Fibromyalgia is a condition of unexplained musculoskeletal pain. This problem has interested researchers since a long time. Pain occurring at various sites in the body and hardening of muscles occurs, without specific medical cause. It is induced by mental stress.
This is a condition seen in young adults affecting more women than men.
There is no known specific underlying cause for fibromyalgia. Despite extensive investigations no structural, inflammatory, metabolic or endocrine abnormality has been found in the muscles. Mental stress has been known to precipitate fibromyalgia. A hereditary predisposition is postulated though clear evidence for it is lacking. Sleep disturbances are always associated with fibromyalgia. The affected persons find it difficult to sleep well. Either they do not get sleep at all, or it is disturbed. There is also sense of fatigue. Some persons suffering from fibromyalgia have associated depression and irritable bowel syndrome.
The levels of serotonin are found to be reduced in the brain in cases of fibromyalgia. This causes reduced tolerance and perception to pain. At the slightest touch they feel pain on the affected site. There may be associated morning stiffness of affected part. Mental tension is a strong precipitating factor for causing fibromyalgia. Divorce, marital discord, work place tensions poverty, alcoholism e.t.c. are life events that are seen to be associated with this condition.
Pain can occur at one or multiple sites and is often associated with slight pain on touching the site. Common sites for pain are upper back, chest, elbow, e.t.c.
It is essential to diagnose fibromyalgia for its proper management. Diagnosis is made by excluding other causes of musculoskeletal pain. Since the clinical examination and tests are often normal, these patients are often labeled as hypochondriacs. This approach is not correct. This is a specific condition. As pain killers have no response they should be best avoided, especially if no response is seen in one or two weeks. Physiotherapy is known to aggravate the symptoms and therefore should be avoided.
Informing the patient regarding the nature of the problem and counseling her/him is very useful. Discussion about the personal life of the affected person, her problems and anxieties is also very helpful. Sometimes just unburdening one’s mind to a stranger is useful and helps in improvement of pain.
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