Tuesday, November 3, 2009

What Does It Mean To Have FibroMyalgia?

Today’s blog post comes from Dr. Bellinger’s November Newsletter.

At my Glastonbury CT office, I often see patients who have been diagnosed with fibromyalgia. Fibromyalgia is not a condition that you can say has a specific cause with a clear origin and means of diagnosis. It is one of those conditions that are obscure and can only be diagnosed by eliminating other, more common conditions. Fibromyalgia is one of those conditions where the degree of pain and disability can be profound and life quality interrupting, yet all the tests come back negative and there are no other conditions to explain the collection of symptoms. It is at that point when the diagnosis of fibromyalgia is typically made.

Fibromyalgia is typically a chronic (symptoms have been present for at least 3 months) condition where the patient complains of widespread, generalized muscle, ligament and tendon pain accompanied with fatigue and multiple tender points on the body that hurt with only light pressure. To be considered “widespread,” it usually affects both sides of the body and is both above and below the waist. It occurs in approximately 2% of the population in the US and women are 3-4 times more likely to develop fibromyalgia. The risk of fibromyalgia increases with age and can be secondary to other physical or emotional trauma, or it can occur all by itself. No obvious pattern usually exists as signs and symptoms can vary depending on weather, stress, physical activity, and even the time of day.

Sleep quality is an issue that seems well agreed upon as regardless of the number of hours in bed, the deep, restorative stages of sleep are seldom reached. Other sleep disorders frequently associated with fibromyalgia include sleep apnea and restless leg syndrome.. “central sensitization”. This is basically a low threshold for pain because of increased sensitivity in the brain to the incoming pain signals. Certain chemical (neurotransmitters) changes in the brain have been identified resulting is hypersensitivity creating an overreaction to pain signals.

The American College of Rheumatology has established two diagnostic criteria that include
  1. widespread pain lasting at least 3 months
  2. at least 11 out of 18 positive tender points using just enough pressure to whiten the fingernail bed.
What are these 18 tender points that have been identified?

Tender Points seen in Fibromyalgia patients

  1. Lower neck in front (2)
  2. Edge of upper breast bone (2)
  3. 2 cms below side bone at elbow (2)
  4. Just above knee on inside (2)
  5. Attachment of neck muscles at the base of the skull (2)
  6. Midway between neck and shoulder (2)
  7. Muscle over upper inner shoulder (2)
  8. Upper outer buttock (2)
  9. Hip bone (2)
There are no direct blood tests to confirm a diagnosis of fibromyalgia but other conditions can affect or cause Fibromyalgia can be diagnosed with blood testing. These include:

1 comment:

Neck Exercises said...

Do you find that the trigger points behind the base of the skull also be related to headaches?


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