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is fibromyalgia? ไฟโบรมัยอัลเกีย |
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WebMD
Fibromyalgia is a condition
characterized by aching and pain in muscles, tendons and joints all over
the body, especially along the spine.
There are measurable changes in
body chemistry and function in some people with fibromyalgia. These
changes may be responsible for certain symptoms.
However, fibromyalgia is not
associated with muscle, nerve or joint injury; inadequate muscle repair;
or any serious bodily damage or disease. Also, people who have
fibromyalgia are not at greater risk for any other musculoskeletal
disease.
What
are the symptoms of fibromyalgia?
The pain of fibromyalgia usually seems worse when a person is trying to
relax and is less noticeable during busy activities or exercise.
Other symptoms are often associated
with the pain, including the following:
- Sleep disturbance
- Depression
- Daytime tiredness
- Headaches
- Alternating diarrhea and
constipation
- Numbness and tingling in the
hands and feet
- Feelings of weakness
- Memory difficulties
- Dizziness
What
causes fibromyalgia?
The exact cause of fibromyalgia is unknown. There are, however, many
theories about why people get fibromyalgia.
One theory suggests that stress
contributes to the onset of fibromyalgia. Other possible causes are:
- Distress (stress related to
finances, work, marriage or recent loss such as the death of a close
family member)
- Conscious or subconscious
tension, disordered sleep
- Abnormal production of
pain-related chemicals in the nervous system
- Lower pain threshold, heightened
perception of pain
- Tenderness in certain areas,
such as the upper back and forearms
Symptoms
of fibromyalgia
When fibromyalgia begins, stresses in a person's life are prominent.
Stress often results in disturbed sleep patterns and a lack of restful
sleep. When you don't get enough sleep, your body does not produce the
chemicals necessary to control or regulate pain. A lack of these
pain-regulating chemicals results in tenderness in the upper back and
forearms, leading to the symptoms of fibromyalgia.
Physical and emotional factors may
also contribute to the onset of fibromyalgia. For example, a physical
illness (such as an infection) could cause changes in your body chemistry
that lead to pain and sleeplessness.
When you are sick, you may worry
about your health and become anxious, depressed or inactive. These
emotional factors could make your symptoms worse and aggravate
fibromyalgia.
Who
is affected by fibromyalgia?
Women tend to have fibromyalgia more often than men. In Europe, some
studies suggest that as many as 14 percent of women may have fibromyalgia
symptoms. In the United States, the fibromyalgia estimate is much lower -
2 to 4 percent of women and men.
How
is fibromyalgia diagnosed?
The diagnosis of fibromyalgia is based on a combination of factors,
including the following:
- 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.
- Presence of very tender areas
("tender points") at specific locations. People who have
fibromyalgia experience abnormal sensitivity when light pressure is
applied to many of the locations shown here.
Figure 1: Common areas of pain and tenderness
(called "tender points") in people who have fibromyalgia.
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 the following:
- Medications that decrease pain
and improve sleep
- Lifestyle changes, including
stress reduction
- Exercise to improve
cardiovascular (heart and lung) health
- Relaxation techniques to relieve
muscle tension
Medications
Medications that increase restful sleep may help, such as low doses of
antidepressant medication taken before bedtime. Other kinds of sleeping
pills are not very helpful for people who have fibromyalgia.
Nonsteroidal 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 interact
unfavorably with other drugs, such as medications for high blood pressure.
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 did not improve symptoms in
tests.
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 30 minutes three times each week is an important step to improve
fibromyalgia symptoms. Exercise increases heart and lung function and
stretches tight, sore muscles.
Coping
with Stress
Certain stress factors in life (financial burdens, or difficulties with a
boss, coworkers or your spouse) may not be easily eliminated. Evaluating
the causes of stress and learning new ways to handle or 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 the initial 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 can alter the balance of
pain-producing chemicals, such as anti-depressant drugs, should improve
symptoms by 30 percent.
When other forms of therapy such as
acetominophen (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.
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