Fibromyalgia?
I'm 18 and I think I have fibromyalgia. I've suffered pains in my back, neck, ankles, legs, chest and hips since I was 11. I've had twitching and pains for no reason.
These are my other symptoms
fatigue, pain with change of weather, skin tingling, muscle spasms, insomnia, stiffness, numbness in feet and hands, weakness, swelling in ankles, burning muscles, low b12, brain fog, stress, migraines, impaired memory, gluten sensitivity, depression, PTSD, dizziness, vision problems, teeth grinding, PMS and more.
I've been in 3 serious motor vehicle accidents. I have pain all over my body, on both sides and top and bottom.
I live in New Zealand. I'm just wondering what my next step should be. Should I speak to my physiotherapist about this?
Does it sound like fibromyalgia?
Any help appreciated. =]
Thanks.
Public Comments
1. Yes it does sound like fibromaylgia. Congratulatons on making what is a difficult diagnosis for experienced clinicians.Here's a patient handout that I wrote and will share with you:
FIBROMYALGIA
FIBROMYALGIA [FM] is a condition of the [central] nervous system experienced predominantly as pain, tenderness and stiffness in the bones, joints and muscles.
The cause is unknown. Many afflicted individuals have a history of physical trauma such as a motor vehicle accident. Often there is trauma to the neck and upper shoulder area. In other cases, an infection or hormonal problem has preceded the onset of symptoms. The objective abnormalities that can be found are chemical, and are in the brain and spinal cord. When the tender muscles and joints are examined microscopically, the tissues appear normal. When spinal fluid is tested, abnormalities in serotonin and substance P levels are detectable. Chronic stress, anxiety and insufficient quality sleep factors which may result from the condition and then contribute to its severity by making it worse.
FEATURES WIDESPREAD PAIN and TENDERNESS – Widespread aching, pain and stiffness of the muscles and musculotendinous structures is the dominant problem in fibromyalgia (FM). The pain is symmetrically distributed, always present, and exacerbated by cold, dampness, sleep deprivation, stress and excessive physical activity. Chiefly afflicted are neck, shoulders, hips, low back and buttocks and upper legs. The areas of maximal tenderness tend to remain constant. These tender points are not the same thing as trigger points, and they tend to be resistant to treatment with trigger point injections.
STIFFNESS / sense of SWELLING – stiffness is frequently worst upon arising in the morning or after prolonged sitting, and tends to soften with activity. The sensation of swelling is real, but the swelling itself generally isn’t. Although the joints feel swollen, they look normal - or nearly so.
FATIGUE – may be minimal, or profound and debilitating. The afflicted individual needs frequent breaks and rest periods to accomplish tasks that were previously done without stopping.
CLUMSINESS – some people have trouble gripping and holding. They may drop and break objects more frequently than is common.
NUMBNESS / TINGLING – variably present, usually in the arms and legs.
DISORDERED SLEEP – insomnia is generally present, and makes the condition worse. In addition, because the sleep is disrupted, it is nonrestorative - that is, the individually awakens sleepy and tired in the mornings. Often, there are jerking limb motions - called periodic movements or myoclonic jerks – which occur during sleep.
ANXITEY / mild DEPRESSION – most patients with fibromyalgia have never been correctly diagnosed. Their physicians often have caused them to feel guilty, crazy or in some way at fault. Their frequent complaint for help with pain often leads to accusations of inappropriate drug seeking.
IRRITABLE BOWEL SYMPTOMS [IBS] – diarrhea, constipation, or and alternating of both may frequently be present.
IRRITABLE BLADDER SYMPTOMS – unexplained recurrent bladder pain or burning – called interstitial cystitis [IC] – is frequently present
Laboratory studies:
(a)Normal ESR, RA latex, Lyme serology and CBC. ANA is often moderately and nonspecifically elevated. TFT’s are normal
(b)Serum somatomedin C (the major mediator of the anabolic function of GH) and cerebrospinal substance P levels are low.
(c)Muscle and soft tissue biopsies are normal.
Therapeutics:
(a)SSRIs – in their higher dosing range ( i.e., PROZAC 20-40mg QD or LEXAPRO 10-20mg QD). These are effective for the treatment of both pain and fatigue even if there is no sign of depression. EFFEXOR 150-225mg and CYMBALTA 60mg are also effective
(b)Sleeping medications – these are important, and should be encouraged if necessary. Use only those which preserve normal or near-normal sleep architecture: amitryptiline 25-50 mg, doxepin 25-50 mg, or AMBIEN 10mg hs.
(c)Sedatives – BUSPAR 7.5 – 15mg Q12-24hrs or a benzodiazepine ( XANAX 0.25-0.50 mg Q6 - 12hrs, or ATIVAN 0.5 - 1mg Q6 - 12hrs) is often helpful.
