Fibromyalgia

Description

Fibromyalgia is sometimes referred to as Fibrositis although the known cardinal signs of inflammation are not seen in this condition and no pathologic tissue basis for this condition has been discerned thus far. Thus, Fibromyalgia is a more appropriate term.

Fibromyalgia has been termed a functional disease because the patient inflicted with this malady is truly impaired, and thus non-functional. In today’s psychiatric and psychologic terminology, functional disease implies non-organic origin, hence, a benign functional impairment of psychologic origin.

Clinically, the patient presents with symptoms of diffuse aching, tenderness, and stiffness. This aching and stiffness, noted more frequently in the morning, are associated with headaches, poor rest pattern from sleep, exhaustion. and fatigue. Patient may feel awake feeling tired even after an apparent adequate night sleep.

fibromyalgia 2

Symptoms are usually bilateral and are noted in the shoulder region [upper trapezius], the anterior midline region of the neck behind the sternocleidomastoid muscle, the region of the lateral epicondyle of the forearm [similar to tennis elbow], the medial knee joint region, and the posterior aspect of the pelvis in the vicinity of the iliac crest.

A personality characteristic in patients with fibromyalgia has been identified as those who appear to be self-driven, intense, compulsive, and fervently involved in numerous activities.  Their personalities strongly resemble those of migraine patients. They are also very sensitive and responsive to cold, heat, humidity, and noise.

Medical Treatment

Treatment of fibromyalgia taxes patience and expertise of the clinician. A good rapport between the patient and the therapist/clinician is mandatory.

Stress management is probably the best beneficial approach to treatment. Life stresses be recognized and coping mechanism developed. Lifestyle must be altered.

Trycyclic drugs or Benzodiazepines may be valuable for the sleep pattern abnormality.

Physical Therapy Management

Physical therapy management may include local treatment of the tender site. Passive and active stretching exercises, deep massage, acupuncture or dry needling may be helpful.

Active exercises as well as progressive relaxation exercises are of great value.

Correction or modification of posture in everyday activities is mandatory.

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