Fibromyalgia is a real condition that can be treated by a physician, general practitioner, pain management specialist, or rheumatology specialist. When I was a pain management provider, I treated many patients with fibromyalgia. Not every patient presented the same way in the clinic. Frequently, patients were dismissed from their previous provider as psychiatric patients because of the various symptoms and behaviors. When patients are treated this way, they may stop seeking help, have an increase in depression, have suicidal thoughts, have a decline in activities of daily living, experience poor relationships, and self-medicate by using alcohol and illegal drugs. Patients need to be heard and not
judged when they are seeking help. If healthcare providers take the time to listen to their patients, then patients are more likely to trust their healthcare provider and adhere to the treatment plan. I believe more positive outcomes will occur if healthcare workers develop a rapport with their patients.
What is Fibromyalgia?
● Fibromyalgia is diffuse tenderness and neuropathic pain throughout the body.
● It occurs more often in women than men.
● Fibromyalgia can mimic other rheumatic diseases that cause inflammation in the joints, tendons, ligaments, bones, and muscles.
● No one patient presents with the same symptoms.
Signs and Symptoms
● generalized chronic pain
● fatigue
● insomnia
● mood swings
● confusion
● stiffness
● poor balance
● impaired physical functions
● sexual dysfunction
● memory problems
Often, patients will have other comorbidities associated with their pain such as musculoskeletal pain, lower back pain, irritable bowel syndrome (IBS), pelvic pain, and cystitis. All these symptoms can cause a decline in daily activities.
Diagnosis
● In the past, the American College of Rheumatology (ACR) criteria was used to diagnose fibromyalgia. The assessment required the documentation of more than eleven out of eighteen tender points as well as chronic widespread pain. Unfortunately, not everyone uses the ACR criteria because not all patients being treated for fibromyalgia.satisfy the criteria or healthcare providers may fail to recognize other symptoms associated with fibromyalgia.
● Today, healthcare providers diagnose fibromyalgia based on the patient’s symptoms since no specific test is available to determine if a patient has fibromyalgia.
● Lab tests and X-rays can be ordered to rule out other diagnoses.
Treatment
● Opioids are not effective medications for treating fibromyalgia.
● The best treatment plan for fibromyalgia includes educating the patients and their family members about the disease, antidepressants (ex: Amitriptyline), neuropathic pain medication (ex: Gabapentin or Lyrica), muscle relaxers (ex: Robaxin), exercise (ex: yoga or high/low impact cardio), cognitive behavioral therapy, and relaxation teaching.
References
American College of Rheumatology. (2019). Read More.
Lightspring. (2019). Human body joint pain concept as skeleton and muscle anatomy of the body with a
group of sore joints as a painful injury and medical symptoms with 3D illustration elements. [Illustration].
https://www.shutterstock.com/image-illustration/human-body-joint-pain-concept-skeleton-1460559845
?src=3oyeV7lMLWAPMuqpjPDE5g-1-2