INTRODUCTION

Fibromyalgia is a condition that results in pain all over the body or there is widespread pain, disturbed sleep, fatigue, and emotional and mental disturbances. People who already have fibromyalgia may be more sensitive to pain as compared to people who don’t have fibromyalgia. 

This is known as abnormal pain sensation or perception which is normally not found. The reason for fibromyalgia is still not known but is considered to be a curable disease.

PATHOPHYSIOLOGY

In fibromyalgia, there will be an issue with the activity of pain in the brain. People who have fibromyalgia generally become oversensitive to the sensation of pain. The constant oversensitivity to pain is also related to various psychological problems. 

Abnormalities found in fibromyalgia are:

• Raised levels of the excitatory neurotransmitters like glutamate and substance P
• Decreased levels of serotonin and norepinephrine in the descending antinociceptive pathways in the spinal cord
• Long-time development of pain sensations

• Dysregulation in dopamine level

SIGNS AND SYMPTOMS 

The most common symptoms are

• Pain and spasms all over the body
• Lethargy and tiredness
• Depression and anxiety
• Disturbed sleep 
• Difficulty in concentration
• Headaches/migraines 

OTHER SYMPTOMS ARE

• Tingling or numbness in hands and feet
• Pain in the area of the face or jaw, including diseases of the jaw known as a temporomandibular joint syndrome (also known as TMJ)
• The problem in digestion, such as abdominal pain, bloating, constipation, and even irritable bowel syndrome (also known as IBS)

CAUSES/RISK FACTORS

Medical experts don’t know the reason why some individuals develop this disease. It is sometimes genetic or hereditary. Some events may show in symptoms, such as:

• Stressors like: being born premature, and traumatic life events for example abuse, and accidents.
• Medical conditions like viral infections or other diseases.
• Depression, anxiety and other mental disorders.
• Disturbed sleep.
• Reduced physical exercises.

OTHER PREDISPOSING FACTORS:

• Age. It can affect people of all age groups, including children. Although, mostly it is diagnosed during middle age and is more likely to occur at an older age.
• In Lupus or Rheumatoid Arthritis, it is more likely to appear 

DIAGNOSIS

It is generally diagnosed by taking a patient’s history, physical examination, X-rays, and blood investigation. Any specific diagnostic procedure is not available.

TREATMENT

Fibromyalgia can be effectively managed by medication and self-management strategies. And by switching to healthy lifestyle habits like physical activity, a healthy and balanced diet, reduce stress.

Health professionals normally treat fibromyalgia with a combination of treatments, which include:

• Analgesics or pain killer medicines
• Cardiac exercise and muscle strengthening exercise
• Patient education sessions or therapy.
• Stress management procedures for example meditation, yoga, and massage
• Improve sleep patterns to improve the quality of sleep
• Cognitive behavioural therapy (CBT) to manage depression. CBT is a kind of discussion therapy that helps to modify the way people behave or think. 

COMPLICATIONS 

Fibromyalgia can result in pain, and physical disability, and diminish the quality of life. 

Frequent hospitalizations. If someone has fibromyalgia, he/she is more likely to be hospitalized as compared to someone who doesn’t have fibromyalgia.

• Poor quality of life. 
• Higher rates of mental depression. Adults suffering from fibromyalgia have more chances to have major depression than adults who don't have fibromyalgia. investigation and treatment for depression are very important.
• Higher frequency of death and committing suicide or physical injuries. Death rates from suicide and injuries are higher among fibromyalgia patients, but overall mortality among adults with fibromyalgia is similar to the general population.
• High chances of other rheumatic diseases. Fibromyalgia generally re-occurs with other kinds of arthritis for example osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, and ankylosing spondylitis.

LIFE WITH FIBROMYALGIA

However, there are many techniques and procedures to manage, patient self-care is effective to improve the symptoms and day to day activity. Along with the medical treatment, healthy lifestyle behaviours can decrease pain, increase sleep quality, lessen fatigue and help you cope better with fibromyalgia. With appropriate treatment and self-care, one can get better and lead a normal life. Here are a few tips for self-care with fibromyalgia:

• Take out time to relax every day. Breathing exercises, meditation and yoga will improve the condition and reduce the stress that can cause symptoms.
• Fix a regular sleep pattern. Try to fix the sleeping and wake-up time or in other words manage the routine. Getting appropriate sleep allows the body to repair itself, physically and mentally. Also, avoid daytime napping and reduce caffeine intake, which can disrupt sleep. Nicotine is a stimulant, so those who have fibromyalgia with sleep problems definitely should stop smoking.
• Exercise as much as possible. This is a very important segment in fibromyalgia treatment. Although difficult at first, daily exercise and physical activity generally reduce pain symptoms and fatigue. Start using the stairs instead of the elevator if possible, or park your vehicle further away from the shops so that walking will be possible. As the symptoms minimize with drug treatments, one should start increasing physical activity. If feasible then do some walking, swimming, water aerobics and/or stretching exercises, and start to do things that you stopped doing because of the pain and other symptoms. It takes time to build a comfortable routine. Just get moving, stay active and never give up.
• Educate and spread awareness for the same. 
• Always look ahead positively, do not be pessimistic. Concentrate on what you need to do to get better, not what caused the disease.

Fibromyalgia is not something which can’t be treated. It is possible to correct the condition but effort and consistency are required along with the specialist suggestion for the proper and complete treatment of Fibromyalgia. 

“Pain diminishes us, and it is so important to remember that in the midst of pain and everything that pain takes from you, that still ... you are enough. You are enough just as you are. You are worthy of love and kindness. You are enough. And you have enough.”
― Steve Leder

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