Fibromyalgia is a chronic or long-lasting disorder characterized by generalized pain in the muscles and bones, areas of sensitivity and general fatigue. Their symptoms are subjective which means that they can not be determined by tests and there is no clear known cause, fibromyalgia is often misdiagnosed as another disease.
The most common symptoms are:
Pain and stiffness throughout the body.
Generally chronic fatigue, which affects four out of five people with the disorder
Depression and anxiety, mood swings
Problems with thinking, memory and concentration.
Vertigo, migraine or sensitivity to light, sound or odors.
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Other symptoms may include:
Tingling or numbness in the hands and feet.
Pain in the face or jaw, including jaw disorders,
Digestive problems such as abdominal pain, diarrhea, constipation.
Reproductive symptoms such as painful periods, pelvic pain or premature menopause.
What are the risk factors for fibromyalgia?
Age: Fibromyalgia can affect people of all ages, including children. It is diagnosed more frequently between 20 and 50 years, although symptoms usually develop several years earlier.
Sex: It mainly affects women, it has been suggested that the decrease of estrogen during menstruation (in particular or at the beginning of menopause) can trigger symptoms in some women.
Stress: It seems to precipitate the symptoms, when accompanied by sleep problems, the perception of pain increases even more, as does the risk of fatigue and depression.
Family history: Research suggests that having a father or brother with fibromyalgia significantly increases your risk.
How is fibromyalgia diagnosed?
The diagnosis is usually a meticulous process that must be evaluated by a rheumatologist or a neurologist. Since 1990, fibromyalgia has been diagnosed mainly by the presence of tender points that cause pain when it is pressed.
There are 18 bilateral points on the body, nine on one side and nine on the other, where pain can be felt under the skin when pressed. A point can be as small as a penny and change in intensity and location.
The nine bilateral points are found in the following parts of the body:
Lower neck muscles
Upper chest just below the clavicle
Back of the neck in the muscles of the base of the skull.
Trapezius muscles of the shoulders back.
Supraspinatus muscles in the scapula area.
Outside the elbow where the tendons adhere to the bone.
Upper-outer quadrant of the gluteus muscle of the buttocks.
Out of the hip.
Changes in diagnostic criteria:
For the year 2010 and 2016 the American College of Rheumatology (ACR) revised its diagnostic guidelines by replacing the examination of tender points with two separate tests that characterize the overall symptomatic experience.
Instead, the ACR introduced two separate assessment tools: the generalized pain index (WPI) and the symptom severity scale (SS).
The WPI: It is a questionnaire in which you are asked if you have experienced pain in one of the 19 parts of the body in the last week. Each “yes” answer receives a score of 1 for a possible maximum score of 19.
The SS: It is a questionnaire that is used to classify the severity of four different symptoms (fatigue, unrefreshing sleep, cognitive symptoms and physical symptoms) on a scale of 0 to 3 for a possible maximum score of 12.
These tools are used by doctors today to perform the diagnosis of fibromyalgia.
How is fibromyalgia treated?
It can be treated and managed effectively with self-management strategies and a combination of medications:
Medications, including prescription and over-the-counter pain relievers.
Aerobic exercise and muscle strengthening.
Stress management techniques such as meditation, yoga and massage.
Good sleep habits to improve the quality of sleep.
Cognitive behavioral therapy to treat underlying depression.
Frederick Wolfe, Daniel J. Clauw and Mary-Ann Fitzcharles. (May 2010). Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity. Arthritis Care & Research, Vol. 62, No. 5, pp. 600-610. The American College of Rheumatology