FIBROMYALGIA

Fibromyalgia is a generalized chronic pain syndrome with a presentation of a widespread pain and tenderness to palpation at multiple soft tissue body sites. This condition is usually accompanied by depression, anxiety, insomnia, cognitive dysfunction, chronic fatigue, irritable bowel syndrome, endocrine dysfunction and dysfunction of the autonomic system.  Fibromyalgia could be also be accompanied by rheumatoid arthritis, lupus and hypothyroidism. The pain could be symmetric and asymmetric in presentation.

Fibromyalgia Tender Points

Fibromyalgia is distinct from the myofascial pain by having a very low threshold of the pain at the tender spots of the body.  Myofascial pain is generally a soft tissue injury which could be self-limited and usually not a long-term condition, also fatigue and morning stiffness is uncommon for myofascial pain.

Common symptoms of fibromyalgia syndrome are widespread pain, chronic insomnia, depression, anxiety, physical fatigue from regular daily activities, prolonged morning stiffness, lightheadedness, dizziness, syncope, irritable bowel, abdominal pain, diarrhea, urinary frequency, urgency, pain with urination and other.

The treatment of fibromyalgia should be emphasized on patient’s education and reassurance. There are available techniques of conservation of energy, following routine daily activities, low impact graded aerobic exercises.  Treatment modalities as biofeedback, tender point injections, combination therapy and acupuncture are usually effective.  Patient’s also benefit from the treatment using tricyclic antidepressants, pregabalin, SSRIs, muscle relaxants and tramadol.