Figure 2. Common areas of pain and tenderness (called "tender
points") in people who have fibromyalgia. |
How is fibromyalgia diagnosed?
The diagnosis of fibromyalgia is based on a combination of factors, including:
• Complete medical history and physical exam (to exclude other illnesses
that may have similar symptoms such as rheumatoid arthritis, muscle
inflammation, bursitis or tendinitis).
• Presence of widespread pain together with some of the other symptoms of
fibromyalgia (see list, above).
• Presence of very tender areas ("tender points") at specific
locations (see Figure 2). People who have fibromyalgia experience abnormal
sensitivity when light pressure is applied to many of the locations illustrated
above.
How is fibromyalgia treated?
People with fibromyalgia receive individual treatment based on several factors
including their overall health, medical history, number of tender points,
severity of pain and presence of other symptoms.
Treatment for fibromyalgia includes:
• Medications that decrease pain and improve sleep
• Lifestyle changes including stress reduction
• Exercises to improve cardiovascular (heart and lung) health
• Relaxation techniques to relieve muscle tension
Medications
Medications that increase restful sleep, such as low doses of anti-depressant
drugs taken before bedtime, may help. Other kinds of sleeping pills are not very
helpful for people who have fibromyalgia.
Non-steroidal anti-inflammatory drugs including aspirin and ibuprofen (such
as Motrin) may help decrease pain, but should be used sparingly. These drugs
have many side effects such as stomach upset and fluid retention. They may also
have unfavorable interactions with other drugs such as high blood pressure
medications.
No currently existing medications completely relieve fibromyalgia pain.
However, acetaminophen (such as Tylenol) is both helpful and safer than other
analgesics (pain-relieving medications).
Anti-inflammatory medications (such as cortisone derivatives) used to treat
other rheumatic conditions have been tested in people with fibromyalgia and do
not improve symptoms.
Exercise
Brisk walking, biking, swimming and water aerobics are good activities to choose
when starting your exercise program. Your physician can help you choose an
exercise program that’s right for you.
Participating in aerobic exercise for half an hour, three times each week is
an important step toward improving fibromyalgia symptoms. Exercise increases
heart and lung function and stretches tight, sore muscles.
Coping with stress
Certain stress factors in life (such as financial burdens, difficulties with a
boss, coworkers, or your spouse) may not be easily eliminated. Evaluating the
causes of stress and learning new ways to cope may improve fibromyalgia. Anxiety
and depression are major contributors to stress and must be treated to enable
fibromyalgia to improve.
Relaxation techniques can help relieve muscle tension and reduce stress.
Professionals trained in stress management can teach you these techniques.
What is the long-term outlook for people with fibromyalgia?
Often, if the situations that caused stress are resolved, fibromyalgia may
spontaneously improve and medications may not be necessary.
Many people with fibromyalgia will continue to have symptoms despite
treatment, especially when life is stressful. However, medications that may
alter the balance of pain-producing chemicals (such as antidepressant drugs),
should improve symptoms by 30%.
When other forms of therapy such as acetaminophen (Tylenol) and aerobic
exercise are combined to treat fibromyalgia, even more improvement can be
expected.
Those who are able to continue working and fulfilling their social
obligations – despite their pain – do best.