Fibromyalgia - Research Paper Example

?Fibromyalgia Approximately 10 million Americans are suffering from fibromyalgia, a majority being women, Fibromyalgia is an unremitting condition characterized by extensive pain in every one of the four quadrants in the body. Those affected are faced with tenderness, stiffness and aching of the joints, muscles and tendons although inflammation is not observable. Further symptoms include fatigue; sleep disorders, trouble with cognitive performance, headaches and migraines, hyper-reaction to environmental conditions and irritable bowel syndrome (“Fibromyalgia Fact Sheet”, n.d). Diagnosis Typically, the pain that patients face should have been ongoing for a minimum of three months for a correct diagnosis. However, as disabling as the pain is, it does not result in any deformity or damage to internal organs. This is what differentiates fibromyalgia from numerous other rheumatic conditions for instance, systemic lupus, rheumatoid arthritis and polymyositis. This is because these conditions are typified by tissue inflammation that results in damage to muscles or internal organs and deformity to joints (Shiel, 2012). During diagnosis, pain is mapped out from the upper and lower parts of the waist, either sides of the body and the axial skeleton; this accompanied with fatigue, sleep interruptions and non-restorative sleep should lead the physician to diagnosing the patient with fibromyalgia. In addition, the incidence and intensity of the pain is noted to verify the progression of the condition (Lesley et al, pg. 458). Furthermore, in establishing fibromyalgia in patients, the tenderness and pain should be verified using a force of 4kg on a minimum of 11 of 18 tender points within the body. Generally, the diagnosis of fibromyalgia relies on information from the patient, since its existence cannot be determined by objective medical findings, radiographic anomalies or regular laboratory tests. The information provided by the patient indicates the exact location of the pain and its severity as this will help in finding the proper treatment (Lawson, 2009). Notably also, is that even though there are no blood tests or X-Rays that specifically point to diagnosis of fibromyalgia, there is a need to carry out blood tests to exclude other medical conditions and laboratory tests to explain causes of certain symptoms (Lesley et al, pg. 462). Causes and Risk factors Because of the condition being present within families, for example, between mothers and their daughters, researchers have arrived at the conclusion that a genetic component may be the cause. It is commonly preceded by a physical trauma in the form of a rigorous disease/injury. This sets off the progression of the condition with the central nervous system acting as the point of origin as patients experience pain to stimuli that are not ordinarily experienced by other individuals (“Fibromyalgia Fact Sheet”, n.d). Over 80% of persons affected by fibromyalgia are women that fall under the age bracket of 35-55. The condition is onset by pathological conditions in some patients while in others by somatization subsequent to traumatic events. Although not recurrent, the elderly, men and children have been seen to be affected by the condition. Conditions such as rheumatoid arthritis and systemic lupus contribute to the risk of developing this condition (“What causes fibromyalgia”, 2012). Continuous studies have also shown that fibromyalgia patients have advanced levels of a chemical signal known as substance P found in the nervous system, and within their spinal fluid a nerve growth factor. Moreover, patients exhibit levels that are minimal, of chemical serotonin that originates in the brain. This suggests super-sensitivity in the central nervous system particularly around the brain, due to the severity of the pain that patients experience. This has led scientists to highlight that pain perception among fibromyalgia patients is distorted (“What causes Fibromyalgia”, 2012). Symptoms The primary symptom of fibromyalgia, which is pain, is attributed to allodynia- abnormally high sensitivity to stimuli that are not ordinarily sensitive and hyperalgesia- a heightened response to painful stimuli (Lesley et al, pg. 458). The stimuli to be tested would be light, sound and the reaction would be through touch; therefore, as earlier mentioned, patients with this condition are also likely to have trouble with cognitive functions such as impaired memory and concentration. Moreover, other conditions go beyond these, such as vision problems, ringing in the ear, dizziness, skin rashes, dry eyes and mouth (“Symptoms”, n.d). Vision problems that occur among fibromyalgia patients are usually