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What are the symptoms of fibromyalgia?

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Posted on Mon, 8 Sep 2014
Question: i have an appointment with a new physician in october. i wanted to know if i could have fibromyalgia so that i can ask him about that. my symptoms are severe morning stiffness, pain in my feet, severe fatigue, some days i cant manage my daily tasks and my kids. i also have started getting headaches. i have already been diagnosed with chronic fatigue, depression, anxiety and ibs. could this possibly be something else going on or a collection of symptoms from the things i already have?
doctor
Answered by Dr. Shafi Ullah Khan (2 hours later)
Brief Answer:
Fibromyalgia possible, but needs work up

Detailed Answer:
Thank you for asking
Fibromyalgia is a disorder of chronic, widespread pain and tenderness. It typically presents in young or middle-aged women but can affect patients of either sex and at any age. And considering your history and associated psychological issues it is highly likely that it can be fibromyalgia but before confirming that a little lab work would be needed as fibromyalgia is a diagnosis of exclusion.

I want you to know that Fibromyalgia is a syndrome that consists of the following signs and symptoms

Persistent (≥ 3 mo) widespread pain (pain/tenderness on both sides of the body, above and below the waist, and includes the axial spine [usually the paraspinus, scapular, and trapezius muscles])
Stiffness
Fatigue; disrupted and unrefreshing sleep
Cognitive difficulties
Multiple other unexplained symptoms, anxiety and/or depression, and functional impairment of activities of daily living (ADLs)

As i mentioned earlier Fibromyalgia is a diagnosis of exclusion and patients must be thoroughly evaluated for the presence of other disorders that could be the cause of symptoms before a diagnosis of fibromyalgia is made. The clinical assessment may reveal objective evidence for a discrete or comorbid illness, such as the following:

Hypothyroidism
Rheumatoid arthritis
Systemic lupus erythematosus
Polymyalgia rheumatic
Other inflammatory or autoimmune disorders
Serious cardiac conditions in those with chest pain, dyspnea, and palpitations.

try the following questionniers regarding fibromyalgia and get self educated further.

Modified Health Assessment Questionnaire
Fibromyalgia Impact Questionnaire
Checklist of current symptoms
Scales for helplessness and cognitive performance
The Physician Health Questionnaire - 9 for depression
The Generalized Anxiety Disorder - 7 questionnaire for anxiety
The Mood Disorder Questionnaire to screen for bipolar disease

As i said There is no cure for fibromyalgia, but education, lifestyle changes, and proper medications can help the individual to regain control and achieve significant improvement.

Models of pain behavior that interrelate biologic, cognitive, emotional, and behavioral variables form the basis for cognitive-behavioral and operant-behavioral approaches to adult pain management. Fibromyalgia in children responds to a combination of psychotherapy, exercise, relaxation techniques, and education. Pharmacotherapy is generally not indicated in children.

Nonpharmacotherapy options which help in Fibromyalffia are mentioned below.

Diet (eg, promote good nutrition, vitamin supplementation, bone health, weight loss)
Stress management
Aerobic exercise (eg, low-impact aerobics, walking, water aerobics, stationary bicycle)
Sleep therapy (eg, education/instruction on sleep hygiene)
Psychologic/behavioral therapy (eg, cognitive-behavioral, operant-behavioral)
Pharmacotherapy

Always combine pharmacologic and nonpharmacologic therapy in the treatment of fibromyalgia. Aggressively treat comorbid depression.

Medications used in the management of fibromyalgia include the following:

Analgesics (eg, tramadol)
Antianxiety agents (eg, alprazolam, clonazepam, zolpidem, zaleplon, Trazodone, buspirone, temazepam, sodium oxybate)
Skeletal muscle relaxants (eg, cyclobenzaprine)
Antidepressants (eg, amitriptyline, duloxetine, milnacipran, venlafaxine, desvenlafaxine)
Anticonvulsants (eg, pregabalin, gabapentin, tiagabine)
Alpha 2 agonists (eg, clonidine)
Other agents used in fibromyalgia may include the following:

Vitamins and minerals
Malic acid and magnesium combination
Antioxidants
Amino acids
Herbs and supplements
If nonpharmacotherapy fails to improve sleep problems, the following medications may help:

Antidepressants (eg, trazodone, SSRIs, SNRIs, tricyclic antidepressants)
Anticonvulsants (eg, clonazepam, gabapentin, tiagabine)
Nonbenzodiazepine hypnotics (eg, zolpidem, zaleplon, eszopiclone)
Muscle relaxants (eg, cyclobenzaprine, tizanidine)
Dopamine agonists (eg, pramipexole)

Nut shell, get to a rheumatologist and let them take care of your troubles. Try to combat your anxiety and depression and get a psychiatric rehabilitation and try to be in touch. Hope for the best.

