WHAT IS FIBROMYALGIA?
Fibromyalgia is a long-term condition that is associated with chronic pain, fatigue, memory problems, and a long list of other symptoms. Rather than a discrete disease, Fibromyalgia is recognised as a syndrome (known as Fibromyalgia Syndrome or FMS), which is a collection of symptoms that often go hand in hand.
Despite the severity of symptoms, Fibromyalgia is not life-threatening, though it can be responsible for significant reduction in quality of life if it is not well managed.
In New Zealand, FMS is estimated to affect around 1% of the general population, with figures around 1.1% for Māori, and 1.5% for European New Zealanders, and it affects more women than men. FMS has a significant impact on wider society, as patients typically require double the number of medical appointments; have increased rates of medication; and many have to leave or reduce paid employment due to their Fibromyalgia.
Fibromyalgia is typically associated with chronic pain, fatigue, memory problems, mood disturbances, poor sleep, joint stiffness, headaches, parasthesias, irritable bowel, and Raynaud’s. It may also be associated with increased anxiety and depression, though it is not clear if this is a symptom of Fibromyalgia itself, or a consequence of living with such symptoms.
The cause of Fibromyalgia remains unknown, however, emerging evidence suggests that the condition may be associated with abnormalities in both the central (brain and spinal cord) and peripheral (nerves) nervous system. It is hypothesised that these abnormalities impair the nervous system’s ability to inhibit pain messages. Onset of FMS may also be related to physical or psychological trauma, or infections such as Glandular Fever.
Fibromyalgia is usually a diagnosis of exclusion, meaning that Fibromyalgia is usually the label applied when all other possible causes of the symptoms have been disproven. It is also diagnosed by putting pressure on eighteen tender points, including the upper chest, neck, elbows, knees, shoulders, back and sides of the hips. If eleven of these points are found to illicit significant pain, then Fibromyalgia is usually diagnosed. Fibromyalgia is not a short term illness, however, so it is important to recognise that these pains are not the result of a recent injury, but rather are ongoing. Many patients with Fibromyalgia go many years before being diagnosed.
There is no cure for Fibromyalgia, but there are many treatments available to help manage most symptoms. Because people with FMS typically experience many symptoms, it’s important for patients to develop a comprehensive treatment plan with their healthcare providers. Most people with FMS manage their symptoms through a combination of pharmacotherapy, physical therapy, nutrition, exercise, and psychological approaches like Cognitive Behavioural Therapy.