Fibromyalgia is one of the more common pain syndromes encountered by pain physicians. This condition consists of chronic widespread aches, pain, stiffness and tenderness. Pain is considered to be widespread when it affects all four areas of the body. A patient with at least 11 of 18 specific trigger points involving all four quadrants of the body must be present to establish the diagnosis. Fibromyalgia is often also associated with difficulties sleeping, fatigue, depression, headaches, and anxiety. Patients with this condition have specific anatomical trigger points, or tender points that hurt when pressed. Touching these sensitive spots will cause the patient to pull back or flinch. Tissue trauma is very common in patients with fibromyalgia, although the exact cause is still unknown.
The condition is more common in women and occurs more frequently for patients in their 40s and 50s, but can occur at any age. Although the exact cause in not yet known, there is evidence of biochemical changes in the cerebrospinal fluid in these patients which can explain increased pain sensitivity and increased pain sensation.
According to the diagnostic criteria for Fibromyalgia Syndrome (FMS) published by the 1990 American College of Rheumatology (ACR).
Fibromyalgia patients must have:
Widespread pain in all four quadrants of their body for a minimum of three months. At least 11 of the 18 specific tender points.
Although the above criteria, created for research purposes, focuses on tender point count, a recent consensus of 35 FMS experts has determined that a person does not need to have the required 11 tender points to be diagnosed and treated for FMS.
Many people who have less than 11 of the required tender points may still be diagnosed with FMS as long as they have widespread pain and many of the common symptoms associated with FMS.
Commonly associated symptoms include:
- Fatigue
- Sleep disorder (or sleep that is unrefreshing)
- Jaw pain (TMJ dysfunction)
- Post-exertion malaise and muscle pain
- Numbness and tingling
- Skin sensitivities
- Morning stiffness
- Irritable bowel
- Chronic headaches (tension type or migraines)
- Cognitive or memory impairment
- Menstrual cramping and PMS
- Dizziness or impaired coordination
Treatment of Fibromyalgia
The first sign of fibromyalgia is usually pain and fatigue, but since these symptoms overlap with other pain conditions, doctors have to rule out any other conditions before they diagnose the patient with fibromyalgia. Currently, there are no laboratory tests to diagnose fibromyalgia. When treating fibromyalgia our pain specialists have multiple modalities available which can help improve pain and function of a patient. Since depression is sometimes present in patients suffering from fibromyalgia, antidepressants and/or psychological treatment may be included in treatment plans. Alternate treatments for pain control may include using physical therapy and possibly trigger point injections.
Our highly trained pain treatment doctors can help manage the pain of Fibromyalgia. Our pain management physicians in Orange County care about improving your pain and quality of life. For more information on how Pain Specialists of Orange County can help treat your Fibromyalgia, please contact us at 949-297-3838.