What is fibromyalgia?
The main symptoms of fibromyalgia include widespread pain which can be felt in the joints, muscles or both. Fatigue (often severe) and sleep disturbance are very common. Widespread pins and needles sensations, irritable bowel symptoms, non-cardiac chest pain and headaches are also common.
How is fibromyalgia diagnosed?
There is no specific test for fibromyalgia. The diagnosis is made by recognizing the presence of typical features, the absence of evidence of alternative conditions and the demonstration of an overactive pain system.
How is fibromyalgia treated?
There is no single medicine that can cure fibromyalgia. The aim of management is to minimize the symptoms where possible, and to learn to make adjustments where necessary to minimize the impact on the patient's life. Progress will be measured in periods of months rather than days.
a) Medication.
The commonest agents used include:
1. Tricyclic antidepressants.
2. Tramadol and Paracetamol.
3. Pregabalin
4. Duloxetin
b) Exercise.
Exercise has been shown in many studies to be beneficial. It is an essential part of a multi-disciplinary management program. Gentle aerobic exercise (walking), swimming, cycling, or gym-based exercises are all good. Aqua-jogging or Tai Chi may be appropriate. A little every day is important.
3) Psychological management.
Many studies have highlighted the benefit of CBT - cognitive behavioural therapy - in the management of fibromyalgia. Techniques to "fool" the pain centers of the brain into minimizing their activity, and exploration of any background issues of stress or depression are very important
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