I hope it helps. Take good care of yourself and dont forget to close the discussion please.

May the odds be ever in your favour.

Regards
Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3614 Questions

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What are the symptoms of fibromyalgia?

Brief Answer: Fibromyalgia possible, but needs work up Detailed Answer: Thank you for asking Fibromyalgia is a disorder of chronic, widespread pain and tenderness. It typically presents in young or middle-aged women but can affect patients of either sex and at any age. And considering your history and associated psychological issues it is highly likely that it can be fibromyalgia but before confirming that a little lab work would be needed as fibromyalgia is a diagnosis of exclusion. I want you to know that Fibromyalgia is a syndrome that consists of the following signs and symptoms Persistent (≥ 3 mo) widespread pain (pain/tenderness on both sides of the body, above and below the waist, and includes the axial spine [usually the paraspinus, scapular, and trapezius muscles]) Stiffness Fatigue; disrupted and unrefreshing sleep Cognitive difficulties Multiple other unexplained symptoms, anxiety and/or depression, and functional impairment of activities of daily living (ADLs) As i mentioned earlier Fibromyalgia is a diagnosis of exclusion and patients must be thoroughly evaluated for the presence of other disorders that could be the cause of symptoms before a diagnosis of fibromyalgia is made. The clinical assessment may reveal objective evidence for a discrete or comorbid illness, such as the following: Hypothyroidism Rheumatoid arthritis Systemic lupus erythematosus Polymyalgia rheumatic Other inflammatory or autoimmune disorders Serious cardiac conditions in those with chest pain, dyspnea, and palpitations. try the following questionniers regarding fibromyalgia and get self educated further. Modified Health Assessment Questionnaire Fibromyalgia Impact Questionnaire Checklist of current symptoms Scales for helplessness and cognitive performance The Physician Health Questionnaire - 9 for depression The Generalized Anxiety Disorder - 7 questionnaire for anxiety The Mood Disorder Questionnaire to screen for bipolar disease As i said There is no cure for fibromyalgia, but education, lifestyle changes, and proper medications can help the individual to regain control and achieve significant improvement. Models of pain behavior that interrelate biologic, cognitive, emotional, and behavioral variables form the basis for cognitive-behavioral and operant-behavioral approaches to adult pain management. Fibromyalgia in children responds to a combination of psychotherapy, exercise, relaxation techniques, and education. Pharmacotherapy is generally not indicated in children. Nonpharmacotherapy options which help in Fibromyalffia are mentioned below. Diet (eg, promote good nutrition, vitamin supplementation, bone health, weight loss) Stress management Aerobic exercise (eg, low-impact aerobics, walking, water aerobics, stationary bicycle) Sleep therapy (eg, education/instruction on sleep hygiene) Psychologic/behavioral therapy (eg, cognitive-behavioral, operant-behavioral) Pharmacotherapy Always combine pharmacologic and nonpharmacologic therapy in the treatment of fibromyalgia. Aggressively treat comorbid depression. Medications used in the management of fibromyalgia include the following: Analgesics (eg, tramadol) Antianxiety agents (eg, alprazolam, clonazepam, zolpidem, zaleplon, Trazodone, buspirone, temazepam, sodium oxybate) Skeletal muscle relaxants (eg, cyclobenzaprine) Antidepressants (eg, amitriptyline, duloxetine, milnacipran, venlafaxine, desvenlafaxine) Anticonvulsants (eg, pregabalin, gabapentin, tiagabine) Alpha 2 agonists (eg, clonidine) Other agents used in fibromyalgia may include the following: Vitamins and minerals Malic acid and magnesium combination Antioxidants Amino acids Herbs and supplements If nonpharmacotherapy fails to improve sleep problems, the following medications may help: Antidepressants (eg, trazodone, SSRIs, SNRIs, tricyclic antidepressants) Anticonvulsants (eg, clonazepam, gabapentin, tiagabine) Nonbenzodiazepine hypnotics (eg, zolpidem, zaleplon, eszopiclone) Muscle relaxants (eg, cyclobenzaprine, tizanidine) Dopamine agonists (eg, pramipexole) Nut shell, get to a rheumatologist and let them take care of your troubles. Try to combat your anxiety and depression and get a psychiatric rehabilitation and try to be in touch. Hope for the best. I hope it helps. Take good care of yourself and dont forget to close the discussion please. May the odds be ever in your favour. Regards Khan