Fibromyalgia By: Amanda Andrews, Pharm D. Candidate What is it? and/or tingling. This is different from Fibromyalgia is a chronic pain illness. pain localized in one area that leads to Symptoms of the disease include a specific diagnosis (such as pain in muscle aches, pain and stiffness of big toe, which may lead to a diagnosis joints and muscles, soft tissue of gout). Cold or humid weather make tenderness, general fatigue, and sleep the pain increase. Sleep that is not disturbances. Common sites of this restful also increases the pain level in widespread pain include: neck, patients with fibromyalgia. Stress, shoulders, back, pelvic girdle, and anxiety, and physical inactivity also hands. Any part of the body may be increase the amount of pain the patient affected by the disease and its experiences. progression. The difficulty with fibromyalgia and pain levels the Fatigue associated with fibromyalgia patient experiences will change over is more than being a little tired on a time. Sometime the patient feels better given day. This fatigue is life and sometime the patient feels worse impairing. The fatigue experienced can since the pain waxes and wanes over be described as complete exhaustion. time. The pain with fibromyalgia can This fatigue interferes with even the even be migratory. simplest daily activities, even the ones which the patient enjoys. Sleep Who is affected? disturbances associated with Women comprise 80-90% of the fibromyalgia interfere with the population affected with fibromyalgia. patient’s restful sleep. Patients with The symptoms of fibromyalgia fibromyalgia do go to sleep, but they commonly present in early adulthood. do not get into deep sleep (stage 4) However, men and children may also which restores their body. Stage 4 be affected. Fibromyalgia is thought sleep is slow wave sleep and is the to affect between 3-6% of the most intense type of sleep. During the population. Other characteristics that sleep cycle, patients with fibromyalgia are common with fibromyalgia experience burst of awake-like patients include: less educated, lower activity. Other symptoms patients economic status, divorced, and with fibromyalgia may also experience smokers. are: irritable bowel syndrome, migraines, restless leg syndrome, decreases in memory and What are the specific symptoms? concentration, rashes, dry eyes, dizziness, and impaired coordination. Pain with fibromyalgia is widespread Ninety percent of all fibromyalgia and chronic, migrating to all areas of patients have some psychiatric the body. The pain may be described diagnosis such as depression, as: stabbing and shooting, muscular generalized anxiety disorder, or bipolar aches, throbbing, twitching, numbness, disorder. How is fibromyalgia diagnosed? medicine treatments) and medicine There is no laboratory test to diagnose treatments. fibromyalgia. To determine that a Nonpharmacological treatments patient has fibromyalgia, it is very include exercise, acupuncture, and important that doctors conduct a biofeedback or relaxation. The best thorough history, physical nonpharmacological treatment is examination, and manual tender point exercise. This especially is the most examination. The American College of effective treatment for very mild Rheumatology (ARC) uses the manual fibromyalgia. Aerobic exercise is the tender point examination to determine best. This includes activities such as a diagnosis. For a patient to receive a walking, jogging, and biking for at diagnosis of fibromyalgia they must least 30 minutes daily. Stretching have widespread pain in all 4 before and after exercise also helps quadrants of the body for 3 months and decrease the pain in the muscles. tenderness or pain in at least 11 out of Medications used to treat 18 specified tender points when fibromyalgia include: Non-steroidal pressure is applied. These pressure anti-inflammatories (such as Advil or points are located at different points in Aleve), antidepressants (such as Zoloft the body around the neck, shoulders, or Prozac), analgesics (such as back, and legs. Many patients go Darvocet or Ultram), and other through numerous test and doctors medications that are normally used to before they get a diagnosis of treat seizures. There is only one fibromyalgia because the symptoms of medication approved by the FDA for widespread pain and fatigue are so treatment of fibromyalgia. This vague. medication is Lyrica and is used to treat neuropathic pain. The normal Causes of Fibromyalgia?? dosage used for treatment with Lyrica Fibromyalgia is a disorder of the is 75mg daily. To relieve pain central processing of neurotransmitters associated with fibromyalgia, the and the neuroendocrine system. dosage of Lyrica is 300-450 mg daily. Patients with fibromyalgia also have The most common side effects of this increased levels of substance P, one of medication are dizziness and the reasons we feel pain. Genetic sleepiness. Other prescription factors also predispose people to medications that are used to treat developing fibromyalgia. However, we fibromyalgia may be effective but do do not know one specific reason of not have FDA approval for use. development or cause of fibromyalgia. Tricyclic antidepressants such as There is a hereditary component to Elavil, and Pamelor, Selective fibromyalgia. It is more common for Serotonin Reuptake Inhibitors such as someone to develop fibromyalgia if a Paxil or Zoloft may also be used in the close blood related relative has the treatment of fibromyalgia. Neurontin disease. or Topamax, medications used for neuropathic pain and seizures Treatment of Fibromyalgia? respectively, may also be used in the treatment of this disease. Fibromyalgia is treated with nonpharmacological treatments (non- Conclusion Fibromyalgia is a debilitating condition. Currently, there is only one FDA approved medication for the treatment of fibromyalgia. Any treatment for fibromyalgia should include medications and exercise. For more information about fibromyalgia contact American College of Rheumatology or The National Fibromyalgia Association.