Understanding Fibromyalgia
Here is a brief overview of the disorder, a short look
at the treatment options and a few caveats for working with these
clients. 
Joint pain, fatigue, lack of sleep, anxiety and
depression - they all add up to fibromyalgia (FMS). Or do they?
fibromyalgia is a confounding disorder. Many symptoms can be hallmarks of
other conditions, which can result in years of shuffling from specialist to
specialist for those seeking a diagnosis and treatment.
Once thought to be a
psychosomatic expression, FMS is
now recognized as a systemic disorder. It is estimated that between 3-6
million Americans suffer from FMS patients, the syndrome invades every aspect of
life. It is chronic, rarely ends in remission and has no consistently
effective medical treatment, The good news is that FMS is non-degenerative
and non-progressive.
Symptoms
Although
symptoms generally begin gradually, in some cases there is a relatively sudden
onset following a specific event, such as stress, physical or mental trauma, or
infection. The symptoms are diverse and can change in any individual on a
day-to-day basis. Trigger point pain is the most characteristic
feature. Although there is no joint stiffness and a swollen feeling,
patients have no visible signs of swelling. They also experience
depression and anxiety, but this is considered a result, not a cause of the
disorder. While fatigue, non-restorative sleep patterns and stiffness on
waking are reported in at least 75% of cases, each case differs considerably in
severity of pain and fatigue symptoms and in functional ability.
Overall,
GMS suffers experience greater sensitivity, not just to pain, but also to loud
noises, odors and bright lights. There can be non-cardiac chest pain,
urinary urgency, sinusitis and tension headaches, excessive menstrual pain, strange
sensations in arms and legs, and irritable bowl or bladder syndrome.
Because
of these symptoms, people with FMS often experience serious impairment in social
interaction and normal daily functioning, resulting in withdrawal and isolation,
and a diminished quality of life.
Research
has shown that FMS patients have abnormal EEG patterns during sleep and lower
levels of growth hormone. Higher levels of a substance involved in pain
transmission and lower amounts of serotonin, the chemical related to sleep, mood
and pain regulation, have also been associated with the disorder.
Speculation
about the cause of FMS centers on an imbalance in neurotransmitters in the spine
or brain, possible trauma to the central nervous system, or an infectious agent
that triggers the response; but the exact cause remains unknown.
Experts
question whether it is a homogenous condition or one in which the clinical
picture is an expression of a number of other conditions. It can be
precipitated or increased by stress, cold weather and exertion. The second
most common diagnosis in rhematology, FMS occurs primarily in women of child
bearing are, but can also affect children, men and the elderly.
Current
treatment
Although
there is no known cure for FMS today, some treatments can help moderate the
symptoms. Most physicians prescribe a combination of medication and non-pharmacological
approaches. The most successful medications appear to be those affecting
neurotransmitter metabolism at the receptor site. Antidepressants and
selective serotonin reuptake inhibitors have been used with less success.
Although FMS can mimic signs of inflammation, nonsterodal anti-inflammatories
have not been found to be terribly effective in fighting pain.
The
most successful strategies seem to be those which teach patients how to relax,
manage stress and gain mental control. Also, studies have shown that
aerobic exercise, such as swimming and walking, can reduce some of the pain and
improve muscle tone. In a recent survey of more than 300 FMS patients, it
was indicated that therapeutic massage every two weeks was possibly the most
effective adjunct therapy to keep them functional and employed.
Scientific
research regarding the effects of massage for FMS symptoms has been limited, but
promising. One study, published in 1999 by the European Journal of Pain
focused on the use of connective tissue massage. In a series of 15
treatments, subjects in the massage group experienced a pain-relieving effect of
37%, reduced depression and use of analgesics and a positive impact on quality
of life. The effects appeared to decline over the treatment period of 10
weeks. Three months after treatment, 30% of the pain-relieving effect was
gone and six months later pain was back to 90% of the base level at the
beginning of the study.
Despite
scant research into the use of massage, FMS patients are often very
enthusiastic. Massage provides a positive adjunct to traditional therapies
which by themselves often don't provide adequate relief from symptoms.
Did
you know? The
Symptoms of Fibromyalgia
 |
Three
month history of widespread pain in all four body quadrants. |
|
Tenderness
in 11 of 18 trigger points when physician presses on them. |
|
Axial
skeletal pain - in the cervical spine, anterior chest, thoracic
spine or low back. (As with many syndromes, not every case
will meet these exact criteria.) |
|
