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.
Fibromyalgia symptoms usually involve wide spread pain affecting the neck, shoulders and back, associated with multiple trigger points which, when touched, can reproduce the pain. Tender areas also occur in the sternum, hips, shins, elbows and knees. Secondary to the pain, Fibromyalgia also creates a significant amount of fatigue, with sleep disturbances and reduced exercise tolerance working to create a general lower mood, exacerbating the other symptoms of the condition.
Fibromyalgia can occur on its own (primary) or can be secondary to a number of other, painful conditions including: Chronic Regional Pain Syndrome, Cervical Facet Joint Syndrome and whiplash.
Fibromyalgia can often be misdiagnosed as myofascial pain syndrome, due to their similar symptoms. However, while myofascial pain syndrome generates pain in very specific areas, fibromyalgia is notable for creating widespread pain across multiple areas of the body. Furthermore, while fatigue is a very common secondary effect of fibromyalgia, it is quite uncommon in myofascial pain syndrome. If widespread pain and fatigue accompany the other symptoms, it’s important to notify the physician.
The precise causes of fibromyalgia are unknown, but there are thought to be multiple factors that correlate between cases. Scientific research shows that patients who suffer from fibromyalgia have notable changes that occur in the peripheral and central nervous systems, meaning that treatment directly affecting these systems is effective. These changes make patients hypersensitive and more likely to experience pain.
Clinical examination findings reveal multiple trigger points of pain across the body. These trigger points are taut bands of muscle which, when palpated (pushed) on examination, reproduce the pain.
The painful symptoms of fibromyalgia can be managed with a course of medication. This is usually anti-neuropathic medication, but can also include opiates. Other conservative treatment includes physical therapy and alternative therapies, such as acupuncture and deep tissue massages, which have also seen significant results in the management of the pain.
If the specific nerve roots that are causing the pain can be identified, pulsed radiofrequency treatment can be applied to provide longer term relief. Finally, more advanced intervention can be considered. This includes injections of local anaesthetic and anti-inflammatory medicine or injections of Botox. Both of these injections target the trigger points where the pain is emanating from.