25 Nov Overview of Fibromyalgia Treatment in Arizona
Fibromyalgia has become an increasingly recognized term over the past decade. As it has gained more attention, it has presented a challenge to medical professionals as well as the public at large. Highlighting the complexities of interactions between the mind and body, Fibromyalgia can be difficult to understand or identify, let alone treat. Patients may feel stigmatized that it’s “all in their head”- despite the fact their symptoms, and in some cases a decreased quality of life, are quite real.
It is commonly characterized by the experience of fatigue, multiple trigger points with stiffness, aching, or tenderness to palpation in different locations on the body. Commonly reported locations include the back of the head, neck, shoulders, ribs, elbows, buttocks, hips, and knees.
Sleep quantity (hours) and quality may be affected as well, resulting in unrefreshing sleep. Interestingly, Fibromyalgia has been demonstrated to be associated with high prevalence of anxiety and depression. Of patient groups affected by FM, 80-90% are middle-aged women, some of whom are overweight or obese.
Worsening factors of these symptoms include increased emotional stress, sleep deprivation, cold temperatures, or even changes in the weather. Positive factors that have been noticed to potentially improve physical symptoms are adequate rest, warmth, and actually mild exercise.
In seeking to understand and treat this perplexing condition, it is important to gain more insight into the difficult topic of “the mind-body connection”. An older medical term for Fibromyalgia was “Psychosomatic Depression”, quite literally: mind-body depression. Medical Science has established that depression and anxiety actually alter a person’s perception and sensation of pain throughout their body.
Interestingly, it is a reciprocal relationship too- chronic pain and musculoskeletal tension throughout the body can, in turn, negatively affect our conscious mind. This creates a quite complex and very real dynamic relationship between our minds and bodies.
Before a diagnosis of Fibromyalgia can be assessed, numerous physical conditions must be considered and excluded. These include: myofascial syndromes, rheumatoid disease, arthritis, lupus, polymyalgia rheumatica, polymyositis, ankylosing spondylitis, spondyloarthropathy, chronic fatigue syndrome, Lyme disease, hypothyroidism, and psycho-somatization disorder.
Treatment for Fibromyalgia includes a holistic and interdisciplinary approach. Patients are advised to stay active and productive. Although it may seem counterintuitive or difficult, medical research studies have shown that gradual, low impact exercises improve pain and fatigue, with long-term benefit. Regular aerobic exercise is very effective because it looses muscle tension and knots within connective tissues, which are commonly perceived as the ‘trigger points’. (Examples: fast walking, swimming, water aerobics, yoga). Overweight and obese patients should be strongly advised and educated on losing weight, which improves symptoms as the bones and muscles begin to carry less tension.
Consider Psychiatric Evaluation and ask your Doctor about Cognitive Behavioral Therapy (CBT). This is not at all confirming a stigma, “it’s all in your head”, but rather it is to assess, identify, and empower the patient in learning strong psychological coping skills. Lack of good coping skills with poor, victimized beliefs about oneself can worsen a patient’s physical and mental perception of their body. That, in turn, may precipitate worsening of depressive symptoms that reciprocally affects sensory awareness of pain, energy, fatigue, etc.
Unfortunately, drugs are generally not very effective. If one is open to really understanding the powerful mind-body connection, this may not be surprising. Few drugs that have been associated with slight improvement in symptoms include, interestingly- anti-depressant medications (SSRI’s, SNRI’s, TCA’s). These drugs work in the brain to improve the person’s mood, decreasing their perception and sensitivity to pain, and also affect nerve transmission of pain signals. Two other drugs include Gabapentin, and Lyrica (pre-gabalin), which aim to affect nerve pain signals as well, among other things.