Fibromyalgia, or Fibromyalgia Pain Syndrome, is a chronic and widespread musculoskeletal pain and fatigue disorder. It is defined as a long-term, body-wide pain in muscles, ligaments and tendons – the soft fibrous tissues in the body. It is typically characterised by widespread aches and pains, restless sleep, awakening feeling tired, fatigue, anxiety, depression and disturbances of bowel function.
Unfortunately the cause of Fibromyalgia is unknown, but there are thought to be multiple factors involved. Scientific research shows that patients who suffer from the pain of fibromyalgia have changes that occur in the peripheral and central nervous systems. These changes make patients hypersensitive and more likely to experience pain. Clinical examination findings reveal multiple trigger points- these are taut bands of muscle which, when pushed (palpated) on examination reproduce the pain. There are various treatment types for these trigger points.
The anti-neuropathic medication used to relieve the nerve pain caused by fibromyalgia can be split into two groups, antidepressants and anticonvulsants.
The tricyclic antidepressant amitriptyline is used to increase the levels of serotonin in the brain. People with chronic pain conditions, such as fibromyalgia, often have decreased levels of serotonin – a calming neurotransmitter. Amitriptyline can relax painful muscles and heighten the effects of endorphins, which are the body’s natural painkillers.
Pregabalin and Gabapentin, originally used to treat epileptic seizures, can also reduce the pain and fatigue associated with fibromyalgia and improve sleep. These anticonvulsants affect the chemicals in the brain that send signals across the nervous system.
When combined with anti-neuropathic medication, non steroidal anti-inflammatory drugs (NSAIDs) have shown to significantly increase their pain-relieving effects. Common forms of NSAIDs, available over the counter, are aspirin, ibuprofen and naproxen.