"No, you hadn’t any disease. You are all right Nicholas" said by the Doctors. His age was 13 but when he was 8 he was exhibiting symptoms of somewhat unknown problem. Most of the times he complained stomach & back pain, & side hurts. Doctors found a kidney stone but that was too small to be causing any pain. So, what was causing the pain???? Doctors didn’t know.
Nicholas was diagnosed with Fibromyalgia when he was 14.Some doctors gave him drug Percocet, Darvocet, Tylenol 3 with codeine which helped sometimes a little.
Autoimmunity research Foundation working with physicians around the world to implement effective therapies based on the new discoveries.
What is Fibromyalgia?
Fibromyalgia is a syndrome that affects the connective tissue & locomotors system with pain and fatigue disorder in muscles, ligaments and tendons. "Fibro" describes the fibrous aspect, "my" the muscular aspect, "algia" the condition of pain. Fibromyalgia is one of the most common rheumatic syndromes in ambulatory general medicine, a disorder characterized by widespread musculoskeletal pain accompanied by:
1- Chronic aching pain
2- sleep disorders
3- Memory issues
4- Mood issues
5- fatigue
6- Stiffness
7- Low back pain
8- Subjective numbness
9- Chronic headache & irritable bowel symptoms are common.
Fibrofog:
Another common symptom is a mental haziness some people call fibrofog. This refers to the inability to concentrate, memory loss, and depression that occurs with fibromyalgia.
According to the National Fibromyalgia Association, patients with this condition typically note that pain and stiffness is worse during the morning hours.
Oh My God!
You torment me from deep within
All the way to the outside of my skin
you scrape my bones and pull my hair
I cannot see you but know you are there.
You keep me awake at night
And make my muscles painfully tight
It’s you that I fight
Fibromyalgia this painful disease
someone find a cure please
you make my fingers cramp in pain
Oh yes you are the one to blame
my minds a blur I can’t even speak
You are the one who makes me so weak
I try to walk, to stand, to play
only to have to sit or to lay.
I’ve suffered in silence for too long this time
I don’t care who hears me whine
Fibromyalgia is ruining my life
Good thing I have the will to fight
You cause me unimaginable pain and tears
How can I go on like this for many more years
I take my pills but they don’t work anymore
My whole body is screaming and is still so sore
I lose things, I forget, I cannot understand
Sometimes I feel my mind is in another land.
Please have patience with me
I suffer with an invisible disease.
I may look okay
but today is not a good day
this morning I couldn’t walk,
Tonight I won’t be able to talk.
I get up each day
And fight and struggle to find my way
I try so hard
But feel as though my body is under bars
Fibromyalgia is making me feel this way
Someday there will be a cure and I won’t have to live this way for one more day……
Who Gets Fibromyalgia?
Fibromyalgia is far more common in women than in men. Some interesting studies show that women have approximately seven times less serotonin in the brain. That may explain why fibromyalgia syndrome, or FMS, is more common in women.
Another theory states that fibromyalgia is caused by biochemical changes in the body and may be related to hormonal changes or menopause. In addition, some (but not all) people with fibromyalgia have low levels of human growth hormone, which may contribute to the muscle pain.
Fatigue Irritability
Brain Fog
Restless Legs
Overlapping Syndromes
Muscle and Joint pain
You never feel good
Anxiety & depression
Loss of Control
Grief & worry
Immune dysfunction
A lifetime Fight
Physical examination:
Physical examination is normal except for "trigger Points" of pain produced by palpation of various areas such as the trapezius, the medical fat pad of the knee, and the lateral epicondyle of the elbow.
Brain & spinal cord process pain signals differently, they react more strongly to touch & pressure with a high sensitivity to pain. It is a real physiological & neurochemical problem.
"If Doctors cannot find anything else wrong with you, then say you have fibromyalgia"
Causes of Fibromyalgia:
It is caused by biofilm bacteria. Biofilms are present on the removed tissue of 80% of patients undergoing surgery for chronic sinusitis. Patients with biofilms were shown to have been denuded of cilia and goblet cells. May be it is caused by hormonal disturbances and chemical imbalances. Some experts believe fibromyalgia with its deep muscle pain is linked to stress, illness or trauma. Still others think there is a hereditary cause or some say there is no explanation at all.
Differential diagnosis:
Fibromyalgia is a diagnosis of exclusion. A detailed history & repeated physical examination can obviate the need for extensive laboratory testing.
Rheumatoid arthritis & systemic lupus erythematous (SLE) present with objective physical findings including ESR and C-reactive protein.
Polymyalgia rheumatic produces shoulder & pelvic girdle pain, is associated with anemia & an elevated ESR, and occurs age 50.
Thyroid function tests are useful, since hypothyroidism can produce a secondary fibromyalgia syndrome.
The diagnosis of fibromyalgia probably should be made hesitantly in a patient over age 50 and should never be invoked to explain fever, weight loss or any other objective signs.
Lifestyle changes & home remedies:
Lifestyle & quality of life changes and small steps should be taken towards achieving wellness. When people learn they have fibromyalgia, they can go through the stages of grief & loss because there is no "Magic Surgery" or pills can fix this.
Patients have very high expectations for themselves but they cannot adjust to more realistic expectations after they develop fibromyalgia symptoms.
People reports lower levels of pain when doing some relaxation techniques.
Fibromyalgia affects up to 4% of the population…mostly women and there is still no recognized treatment that works for everyone. That's one reason, say experts, that so many people have turned to diet as a way to relieve some of the symptoms.
