Aching, burning, tense and painful–these are just a few of the words patients use to describe the medical condition now known as Fibromyalgia Syndrome (FMS). Historically, this syndrome has been referred to as chronic rheumatism, myalgia, fibrositis and pressure point syndrome. With each of these disorders, patient experience multiple symptoms.
The symptoms for these disorders, as with FMS, include:
- Generalized aching
- Pain, fatigue
It is this broad range of symptoms, and the fact that no one concrete test exists to definitively determine that a patient has FMS, that make FMS difficult to diagnose. Therefore, a careful and through history and physical exam performed by a qualified medical professional is critical to the overall diagnosis.
In the past, diagnosing a patient with FMS made it even more difficult to treat that patient as not a lot was understood about the disease. To help medical professionals better deal with FMS, the American College of Rheumatology identified specific muscle regions in which patients with FMS experienced tenderness and pain. These regions include the neck, shoulders, waist and knees, and other areas. The pain in these regions can fluctuate in intensity and can move from place to place. Other diagnostic criteria can include family history, insomnia, and/or previous injury to the affected area. In many cases, a final diagnosis of FMS is delayed, as the current medical practice requires weeding out all other possibilities before concluding FMS. Even with a diagnosis, patients are often not relieved, as there is no cure. There are, however, effective treatments, which can ease the symptoms and return most patients to an enjoyable life.
To understand FMS, it is important to understand the processes behind the pain. Fibromyalgia is a biochemical imbalance. This means the communication between the muscle groups, tendons and ligaments are short-circuited. Researchers are still trying to uncover the specific neurotransmitters responsible for the short-circuiting in hopes of finding a permanent treatment.
Many patients diagnosed with FMS also experience Myofascial Pain Syndrome (MPS). The presence and distinction between these two syndromes represents a difficult task for both the patient and medical professional. The easiest way to separate FMS from MPS is to realize that MPS is a muscular response to Fibromyalgia. Chronically positioning to ease the pain of FMS physically causes more inflammation in the related muscle groups, further enhancing an already painful situation.
Treatment for FMS often employs multiple therapies. Initially, non-steroidal anti-inflammatory medications (NSAIDS) are used to treat the swelling and pain. This is a process of finding the right medication for the situation while minimizing the side effects. Other medications used are directed at masking or controlling the pain associated with FMS. These may include muscle relaxants, anti-depressants and opiod-based pain medication. Even though patients who are prescribed anti-depressants may wonder whether or not they are experiencing psychological complications, the anti-depressants, in addition to reducing the associated depression, actually are quite effective in masking or changing the experience of discomfort.
Other treatments for FMS may include biofeedback, T.E.N.S. units, massage therapy, heat and education. And, for flare episodes that occur with FMS, the limited use of trigger point injection is very effective. Trigger point injection delivers an anesthetic mixed with a corticosteroid to relieve the pain and reduce inflammation at the trigger site.
Fibromyalgia, though often chronic and debilitating, can be properly diagnosed and effectively treated. With the appropriate treatment, most patients can experience fulfilling lives.