It is my belief when learning about anything new you first need to know the definition of what you are dealing with. There is an overabundance of information about diseases on the internet but the key is to knowing what sources are good to go to for information. One of the sources I often use is the Mayo Clinic, because let's face it the medical personnel know what they are doing there. So in order to define fibromyalgia I went to the Mayo Clinic's website and chose to share their definition with you.
The Mayo Clinic defines fibromyalgia as, "a disorder characterized by musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues." Sounds like a broad definition doesn't it? That's because it is. The only thing the medical community can agree upon at this point is the definition. They are struggling with finding the sources and curative treatment for this disease process, or as many call it, a syndrome.
The Centers for Disease Control (CDC) reports approximately 4 million adults, or 2% of the population, is affected by fibromyalgia. Häuser and Wolfe in their 2012 article Diagnosis and diagnostic tests for fibromyalgia (syndrome) state, fibromyalgia and fatigue based symptoms have been around as early as the 19th century and well into the 1960s. Testing for Fibromyalgia is still a test of exclusion. There are several diagnostic criteria that apply at this point and this article will discuss those and treatment possibilities.
So what are the common signs of fibromyalgia? The following are several factors doctors use to help diagnose fibromyalgia:
full body and joint pain lasting longer than 3 months
tension headaches and/or migraines
TMJ issues
IBS/SIBO
anxiety/depression
brain (fibro) fog (forgetfulness)
extreme fatigue
age/sex (females are 2 times more likely than men to be diagnosed)
History of autoimmune disorder
Allergies/illnesses
obesity
Trauma/PTSD
Repetitive injuries and/or stress on the joints
Decreased threshold to pain
Pain in 4 out of 5 body quadrants: left/right upper region & left/right lower regions that include the following: shoulders, arms, jaw, hips, buttocks, legs, neck, back, chest or abdomen. These are also known as fibro points.
This is a large list of symptoms and many of these symptoms can mirror other diseases. This is where a good relationship with you doctor comes in. For instance, my doctor knows I don't come in until I have tried every home or natural method to cure what ever is bothering me. He also knows that I have a very high pain tolerance and can push my body to daily limits that are ridiculous. So when I went in complaining of debilitating pain, forgetfulness, and emotions all over the place he knew something was drastically wrong and we started to find out what. Thankfully, I have been part of the medical world since birth and have worked in the field for the past 16 years, so I know the tests to ask for. This is something I am going to provide for you so you know what to ask for as well.
The following list of tests is something I would discuss with my doctor:
Complete Blood Count (CBC)
Blood Chemistry
Routine Urinalysis
Sed Rate
Cyclic citrullinated peptide test
Rheumatoid Factor
Thyroid Function: make sure to ask for TSH, T3 & T4.
Anti-Nuclear Antibody
Celiac Serology
Vitamin D
Allergy Test (Food & Environmental)
Lyme's Disease
Your doctor may tell you they are not all needed but this would be a complete profile for me and what I would ask for, in the end that decision is between you and your healthcare provider. If you do not have a good relationship with your provider it is time to find a new one!
Now for the part many of you are here for: Treatment guidelines. This is the part where some of it is on your doctor to help with and the vast majority is your responsibility. Here is where the problem of not knowing the cause of fibromyalgia comes in, there isn't a cure at this point, most medical providers treat the symptoms not the cause. Yes, there are medications that can help with the symptoms, but are not curative. So here is a list to talk with your healthcare provider about:
Pain relievers: acetaminophen, ibuprofen, naproxen, and I am going to throw in here for the states that have legalized it, medical marijuana and CBD. Most providers have thankfully moved away from opiate based pain relievers and I would strongly encourage you to do the same if your can.
Antidepressants: Cymbalta, Sevella, cyclobenzaprine can be prescribed to ease symptoms such as, pain, fatigue, and sleep issues.
Anti-seizure medications: Gabapentin and Lyrica
Physical therapy
Occupational therapy
Counseling: ok this one I am going to throw in my full 2 cents worth. Absolutely needed!! You are now dealing with a long-term disease that causes pain, anxiety, depression and forgetfulness. Having someone to help guide you through this process is an absolute must for this disease and learning to live with it.
Ok, enough of "modern medicine" treatment modalities. Now for the treatments I utilize for myself! Yes, this is the on you part. Our doctors can help us with current treatments but many of them have not been trained in whole-body, lifestyle change medicine and only recently have medical schools started placing an emphasis on nutrition.
So, here we go!
Nutrition: Yes, there is a reason I list this first. Our S.A.D lifestyle (aka: Standard American Diet), is full of grease, non-nutritional fats, sugar, and processed foods. Many of these foods cause inflammation in our bodies and damage at the cellular level. Damage that is being shown to cause issues in future generations. I would highly suggest looking into the Mediterranean, Pegan, Paleo, Anti-inflammatory, and Keto diets. Find one that works for you and discuss it with your doctor, a health and nutrition coach, or a Registered Dietitian.
Exercise: No, you don't have to go to the gym and start curling 50# dumbbells. Start simple. I enjoy yoga, pilates, light weights, rowing, walking, hiking, horseback riding, and water aerobics/exercises. I can go on all day with exercise options. Find what fits, start small and listen to your body. Not sure how to get going? Hire a personal trainer, go to group classes and sometimes I simply turn to YouTube. I like YogawithAdriene and Fitness Blender to name 2 from YouTube.
Sleep: Our bodies spend a lot of time repairing when we sleep. So if you're not getting enough sleep this can wreck havoc on your health. Stay away from caffeine before bed, and honestly cut back on caffeine period. I will also listen to music that promotes sleep, journal before bed, reiki and/or meditate before bed, I also love a lavender & chamomile tea before bed to help me get to sleep. These are just a few ideas to help you sleep and you can find many more out there in Google land.
Stay away/don't use tobacco
Pace yourself
Yoga/Pilates
Reiki/Meditation/Tai Chi
Massage
Acupuncture
Chiropractor
Red Light Therapy
Epsom Salt soaks
I know I've thrown a lot at you today but I hope it helps you on your journey towards learning your disease and learning how to reclaim your life and live it to the fullest.
Resources
Mayo Clinic. www.mayoclinic.org
Centers for Disease Control. www.cdc.gov
Häuser, W., Wolfe, F. (2012). Diagnosis and diagnostic tests for fibromyalgia (syndrome). Reumatismo. 64(4): 194-205.
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