(d)Recently, LYRICA 150-225mg twice daily has been approved for use in fibromyalgia
(e)Aerobic and stretching exercises – beginning slowly and conditioning up to 20-30 mins 3-4 times weekly.
(f)NSAIDs and steroids are ineffective. Opioids relatively useless for bodily symptoms, but may help headaches when severe.
--------------------------------------
Hope that helps. Contact me if you like. I'm an Ameican physician who treats a lot of fibromyalgia
2. ya according to u r discription i also thnk it is that same but i advice u to seek medical help .so that u r problem willl b clarified .
3. Or it could be Celiac Disease, not gluten sensitivity. These sites will give u more info
www.csaceliacs.org
www.celiac.com
www.celiac.org
4. Medications
Anti seizure
Lyrica (pregabalin) is the first and only treatment approved by the FDA for the management of Fibromyalgia.
Neurontin (gabapentin) can be helpful to treat pain.
Analgesics
Analgesic medications like Tylenol (acetaminophen) or NSAIDS (like motrin, aleve, advil, ibuprofen) or ultram or Ultracet (ultram/acetaminophen) may used to treat the pain of fibromyalgia.
Antidepressants
1. Tricyclic Antidepressants like amitriptyline (Elavil), nortriptyline (Pamelor) or doxepin (Sinequan) can be helpful to treat sleep and depression.
2. Selective serotonin reuptake inhibitors (SSRIs) antidepressants like fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa) are very effective in treating depression.
3. Other antidepressants like duloxetine (Cymbalta) or venlafaxine (Effexor) may also be helpful in fibromyalgia.
Muscle relaxants
Muscle relaxants cyclobenzaprine (Flexeril) or methocarbamol (Robaxin) are used to treat the muscle pain and spasm associated with fibromyalgia. They tend to work better during acute flares, rather than with chronic use. Tizanadine (Zanaflex) may help both muscle spasm and pain.
Dopamine agonist
Pramipexole (Mirapex) has been shown to help some patients with fibromyalgia.
Other medications
Medications like benzodiazepines, narcotics, and steroids (like prednisone) have a limited role in treating fibromyalgia and have not shown long term benefits. Benzodiazepines and alcohol can affect quality of deep sleep. Some people believe that guaifenesin helps with their pain.
Trigger point injections
These are injections into painful areas in your muscles. This can be safely performed in your doctor’s office. They may use medications such as lidocaine or steroids. These injections usually provide temporary relief.
Nonpharmacologic treatment and Self-management
Education and counseling: This is very important for persons with fibromyalgia to have the information they need to help manage their disease over a lifetime. This helps improve outcome, outlook, and coping with chronic issues.
Biofeedback and Cognitive behavioral therapy: These interventions have been shown to decrease pain, depression, sense of disability, and improve self-esteem.
Exercise: Studies have shown that regular aerobic exercise can improve strength, mobility, physical function, aerobic capacity, and depression in persons with fibromyalgia. It can also help prevent bone loss associated with inactivity.
Nutrition and Diet: A well-balanced diet is recommended for all persons with fibromyalgia. There is no proven nutritional supplement for persons with fibromyalgia. Some patient report decreased symptoms and feeling better when they follow a low carbohydrate diet.
Stress reduction: It is important to have a stress reduction plan. You must integrate these techniques into your daily life and practice them. This involves planning time to relax and rest. You must individualize this program for yourself.
Sleep: It is very important for persons with fibromyalgia to have good sleep hygiene. This means a nightly routine that includes relaxation, a regular bedtime, and allowing at least 8-10 hours for sleep. More sleep may be needed during acute flares. Some persons may benefit from a nap during the day.
Prayer and Spirituality: Research suggests that interaction between minds, body, and spirit have effects on our health.
Rehabilitation Treatment
Basic principles
Rehabilitation refers to the process of helping a person return to as much normal function as possible. There are many ways to help improve function.
Rehabilitation professionals
Rehabilitation is provided by many different professionals depending on your symptoms or problems. Often, these professionals work as a team to help coordinate the care they provide.
Physical Medicine and Rehabilitation (PMR) physician or Physiatrist: A doctor who focuses on overall function and symptom complex to suggest treatment and make appropriate referrals for therapy.
Physical therapist (PT): A therapist who focuses on mobility and adaptive equipment used for mobility like canes, walkers, wheelchairs; exercise and modalities to treat pain and improve or maintain function.
Occupational therapist (OT): A therapist who focuses on activities of daily living (ADLs) or ability to perform certain tasks like dressing, cooking, bathing; energy conservation; and adaptive equipment.
Speech therapist (ST): A therapist who focuses on cognition, language skills, voice and swallowing.
Orthotist: A professional who makes splints and braces.
Neuropsychologist: A professional who focuses on in-depth evaluation of brain and brain functioning, including administering extensive testing. They also provide treatment and support counseling to adjust and cope with your situation.
