1. Understanding Fibromyalgia
By Bethany R. Meeks

2. What is fibromyalgia? Chronic pain syndrome Associated conditions
Sleep problems
Mood issues
Gastrointestinal issues
Fatigue
Fibromyalgia is a chronic pain syndrome involving muscles and ligaments. It is believed that fibromyalgia amplifies pain sensations by affecting the way the brain processes pain signals.
Fibromyalgia is also associated with other conditions like sleep problems, fatigue, GI issues and mood issues such as depression.

3. What are the symptoms? Pain Fatigue “Fibro fog” Headaches
Irritable Bowel Syndrome
The main symptom of fibromyalgia is pain described as a constant dull ache which is worse in the morning. The pain is widespread and usually arises from muscles. The pain must be both above and below the waist and on both sides of the body to be considered widespread.
Another common complaint is fatigue. The fatigue can range from mild to severe enough to interfere with job performance. Sleep is commonly disrupted due to pain which further worsens the symptoms.
Many fibromyalgia sufferers experience mental haziness including inability to concentrate and memory loss. This has been termed “fibro fog.”
Head aches and irritable bowel syndrome are also commonly associated with fibromyalgia.

4. Who is affected by fibromyalgia?
4-5 Million Americans
Mostly women
30-50
Other risk factors
It is estimated that fibromyalgia affects 4 to 5 million Americans age 18 and older % of those affected are women aged 30 to 50. Men and children can also be affected by fibromyalgia, but they are diagnosed less frequently.
Those with rheumatoid arthritis, lupus or other types of arthritis are at a greater risk. Individuals who have a close relative with fibromyalgia are more likely to develop it themselves.

5. What causes it? Relatively unknown Genetics
Physical or emotional trauma
The cause of fibromyalgia remains unknown. However, researchers do know that people with fibromyalgia process pain differently.
There is some evidence that genetics may play a role. Those who have close family members with fibromyalgia are more susceptible themselves.
There seems to also be a link to being exposed to stressful or traumatic events like car accidents, infections or being sent to war.
While these have been linked to fibromyalgia, it can occur on its own.

6. How is it diagnosed? Somewhat difficult to diagnose
No specific lab tests
2 criteria
History of widespread pain for more than 3 months
Presence of tender points
Fibromyalgia is sometimes difficult to diagnose because the main symptoms are pain and fatigue. These are common symptoms for many conditions so all of these conditions must be ruled out first.
There are no specific lab tests to diagnose fibromyalgia. However, there are two criteria to make the diagnosis. The first is a history of widespread pain (both sides of the body and above and below the waist) lasting more than 3 months. The second is the presence of tender points. (See next slide.)

7. How is it diagnosed? http://www.mayoclinic.com/health/medical/IM02372
There are 18 sites on the body that are possible tender points. Diagnosis requires 11 or more tender points. Tender is defined as pain when pressure is applied to the site. Pain may be felt other sites but these site are used for diagnosis.

8. What is the treatment? No cure Team approach Medical doctor
Physical therapist
Chiropractor
Nutritionist
Acupuncturist
Therapist
While there is no cure for fibromyalgia there are a variety of treatment options to help alleviate some of the symptoms that may be administered best by a team approach.
Several types of medical doctors may be helpful, particularly a rheumatologist or pain management specialist. A pain management doctor may prescribe medications like Lyrica, Cymbalta or Savella which are all FDA approved for the treatment of fibromyalgia.
Your physical therapist may give you exercises to help keep you moving which is an important part of treating fibromyalgia.
Your chiropractor can help you through spinal adjustments to help keep your nervous system functioning at its best. When your nervous system is functioning optimally your body can better handle stresses. Chiropractors can also perform soft tissue work like myofascial release therapy which has been shown to help relieve some of the musculoskeletal discomfort associated with fibromyalgia.
A nutritionist can help you create an anti-inflammatory diet which may help relieve some symptoms
Some patients have also experienced relief through the use of acupuncture.
A therapist may be a good option to help you cope with living with a chronic condition. They may be able to help you better understand your illness and may be able to help you locate a support group.

9. What is the treatment? Home care Sleep Aerobics Yoga Massage
It is important that you take an active role in treating your fibromyalgia. Some options you might consider include light aerobics, yoga, water therapy, massage or relaxation and breathing techniques
It is also important that you get plenty of sleep. The average adult needs seven to eight hours of restorative sleep, meaning that you feel rested and ready for the day when you awake. If you are having trouble with sleep it is important to discuss this with your doctor as they may be able to offer you advice or other options for getting a good night’s rest.

10. What else can I do? Exercise Changes at work Diet Don’t overdo it
One of the most important things you can do is to keep moving. Although the pain and fatigue can make exercise difficult it is important to stay physically active. If you are in too much pain to exercise try to start by being more active in daily routine. Start with walking or other low impact exercises and work toward increasing endurance and intensity.
Don’t overdo it. Keep your activity at an even level. If you do too much during your good days you may find yourself having more bad days.
If possible, it may be necessary to cut down the number of hours you work or even switch to a less demanding job. An occupational therapist may be able to help you find more efficient and less painful ways to do your job.
There may be certain foods that make you feel better or worse. Discussing this with a nutritionist can help them to better help you. Proper nutrition will help to give you more energy and make you feel better in general.

11. Will fibromyalgia get better?
Chronic
Non-progressive
Fibromyalgia is considered a chronic condition. This means that it lasts a long time, for some it lasts a lifetime.
However, it is non-progressive meaning it won’t continue to get worse.
In many people the condition does improve over time.

12. References
Mayo Clinic. "Fibromyalgia." MayoClinic.com. Mayo Clinic, 22 Jan Web. 23 Mar
Gaupp, Fredrick B. "Fibromyalgia (FM) Causes, Symptoms, Diagnosis and Chronic Pain Treatment by EMedicineHealth.com." EMedicineHealth. WebMD, 14 May Web. 23 Mar <
Chaitow, Leon, and Peter Baldry. Fibromyalgia Syndrome: a Practitioner's Guide to Treatment. Edinburgh ; New York: Churchill Livingstone, Print.