Dr. Robert Bennett, noted expert in diagnosis and treatment of fibromyalgia and on staff at the Department of Medicine at Oregon Health Sciences University, offers insight into the widespread pain in fybromyalgia (FM).
In an article originally published in Pain Digest, Dr. Bennett refers to over 90 previously published editorial pieces dealing with pain and other issues related to FM. His review article focuses on clinical manifestations of FM, its causes and treatment.
The primary symptom of FM is chronic widespread pain lasting more than three months and occurring in 11 of 18 specific tender-point sites. These symptoms vary and flare up with an increase in exercise, injuries, illnesses and psychological stress.
Debilitating fatigue is a hallmark characteristic of FM. Exhaustion occurs from physical and mental effort. Causes of fatigue include nonrestorative sleep, depression and hormone dysfunction. People with FM report feeling exhausted even after 8 to 10 hours of sleep.
Restless Leg Syndrome: Numbness, tingling, itching and restlessness in limbs sometimes in arms as well as legs is found in over 30% of FM patients.
Irritable Bowel Syndrome: About 69% of FM patients compared to 20% of the overall population suffer from IBS, which is manifested by constipation, diarrhea or an alternation between the two.
Irritable Bladder Syndrome: Frequent urinary tract infections or feelings of a need to urinate constantly effect between 40-60% of FM sufferers.
Cognitive Dysfunction: Inability to function at maximum intellectual ability, often affecting the sufferer’s ability to hold a job.
Cold Intolerance: Close to one-third of FM patients develop hyper-sensitivity toward cold. Some actually develop Raynaud’s disease (vascular disorder characterized by vasoconstriction of capillaries to fingers and toes) and pain.
Dizziness: Often no cause can be found.
Most FM patients claim their symptoms began after an injury or repetitive work-related pain. Studies have suggested that FM may develop as a result of a genetic pre-disposition waiting for a trigger. There is also a strong familial occurrence of the ailment. Although FM was previously thought to have no known cause, research from the American College of Rheumatology has made strides in defining the syndrome, which may lead to a better understanding of the disease’s causes.
Those with FM seem to experience pain differently than the general population, which indicates that some problem with how the body processes pain is linked to understanding the disease. FM sufferers are more sensitive to thermal fluctuations, for instance.
Treatments for FM are not long-term. Current philosophy to manage the pain and fatigue that are symptomatic of the ailment involve a multi-modal approach that includes:
* Therapeutic treatment of pain
* Cognitive behavioral therapy
* Exercise and stretching programs
* Treatment of accompanying psychological problems that arise as an adjunct to the disease