. Betty said it was similar to having the "flu", when each movement hurt almost every muscle and joint in her body. Betty also knew she didn't imagine her almost constant fatigue, difficulty in concentration and frustration at not being able to get a good night's sleep. Basically, Betty said her symptoms have "changed her life," and have "made her depressed."
Many different tests, including blood work and x-rays, were performed. All had a similar result, normal. Believe it or not, normal results often help physicians tell patients what conditions they don't have. In Betty's case, the examination was a big clue to her condition. It seemed that Betty had many tender points around her neck, shoulders and elbows. When we sat down and discussed her tests and complaints, the new diagnosis for Betty was Fibromyalgia. I explained to Betty and Jim that it often takes physicians working together to determine the diagnosis of Fibromyalgia
Fibromyalgia is pain in the muscles, tendons and ligaments of the body. The old term was fibrosiitis (meaning inflammation), but medical research has not shown this inflammation to be present in Fibromyalgia. We are not sure of the exact cause of this syndrome, however we do know it affects between 2 and 4 percent of Americans, with the majority being women. Fibromyalgia can be seen in people of all ages, but affected patients often get symptoms when they are in their 20's or 30's. This syndrome can cause widespread muscle and joint pain, and can lead to unexplained headaches, bladder pain, uncontrolled nighttime leg movements and fatigue.
Yes, but this syndrome tends to go in cycles; sometimes worse, sometimes better. One of the keys to feeling better is physical therapy. Even though the muscles and joints feel stiff and hurt to move, too much rest can make this condition worse. A proper exercise program can do wonders. This can help with movement, and encourage the body to produce endorphins, which are the bodies own "natural painkillers." As for the sleeping difficulties Fibromyalgia patients suffer, additional tests are often needed to determine the cause of this problem. Many times the cause cannot be found, but we do our best to help Fibromyalgia sufferers sleep more restfully. This is important and can break the cycle of fatigue and depression.
Unfortunately, there is no pill that can cure Fibromyalgia. However, we sometimes use low doses of an antidepressant medication to help with sleep. This can also help lessen the pain and discomfort of the other symptoms. Antidepressant medications in low doses are not addictive, and many people are able to take them without any bad side effects.
Please ask your family physician if she or he is familiar with Fibromyalgia. If not, many patients are often referred to a physician specialist in the field of Rheumatology. Every Fibromyalgia patient is different, and the treatment plan is tailored specifically for their needs.
For further information, please call the Fibromyalgia Network at 1-800-853-2929.
