Causative & risk factors
The cause of fibromyalgia is believed to be multifactorial. Hereditary factors or certain genetic changes predispose an individual to develop fibromyalgia in response to stress of any kind. People with pre-existing rheumatic diseases have a higher risk of developing fibromyalgia. In a pre-disposed person, the onset of fibromyalgia may be triggered by severe physical or mental trauma, stress, following infections or due to lifestyle factors like obesity, smoking or lack of exercise.
Some studies suggest that women have much lesser levels of serotonin compared to men; hence they are much more likely to develop fibromyalgia.
Clinical presentation
Fibromyalgia leads to the development of fatigue, tiredness and widespread vague pain in various body parts. The individual usually has trouble sleeping and may suffer from sleeplessness (insomnia). They may experience several musculoskeletal symptoms such as tingling of the skin (parasthesia), weakness of the extremities, nerve pain and twitching or spasms in the muscles. Certain spots on the patient’s body may demonstrate heightened pain in response to tactile pressure (allodynia).
Memory and concentration may be impaired giving rise to difficulty in performing simple tasks. Feelings of anxiety or depression are very common in patients with fibromyalgia. Other symptoms that may be experienced include palpitations, disturbances in bowel movements and headaches.
Investigations
The patient’s medical history is taken and a physical exam is performed by the physician. Fibromyalgia is a diagnosis of exclusion. If any person experiences pain at several locations for a period more than 3 months, without any underlying cause being detected; a diagnosis of fibromyalgia is made.
Several tests are carried out to rule out other causes for pain. The blood tests include complete blood count (CBC), lipid profile, liver function tests, kidney function tests, thyroid function tests, ESR, anti CCP, RA factor and ANA.
X rays may be taken to rule out other arthritic causes of pain.
Treatment
Modifying the patient’s lifestyle is beneficial in reducing symptoms of fibromyalgia. Eating healthy, regular moderate exercise and adequate sleep are recommended. The patient is advised to avoid any kind of physical or mental stress. Meditation, Yoga, Acupuncture, Tai chi and massage therapy are beneficial for patients with fibromyalgia. Counseling is recommended to deal with depression.
Medications are prescribed depending upon the severity of the condition. Pain killers, anti-depressant and anti-seizure drugs are usually recommended.
Recent updates
A recent study has found that fibromyalgia is linked to abnormal activity in parts of the brain that process pain signals and link them to other regions. Another study has found that Vitamin D supplementation reduces the pain and fatigue felt by patients with fibromyalgia.