Therapy program
An individualized therapy program is very important for persons with fibromyalgia. Therapy programs are divided into skilled therapy treatment and maintenance home exercise program. Therapy is available in various settings including in the hospital, inpatient rehabilitation unit, outpatient clinic, or at home with home health services. A course of therapy with a skilled therapist can improve mobility and ability to perform activities of daily living. Your doctor will need to write a prescription and refer you for therapy. It is usually covered by your health insurance. A therapy program seems to give patients a greater sense of control which is helpful in dealing with the psychological effects of having chronic symptoms and improves their sense of well being. Education is a big part of the treatment plan. Patients should be referred for evaluation and should have periodic reevaluation as their clinical course changes or progresses. Inactivity results in deconditioning and therapy and exercise can reverse the weakness associated with lack of use. It is important to find the right balance between rest and activity.
Energy conservation and pacing
A physical or occupational therapist can instruct you in an individual program of pacing yourself. This means scheduling and managing activity and tasks so that you do not over-do-it on good days and then have increased symptoms. It also includes breaking big tasks up into smaller jobs or adapting the way you do something.
Exercise
A general exercise program is beneficial for a person with fibromyalgia. A complete program should include aerobic, strengthening, and stretching exercises. Exercise is important for maintaining and even improving mobility, flexibility, balance, and range of motion. It can also help with depression. An exercise program addresses the problems of decreased flexibility, muscle atrophy, decreased strength, difficulty using hands, and aerobic deconditioning. Certain exercises like swimming, walking, low-impact aerobics, yoga, Pilates, and Tai-chi may help reduce joint pain and stiffness.
Stretching
Stretching is critical to maintaining flexibility and range of joint motion. Loss of joint range of motion or tightness in the muscles can lead to increased pain.
Massage
Massage may offer temporary relief of muscle pain and spasm. Massage may have the secondary benefit of offering stress relief.
Aquatic therapy
A therapeutic exercise program can be based on land, in the water, or both. An aquatic program may be helpful for persons with fibromyalgia. The warm water also helps joint and muscle pain and stiffness.
Weight reduction
It is very important for person with fibromyalgia to maintain ideal body weight. Excessive weight can lead to pain and decreased function.
Support groups
For many people, supports groups can be very helpful. They provide education, support, and advice for living with the disease and opportunities to meet others who have similar experiences. These groups can be a source of practical information for living better with fibromyalgia. These groups offer additional benefit to persons with fibromyalgia since the disease is not well understood and dealing with the medical community can be frustrating.
Orthotics
Temporary bracing or splinting may be used to treat a specifically painful area.
Assistive devices
These are devices to improve walking or mobility and a consult with a physical therapist will help you select the most appropriate mobility aid for you. There are many gadgets to improve activities of daily living (reacher, sock aid, button hook, jar opener, book holder) and a consult with an occupational therapist with help you with individual needs.
Modalities
Hot and cold modalities have been used for many centuries (if you have poor circulation, consult your doctor before using cold or heat). In chronic conditions, both are very helpful and usually patient preference determines whether hot or cold is used. These should be used carefully to avoid injury or burns. Most applications should be limited to 20 minutes at a time but can be applied multiple times in a day.
Cryotherapy
Cold treatment with ice, cold water, and biofreeze.
Hot treatment
1. Moist: bath or shower
2. Dry: heating pad
3. Superficial: paraffin, whirlpool, hot packs
4. Deep: ultrasound, diathermy.
Transcutaneous electrical nerve stimulation (TENS): This device is used to treat pain. A therapist can provide a trial of a TENS unit for a patient, and if beneficial, instruct the patient in use of the device at home. A doctor’s prescription is required.
Acupuncture: Performed by a licensed acupuncture therapist. This may be beneficial for some patients for treatment of their pain. The number of treatments and frequency of treatment are variable.
Chiropractic care has offered some patients with fibromyalgia relief.
Osteopathic Manipulation has offered some patients with fibromyalgia relief.
Medical Specialists
There are many different medical specialists that need to be involved in your care to maximize symptom management and improve quality of life.
Physical Medicine and Rehabilitation physician (Physiatrist)
A physician who specializes in treatment of conditions that affect mobility, self care, and interfere with the ability to perform given roles at home, work, and in the community.
Rheumatologist
A physician who specializes in diseases of the musculoskeletal system. They can be experts in diagnosis and treatment of fibromyalgia.
Pain Specialist
There are physicians who specialize specifically in the treatment of pain.
Neurologist
A physician who specializes in conditions of the nervous system.
Internist
A physician that provides general health care to adults.
Psychiatrist
A physician who specializes in the treatment of conditions that affect emotional well-being and cognitive disturbances. They are experts in treating depression and are very knowledgeable in medication and medication side effects. They can be helpful for persons experiencing chronic pain.
