Fibromyalgia 4.44/5 (64)

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Fibromyalgia with rheumatic pain most often among women

Fibromyalgia causes pain and usually attacks women


Definition of fibromyalgia

Fibromyalgia is a common cause of chronic, widespread (generalized) pain in muscles, tendons and joints, mostly among adult women. The pain affects night sleep, the concentration and can contribute to fatigue (fatigue) and depression. The pain threshold is reduced so that small loads cause great pain. A number of symptoms from different parts of the body are common (Reference: Wolfe F, 2015). Rheumatic inflammation is not present and the disease is not a systemic connective tissue disease or vasculitis. Fibromyalgia is included among disease without medically explained physical causes (MUPS). Fibromyalgia reduces quality of life, but usually does not shorten life.

Disease Cause

The cause of the disease is unknown, but the pain gets worse with general tension and stress. Some results may indicate that the brain is affected (Reference: Albrecht DS, 2018), while others emphasize stresses and psychological aspects (Reference: Furness PJ, 2018).

Occurrence

About 2-3% of the population has the disease defined by Wolfe 1990 criteria (see below).

  • Most are women in the age group of 20-49 years, with about 8-10% having fibromyalgia (Reference: Forseth KO, 1992)

Symptoms

Chronic pain in muscles, joints and tendon parties.

  • Symptoms develop gradually, most often over several years
  • Neck- and headache
  • Stiffness, especially after physical activity
  • Chilliness, feeling of fever
  • Varying numbness in the hands and feet
  • Sensation of swelling
  • Eye irritation
  • Discomfort by bright light and high sounds
  • Sensation of foreign body in the throat
  • Alternating stools, diarrhea
  • Reduced sleep
  • Exhaustion
  • Difficulty concentrating

Medical examination for fibromyalgia

Usually, the general practitioner / general practitioner does the medical examinations and makes the diagnosis. Some patients are referred to rheumatologists to confirm the diagnosis. Further follow-up by a specialist is rarely necessary.

  • Medical examinations show normal blood samples, X-rays, MRIs etc. The disease progression shows no evidence of organ damage

Criteria for diagnosis

There are newer criteria, but it is still common to diagnose fibromyalgia (Reference: Wolfe F, 1990) on the basis of

  1. Daily, significant pain in both arms, both legs and neck or back, provided that these have occurred for more than 3 months (chronic generalized rheumatic pain)
  2. In addition, examination requires clear pain in at least 11 of 18 defined points at a certain pressure ("tenderpoints")

It is assumed that no other causes of the pain are detected (Differential diagnosis)

Tender points fibromyalgia

"Tenderpoints" are particularly tender points weighing fibromyalgia. Sav vas, Jmarchn [CC0], from Wikimedia Commons

Incorrect Diagnosis (similar conditions / differential diagnoses)

Treatment of fibromyalgia

Medication

Unfortunately, no drugs are particularly effective

  • Side effects often exceed potential effects
  • Several types of drugs have been tested
  • Sarotex (aminotryptilin) ​​10-25 mg taken an hour before bed can improve sleep and pain in some (but many initially experience "hang-over" with increased fatigue the next morning)
  • More about medications here: Forseth KO, 2006

Informasjon

  • Good information is important for managing the disease in the best possible way

Physical Activity

  • Physical activity or careful training that is individually adapted helps in the long run. Mastering techniques against pain and measures to improve night's sleep are also important
  • Some benefit from exercises in hot water and relaxation exercises

Heat and varm climate

  • Most people with fibromyalgia feel less pain and stiffness in warm climates. Research supports the fact that rehabilitation in warm climate helps (reference: Clarke-Jenssen AC, 2014)

Fibromyalgia and diet

No diet is shown to affect the pain or disease progression. However, dieting can be useful to many who suffer from stomach symptoms or sleep difficulties. About 40% have symptoms of "Irritable bowel"(Bloating, fluctuating fluid and hard stools, normal intestine when examined). Raw onion, broccoli, beans and broccoli are good sources of nutrition, but can contribute to gastrointestinal gas and bloating. Lightly cooked vegetables may be preferred. Some have as well lactose intolerance and experiencing intestinal symptomes (loose, frequent stools, stomach cramps, bloating) of milk products. If one avoids milk products, calcium should be taken via chewable tablets (eg Calcigran Forte).

Guten Sensitivity is quite common in the population and the symptoms overlap with fibromyalgia. Try with Gluten free diet can be done for a limited time (reference: Rossi A, 2015)

Reduced sleep and affected sleep quality are common. Coffee, tea and chocolate can enhance sleep problems, especially when taken in the evening. Alcohol is unfavorable for sleep quality. In general, it is important to find a diet that works well for the individual.

Pain often results in reduced physical activity. Some gain weight. A disparity between nutrition intake and physical activity easily occurs. The diet should consist of much more unsaturated fat via fish, vegetables, fruit and grain products. If a lack of vitamins, iron and salts is suspected, a medical examination should be performed and relevant tests carried out.

Medical prognosis

Most people will have pain for many years

  • Intensity varies
  • After 16's disease progression, two out of three with fibromyalgia report improvement compared with the time of diagnosis
  • There is no evidence that fibromyalgia develops and damage joints, muscles or internal organs
  • No increased mortality has been demonstrated (Reference: Wolfe F, 2011)

Key words for medical examinations, referral to specialist and journal writing in fibromyalgia

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