Fibromyalgia – What is it… Exactly?

There are many conditions that can be attributed to specific causes with a clear origin and means of diagnosis.  However, there are also conditions that are obscure and can only be diagnosed by eliminating other, more common conditions.  Fibromyalgia (FM) is one of those conditions where the degree of pain and disability can be profound and life quality interrupting, yet all the tests come back negative and there are no other conditions to explain the collection of symptoms.  It is at that point when the diagnosis of fibromyalgia is typically made.

FM is typically a chronic (symptoms have been present for at least 3 months) condition where the patient complains of widespread, generalized muscle, ligament and tendon pain accompanied with fatigue and multiple tender points on the body that hurt with only light pressure. To be considered “widespread,” it usually affects both sides of the body and is both above and below the waist.  It occurs in approximately 2% of the population in the US and women are 3-4 times more likely to develop FM.  The risk of FM increases with age and can be secondary to other physical or emotional trauma, or it can occur all by itself.  No obvious pattern usually exists as signs and symptoms can vary depending on weather, stress, physical activity, and even the time of day.

Sleep quality is an issue that seems well agreed upon as regardless of the number of hours in bed, the deep, restorative stages of sleep are seldom reached.  Other sleep disorders frequently associated with FM include sleep apnea and restless leg syndrome. 

Causation for the most part is unknown but genetics (family traits), infections (can trigger or worsen FM), and after physical or emotional trauma (e.g., post-traumatic stress disorder) have been linked to FM.  An explanation as to why it hurts so much centers around a theory called “central sensitization.” This is basically a low threshold for pain because of increased sensitivity in the brain to the incoming pain signals.  Certain chemical (neurotransmitters) changes in the brain have been identified resulting is hypersensitivity creating an overreaction to pain signals. 

The American College of Rheumatology has established two diagnostic criteria that include 1) widespread pain lasting at least 3 months, and 2) at least 11 out of 18 positive tender points using just enough pressure to whiten the fingernail bed.  There are no direct blood tests to confirm a diagnosis of FM but other conditions can affect or cause FM can be diagnosed with blood testing.  These include thyroid disease (thyroid function blood tests), inflammatory arthritis such as rheumatoid (ESR), and a complete blood count to assess anemia and infection.

We take pride in providing quality, evidence-based care and appreciate the opportunity to do so when patients choose our clinic for their chiropractic care.  We realize that there are many healthcare options available.  If you, a friend or family member require care for fibromyalgia, we would be honored to offer our services.

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