FAQ’s on Fibromyalgia Treatment in Philadelphia

 

Fibromyalgia is a condition that causes widespread tenderness and pain. The pain associated with fibromyalgia moves about the body and comes and goes. Many people with this condition report sleep problems, joint arthralgias, and chronic fatigue.

How common is fibromyalgia?

Fibromyalgia affects 2-4% of people, and the majority of those affected are women. There is no cure for this disorder, and it is often diagnosed by symptoms.

What symptoms are associated with fibromyalgia?

With this chronic health problem, the patient has pain all over the body, as well as multiple tender points. Tender points are areas along the muscles of the neck and shoulders that are sore to touch. The pain begins in these areas and spreads to other areas. These include fatigue, tenderness to pressure/touch, joint and muscle pain, sleep problems, memory problems, dizziness, dry mouth, tingling of the feet and/or hands, pelvic pain, headaches, irritable or overactive bladder, and temporomandibular disorder (TMJ). In addition, sleep disturbances involved include restless leg syndrome (RLS) and periodic limb movement disorder (PLMD). Depression and anxiety are also common with this condition.

What causes fibromyalgia?

There is no known cause of fibromyalgia. However, some experts theorize that certain genes contribute to the diagnosis. Other triggering factors include spinal problems, injury, arthritis, as well as emotional and physical stress.

Who is at risk for fibromyalgia?

Fibromyalgia mostly affects women, but it can occur in men. Middle-aged people are mostly affected by this condition. Those at higher risk are people with rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis.

How is fibromyalgia diagnosed?

The doctor diagnoses fibromyalgia by assessing tenderness and tender points on the body. Diagnostic tests are used to rule out certain serious disorders. The doctor will ask several questions about your medical history and symptoms. Certain blood tests are used to rule out conditions that mimic fibromyalgia, such as antibody tests, C-reactive protein, erythrocyte sedimentation rate, and thyroid/liver function tests. To diagnose the condition, the symptoms must last for at least three weeks.

How is fibromyalgia treated?

The doctor will often use a combination of therapies and treatments for fibromyalgia. Options include:

  • Medications – The FDA has approved three drugs for fibromyalgia treatment. These are medicines that change brain chemicals (norepinephrine and serotonin) to control pain levels. These include duloxetine (Cymbalta) and milnacipran (Savella). The other drug, pregabalin (Lyrica), works by blocking nerve cell overactivity. For pain, the doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) and sleeping medicines.
  • Trigger point injections (TPIs) – Trigger points are areas of muscle contraction. These tender areas can be injected with an anesthetic. Based on a recent clinical study, TPIs have a 98% success rate.
  • Acupuncture – To restore energy flow, stimulate endorphin release, and help with pain, the doctor inserts fine needles into acupoints. Acupuncture is a Chinese remedy that is also called dry needling.
  • Botox injections – To paralyze certain muscle regions, the doctor can inject botulinum toxin A. This is used to alleviate pain and relieve tension. For fibromyalgia, Botox was found to offer improved functional ability and provide pain relief, according to a recent research study.
  • Nutritional supplements – Over-the-counter products that treat fibromyalgia include melatonin (regulates sleep-wake cycle), S-adenosyl-L-methionine (SAMe), which relieves morning stiffness and fatigue, and Chorella, which is found in fresh water and relieves pain.

Resources

Dhadwal, N, Hangan, MF, Dyo, FM, Zeman, R, & Li, J (2013). Tolerability and efficacy of long-term lidocaine trigger point injections in patients with chronic myofascial pain. International Journal of Physical Medicine and Rehabilitation.

Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum 2008;58(1):26–35.

McDonald M, DiBonaventura M, Ullman S. Musculoskeletal pain in the workforce: the effects of back, arthritis, and fibromylagia pain on quality of life and work productivity. J Occup Environ Med 2011;53(7):765-770.

Smith HS, Audette J, & Royal MA (2002). Botulinum toxin in pain management of soft tissue syndromes. Clin J Pain, 18(6 Suppl):S147-54.