"This is because fibromyalgia is not a specific illness"
Kent Holtorf, MD, is the medical director of the Holtorf Medical Group Center for Endocrine, Neurological and Infection Related Illness in Torrance, California. He says, "We're at the point now where we know diet plays a role in this disease. It’s just not the same diet for everybody. And not everybody is helped in the same way."
Treatment:
The first crucial element in the treatment of pain, fatigue, and other diverse symptomatology in patients with fibromyalgia (FM) are empathetic listening and acknowledgment that the patient is indeed experiencing pain, i.e., a validation of the patient’s illness.Basically there is no surgical treatment or specific antibiotics for fibromyalgia. For the treatment of fibromyalgia, patient’s education is essential. Patients can be comforted that they have a diagnosable syndrome treatable by specific though imperfect therapies and the course is not progressive.
There is modest efficacy of amitriptyline, fluoxetine, duloxetine, milnacipran, chlorpromazine, cyclobenzaprine, pregabalin, or gabapentin.
Treatment through Amitriptyline:
Amitriptyline is initiated at a dosage of 10 mg orally at bedtime and gradually increased to 40-50 mg depending on efficacy and toxicity. Less than 50% of the patients experience a sustained improvement.
Treatment through other drugs
Some of the other treatments are:
Tramadol and acetaminophen combinations have ameliorated symptoms modestly in short-term trials.
Treatment through Massage therapy:
Massage therapy increases production of body’s natural painkillers.
Treatment through Yoga & Tai chi:
China-India yoga held in Guangzhou. There are about 15 million yoga practitioners in China today.95% of learners are women of yoga.
Lu Zijian, referred to as the Yangtze River’s Great chivalrous man, lives in chongqin and practices Bagua zhang. He has lived through china’s historical decades and is today celebrated as China’s most healthy centenarian. Chen says
"Compare Tai chi and yoga, their principles and similarities, how they look at the human body, mind and spirit, and how they work to improve them"
Healthy chocolate:
A patient has had great success with chocolate... but not the traditional chocolate on store shelves. Rather a healthy chocolate. There are lots of people who are having success with this cold-processed chocolate…..which preserves the antioxidant value of the cocoa bean.
Electromagnetic Wave devices:
Several electromagnetic wave devices appear to be efficacious in treating pain in fibromyalgia. Complex neural pulse stimulation (CNP) device that uses magnetic pulse applied to the cranium through a headset daily for 40 minutes for a few days to a few weeks is most promising because the treatment is self-administered.
Antidepressants:
Antidepressants used to treat fibromyalgia include:
• Tricyclic antidepressants - such as amitriptyline, which raise levels of serotonin and noradrenaline
• Serotonin-noradrenaline reuptake inhibitors : such as duloxetine, which raise levels of serotonin and noradrenaline
• Selective serotonin reuptake inhibitors (SSRIs) : such as fluoxetine and paroxetine, which raise levels of serotonin
Ineffective treatments:
1- Acupuncture is ineffective.
2- Opioids and corticosteroids are ineffective.
Acupuncture therapy is an ancient Chinese practice used to eliminate pain and treat other health problems. It aims to restore balance to your body, helping to improve your overall function. Acupuncture literally means, "Needle piercing," because it uses thin, metallic needles to stimulate special points throughout the body. Needles ranging from 1 to 10 centimeters in length are placed in certain points all over the skin. These points, called acupoints or acupuncture points.
Self-Care:
Effectively dealing with chronic fibromyalgia requires numerous different coping strategies and self-care to properly deal with all aspects of the syndrome. The following are all lifestyle changes that you can do to help yourself live healthier while minimizing the effects of your symptoms.
•Medication
•At-Home Treatment
•Treat Associated Conditions
•Meditation Techniques
•Get the best care possible
•Meditation Tips
•Eat Healthier
•Yoga
•Aerobics for Fibromyalgia
•Develop Your Coping Skills
•Eliminate Perpetuating Factors
•Sleep Tips
•Improve Sleep
•Heat Therapy
•Exercise
•Stretching
•Strength Training
•Back Pain Treatment
•Omega-3s & Pain
•Helping Friends and Family
•Electrotherapy
•Keeping a Journal
•Coping with FMS Guide
•Daily Supplements
•Pilates
•Memory Tips
•Tai Chi
•Organic Foods
•Stress Management
•Humor and Laughter
•Mindfulness
•Fight Fear
•Tips to Overcome Fibro Fear
Use a Tennis Ball:
Sometimes it's too painful to use your hands or other parts of your body to provide the necessary pressure on your tender points. Other times you may not have the strength to create sufficient pressure. That's where the proper use of a tennis ball can be especially beneficial.
A tennis ball for fibromyalgia self-massage is very easy to use. All you need to do is find a way to rub the ball back and forth over the painful muscle. You can use your own body against body pressure. Or you can use a hard object like a wall and lean your body against it with the ball on the sore spot. For a deeper massage, simply use more pressure.
If treating pressure points using a wall, keep your feet 12 inches or more away from the wall to create enough pressure to relieve the pain.
It has been proven beyond any doubt:
Fibromyalgia Syndrome (FMS) is an organic disease with somatic causes.
Has a bad bug gotten hold of you,
Making you feel queasy?
You’re energy’s low, you’re indisposed,
Being sick’s not easy!
Just take this opportunity
To recuperate and rest,
And then when you return to us
You’ll be your very best!
By:
Hamayal Zahra
BPD01101136
Doctor of Pharmacy
University of Lahore
