Fibromyalgia

Dr. Glaxon Alex, Consultant Rheumatologist, SUT Hospital, Pattom

What is fibromyalgia?

Fibromyalgia is a condition with very varied and complex symptoms. It is found in 3% – 4% people in Kerala. Most of them are women. There has been a notable increase in the number of people with this disease during Post Covid. Chronic muscle pain and joint pain are the main symptoms of this disease.the main difference of fibromyalgia from other rheumatic diseases is that the level of fibromyalgia is normal in most blood test and scanning reports. Hence it delays the right diagnosis and there arise a situation where these patients have to endure pain for a long time.

What are the symptoms of fibromyalgia?

• Body pain starts from one side and gradually spreads to whole body which lasts for a long time (Wide spread body pain).
• Patients may experience excruciating pain when touching certain muscles (trigger point).
• Another major symptom is excessive fatigue.
• Some people may experience it as a lump or rashes in the body.
• Anxiety and depression are also seen in most of the patients.
• Lack of sleep, lack of energy in the morning even after a good night’s sleep.
• Memory loss, lack of concentration, difficulty in learning new things (Cognitive Dysfunction).

Other comorbidities seen in fibromyalgia patients include:

• Migraine
• Bowel movements for more than 2 times and Constipation (Irritable Bowel Syndrome – IBS).
• Menstruation with pain.
• Chronic Fatigue Syndrome

Any of these symptoms may be present in a patient.

What causes fibromyalgia?

There is no specific reason for this disease. However, the common condition noticed among these patients is that alterations in some neurochemicals in the brain which control pain. Central nervous system abnormalities are also evident in the studies.
Some people experience it after a mental or physical trauma (Post traumatic stress disorder). Secondary Fibromyalgia is very common as an adjunct to rheumatic diseases like Osteoarthritis, Rheumatoid arthritis, SLE, Seronegative spindyloarthritis, Sjogren’s syndrome.

What are the diagnosis methods?

It is not a disease that can be detected in one or two tests like diabetes or high blood pressure. The peculiarity of this disease is that all the tests will be normal in the patients with fibromyalgia. Tests that show inflammation, mainly ESR and CRP, are normal in most fibromyalgia patients.
Calcium, Vitamin D, ANA test, Thyroid test, Bone scan etc. may be needed to distinguish other diseases that mimic fibromyalgia, such as vitamin D deficiency, osteoporosis, hypothyroidism, Sjogren’s syndrome, etc. Fibromyalgia is diagnosed primarily based on a scoring system. Scoring is based on the prevalence of pain index and severity of the symptoms of the disease. These symptoms must last for more than three months.

Treatment methods

Fibromyalgia is mainly treated with a combination of medication, physiotherapy and psychological therapy. Today it is possible to transform the patient into a way that makes everyday life comfortable, under the guidance of a rheumatologist. Lifestyle changes are important in these patients. Good sleep habits, daily exercise, reducing stress, excess intake of: carbohydrates, red meat, artificial sweeteners and salt should be in control. Cognitive behavioural therapy with the help of a psychologist may also be needed in its treatment.

Public awareness on this disease is rare. Therefore, it is seen that the patients are not getting serious attention from the family members. This can lead to elevation of symptoms like stress, depression, and anxiety in these patients, and also fibromyalgia can become a chronic, long-lasting condition among them.

Fibromyalgia is a disease that can be completely treated and cured if the condition is identified early and appropriate treatments are started with the help of a rheumatologist.