impaired non-rapid eye movement. In addition, they will undergo mood changes, petulance, unease and depression. This combined with the difficulties in cognitive functions has resulted in misdiagnosis of fibromyalgia patients, as the symptoms are similar to those of clinical depression (“What causes fibromyalgia, 2012). The most significant aspect of fibromyalgia is that every patient displays unique symptoms and that they occur sporadically. Treatment Fibromyalgia largely impinges on the patient’s quality of life because of the consequential intensity of pain. However, if properly managed, substantial improvement may be made. Therefore, the patient needs to be willing to adjust their day-to-day activities regardless of the effort and discomfort it may imply. The patient will require extensive knowledge on the condition; this will help in coping, and similarly contact a doctor that is well versed and compassionate as treatment involves routine follow-ups (“Treatment”). Conventional medicine is necessary for the treatment of co-morbid conditions that include mood changes and anxiety. Nevertheless, the role of nutrition, exercise and relaxation techniques cannot be undermined as alternative methods of treatment. The patient also needs to be aware of positive effects of moderating environmental conditions such as weather exposure, noise and temperature. For the patient to achieve optimal sleep, aerobics and activities such as cycling and walking are recommended. Dietary changes such as eliminating coffee and alcohol are helpful while in the case of patients that experience irritable bowel syndrome, a diet that avoids the conditions is essential (“Fibromyalgia- Treatments”). The most common drugs used for treatment of fibromyalgia are non-narcotic pain relievers, serotonin reuptake inhibitors and tri-cyclic anti-depressants in low doses. These are recommended in low doses as they merely aid in sleep improvement and pain relief. Where the focus is on pain, lidocaine injections are used in specific points of pain at tender points. In addition, a regular schedule of stretching and gentle exercise should be adapted in order to reduce the stiffness, sustain muscle tone and relieve pain. The patient is prone to enduring emotional difficulties, due to the chronic feature of this condition. Hence, they are advised to join support groups and be in constant communication with family and friends. In some instances, complementary therapies such as myofascial release therapy, therapeutic massage, acupuncture and cognitive therapy may be implemented (“Treatment”). Conclusion Fibromyalgia has brought about the controversy in its classification as either a disease or condition. This is because of the characteristic growing and fading instances of pain combined with the co-morbid conditions. Scientists and researchers have differed over this as classifying it as a disease is seen to add more psychological trauma to the patient; while classifying it as a condition may lead to its undermining. This, in turn, has also affected the identification of treatment plans. Moreover, there is also the fact that pain is seen, as both a consequence of the condition and a cause of some of the other symptoms particularly fatigue (Lawson, 2009). Largely, fibromyalgia patients can be categorized using the impact the condition has had on their life; comprising of those that are mildly moderately affected and those that are severely affected to the extent of interruption of daily-life activities. For this reason, when establishing a treatment plan, the physician should gather comprehensive medical history of the patient and prescribe medication that deals with the pain and co-morbid conditions (Arnold et al, 2011). References Lawson, K. (2009). “Pregabalin and Fibromyalgia Syndrome: A Treatment Option”. Libertas Academica. Retrieved from Shiel, W.C. (2012). “What is Fibromyalgia”. MedicineNet. 2012. Retrieved http://www.medicinenet.com/fibromyalgia/article.htm#what_is_fibromyalgia “Fibromyalgia Fact Sheet”. (n.d). National Fibromyalgia Association. Retrieved from http://fmaware.org/PageServerc145.html?pagename=fibromyalgia_fmFactSheet “What causes Fibromyalgia” 2012. MedicineNet. Retrieved from http://www.medicinenet.com/fibromyalgia/page2.htm#what_causes_fibromyalgia “Symptoms”. (n.d). National Fibromyalgia Association. Retrieved from http://fmaware.org/PageServerb3b4.html?pagename=fibromyalgia_symptoms Arnold, L.M., Daniel J. C. and Bill H. M. (2011). "Improving the Recognition and Diagnosis of Fibromyalgia." Mayo Clinic proceedings. 86.5: 457-64. “Treatment”. (n.d). National Fibromyalgia Association. Retrieved from http://fmaware.org/PageServerf195.html?pagename=fibromyalgia_treated Read More