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April 8, 2011

Fibromyalgia: A Collection of Symptoms

Fibromyalgia is a collection of symptoms, commonly including fatigue and sleep problems, and chronic pain like a deep ache or burning sensation in the muscles and joints. The problem is compounded by the fact that it can be challenging to diagnose. However, once recognized, a multipronged treatment often leads to relief. Diagnosis is an important component of care. It is often challenging to diagnose because symptoms vary widely from one person to another. There is no test that can confirm the condition. Symptoms can resemble a host of other diseases such as forms of arthritis, underactive thyroid, Lyme disease, sleep apnea and vitamin D deficiency. Successful treatment of fibromyalgia includes education, exercising, reducing stress, improving sleep therapy  and using complementary therapies such as heat packs or hot baths, massage or chiropractic therapy. Medications can help reduce pain and improve sleep. Often, a trial of a drug or combination of drugs is necessary to see if it helps and if a patient can tolerate the side effects. Options may include:
  • Antidepressants Trazodone (Desyrel) is often used to improve sleep. When depression is a concern, more traditional antidepressants such as fluoxetine (Prozac, others) may be recommended.
  • Anti-seizure drugs These medications, which include gabapentin (Neurontin), may reduce pain.
  • Muscle relaxants Most common is Flexeril, a sleep-inducing drug that may be used short term to help relieve muscle pain and spasms.
  • Common pain medications These include acetaminophen (Tylenol, others) and non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin. However, these often don't work as well as other drugs.
The majority of people who develop fibromyalgia are women, though men also can get it. The cause is unclear, but it's thought to involve a genetic predisposition and a triggering event such as an infectious illness or physical or emotional trauma that leads to abnormal processing of pain signals.

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