Fibromyalgia fatigue by benbenzhou


More Info
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-
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.

To top