Understanding the Clinical Management of Pain in Fibromyalgia

Diagnosis of FMS is often very difficult. There are many different symptoms that seem to be unrelated. Some of the symptoms such as fatigue overlap with many other diseases. A patient will often have to visit many different doctors before being properly diagnosed. Also, there currently is no lab test to rule whether or not a patient actually has FMS. As physicians become more aware of the disorder and its classic symptoms, it will be easier for them to diagnose it. Still, many other diseases and disorders must first be ruled out before the patient is diagnosed as having fibromyalgia. The American College of Rheumatology (ACR) has established some criteria for diagnosis: more than three months of muscular pain and tender points, there must be pain in all four quadrants of the body (top, bottom, left, right), and there must be at least eleven tender points (the ACR has established eighteen of these points). (Source 1)

She is oriented x3, alert, cooperative. Good short-term, long-term, and intermediate memory. No aphasia. Normal fund of knowledge. Normal attention and concentration.

Fibromyalgia has been described as a full-body migraine. Another common explanation is to compare everyday life with FMS as being similar to the aches and pains associated with a severe

Fibromyalgia – This condition causes individuals to have aching muscles all over often leaving them in quite a lot of pain, and many fatigued by the simplest of movements.

     If one does though happen to experience the pain from FIBROMYALGIA, it is described as deep-aching, radiating, gnawing, and shooting ranges from mild to severe. FIBROMYALGIA sufferers tend to have pain that weakens through out the day gradually. The pain often increases again during evening at the worst and in activity that is cold, damp weather, which results to stress and anxiety.

The treatment of Fibromyalgia should be viewed as a “team approach”. Most chronic pain does not respond to drugs and may require an aggressive use of no pharmacological therapies or “the rehab approach”. This includes a lifestyle change, physically, mentally, and emotionally. This approach should include use of a physician, occupational therapist, physical therapist, massage therapist, chiropractor, an acupuncturist and any specialists, such as a Rheumatologist. (Mondell, D. L., &ump; Wright, P. (2005)) Psychological counseling is recommended early after receiving the diagnosis of Fibromyalgia. Mainly because it takes many years of visiting doctors and having tests results come back negative that an individual will begin to think this is “all in their head”. Then when finally a diagnosis is given like Fibromyalgia and they are told that “the cause is unknown, the treatment is unknown and there is no cure” can be hard to accept. It is recommended that the patient’s loved ones attend sessions, because they, too, will find it hard to understand the diagnosis. In 2007 pregabalin became the first US Food and Drug Administration (FDA) approved drug for the treatment of FM. Pregabalin and its precursor gabapentin play an important

“Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals (Mayoclinic Staff, 2015).” There are several theories as to why this pain continues to exist post treatment. Researchers have postulated that this disease process amplifies painful sensations in your brain, others retain that it acts like an arthritic condition as it degrades the joint capsule and most soft tissue within. These patients can display a wide variety of symptoms ranging from sleep problems and fatigue, to pain and muscle spasms and or muscle

In this academic journal Melanie Brown reports the benefits and experiences of using alternative and conventional methods to treat muscular skeletal pain. In this study Brown explains the methods people use to indicate what is going wrong or what is causing them problems and the methods they use in order to treat said ailment. Brown explains the methods and treatments used to treat muscular skeletal treatment, but she also shows the methods she used to collect the information. Brown used questionnaires, interviews,

"Approximately 10 million Americans (2-4%) have Fibromyalgia with a ratio of about 8 to 2, women over men." This is a ratio that has been found by the National Fibromyalgia and Chronic Pain Association. Fibromyalgia is a disease that affects the body in many different ways. It comes with pain in the muscles, ligaments, and tendons. Along with chronic muscle pain, it also comes with fatigue, sleep problems, and painful trigger points. Although many doubt a diagnosis of Fibromyalgia, it is a real disease affecting so many people. This confusing diagnosis leads to daily struggles like fatigue, pain all throughout the body, and even depression from time to time, affecting not only the victim of the disease, but also the people around them.

It’s a life of severe chronic fatigue, pain, depression, and anxiety. Unheard of as recently as twenty years ago, fibromyalgia is now the most common diagnosis made by rheumatologists in America, affecting around 10 million people.

It wasn’t till 1990 that the explanation of this disease came to light. Stimuli are normally not painful, however in people suffering with Fibromyalgia there is overall pain of these stimuli due to pressure over the muscle. Patients tend to have more nociceptive signals due to damage, or the constant use of neurotransmitters. Microglial cells that wrap around the axon of the nerve cells activate the pathogens, which then move from one neuron to the next causing pain when the other neurons are stimulated. As of now there’s no methods of prevention, but there are certain things that may trigger it, such as trauma, family history, infections, and autoimmune

In a literal translation fibromyalgia means muscle fiber pain. It is a chronic pain disorder that causes pain and tenderness in the muscle to the touch. By affecting the way your brain processes pain signals, researchers believe that fibromyalgia amplifies those sensations. Robert Bennett MD, explains that different parts of the brain are involved in pain reactions. Pain sensation is necessary; it serves as a reflex to avoid discomfort. This unconscious reflex of avoidance causes the brain to swiftly react, before the actual awareness of the pain sensation occurs. This chronic disorder causes widespread body pain, fatigue, tension headache, digestive problems, depression, anxiety and temporomandibular joint disorder. To have an accurate diagnosis for fibromyalgia health professionals rely on physical examination, a precise tender point examination, and the patient’s history.

Pain is typically the most prominent symptom of fibromyalgia. FM pain is chronic and widespread affecting all four quadrants of the body, although not essentially simultaneously. Its intensity might range from mild to deep. Fm pain tends to wander sometimes affecting one portion of the

(3) Medical management therapies (such as ongoing stretching exercises, physical therapy, NSAIDs, and muscle relaxants) have failed to control the pain;

Also pain may start with a disease or injury that persists due to stress emotional problems, improper treatment, or persistent abdominal pain signals in the body. It is possible for chronic pain to occur any previous injury illness or known cause. Therefore, patients suffering with chronic pain significantly benefit from a comprehensive multidisciplinary approach to treatment. Often you achieve optimal care several different health professionals may be involved in patient care alternative care to the traditional medical phonological could include but is not limited to traditional chiropractic care nutritional diet yoga exercise acupuncture meditation support groups soft tissue therapies and network chiropractic. Often, they cannot be cured, that it can be managed well enough through these alternative disciplines of care to improve the quality of life.