Patients faced with the diagnosis of fibromyalgia are many times left confused by this mysterious disease. This can result in feeling lost and confused, wondering “what is wrong with me?” This is complicated by the fact that many health care professionals know little about this problem or what might be of help for it. The information presented here is only a brief overview of this disorder. Use this as the start of your quest to find out more about this important and prevalent disorder.
Fibromyalgia is a condition that was not well known until recently. The term means pain in the muscles, ligaments and tendons, or the fibrous tissues of the body. The term implies inflammation, though this is not the case.
Fibromyalgia is a disorder that causes it victims to ache all over, and it can produce widespread muscle and joint pain. In addition, the normal sleep/wake cycle is disrupted and this leaves fibromyalgia patients with an overwhelming fatigue. Research has demonstrated that the brain pain centers are highly sensitive to pain signals.
It is diagnosed because of widespread pain, tenderness, sleep disturbance, fatigue, headaches, morning stiffness, muscle twitching, and period burning of the muscles. It is considered to be present when there is wide-spread pain in all four body quadrants, & tenderness to palpation at 11 of 18 tender-point sites–many in the joint areas.
Trauma and Fibromyalgia
The onset of Fibromyalgia frequently can be traced to a time where the individual experienced either a physical or psychological trauma. Child abuse, domestic abuse, trauma’s of having an accident or injury which has created a traumatic response also have been identified as causative factors in this disorder. It is more frequent in women than men, though it is thought to be frequent in anyone who carries many emotional and physical burdens and pressures.
It also seems to be connected to those individuals who have over-worked their bodies for a number of years. Frequently these symptoms come on some time after having experienced a trauma. Stress plays a major part in the exacerbation (i.e., severity increase) in symptoms and problems in functioning.
Past unresolved traumatic experiences can make a patient more prone to developing it. Many adults who are diagnosed with this disorder remember struggling with back pain for many years as a child never knowing what was “wrong” with them and having others tell them that it is all in their head.
Does This Mean It Is Psychological?
It is important to note that Fibromyalgia is a physical disorder that seems to be related to the dysregulation of the central nervous system. Research observations using functional MRI’s (fMRI) have shown that the brains of Fibromyalgia patients are more sensitive to “felt-sensations” of pain and stimulation. We now know that the same center in the brain that is responsible for the regulation of pain is the SAME center of the brain that is responsible for the regulation of moods. The important question is not so much what has caused this disorder. It is more important to focus on what it is that one can control.
We also know that having chronic pain, a condition that lasts more than 3-6 months, is in itself a risk factor for developing depressive and anxiety problems. What this suggests is that an important focus of treatment must include a Behavioral Medicine approach to care, not only to help with the emotional arousal issues, but also to lean new skills in being able to manage this condition over time.
Associated Features of Fibromyalgia
Many other symptoms are also part of this disorder. Many patients with Fibromyalgia suffer with a chronic sleep disorder which at the same time results in the patient having even more symptoms and pain. An irritable bowel syndrome is also frequently associated with this disorder. A sense of chronic exhaustion can come on for what appears to be no particular reason. For example, it is normal to expect that the person suffering with this disorder will have problems in completing household tasks on a consistent basis.
Issues of “Fibro-Fog” are also evident in patients who find themselves fighting to keep themselves focused, oriented, and directed in any consistent manner. They feel disconnected from the “real world” and wonder what is happening to them. Everything seems to be “in a fog” and not very clear–including their thinking and reasoning. This can come and go over time.
Many, but not all, Fibromyalgia patients find themselves unable to work on any consistent basis and find themselves being totally disabled, lost and confused about what to do to help themselves. Others have little understanding for the symptoms experienced by Fibromyalgia patients as they “look so normal” and have no evidence of any obvious injury or physical disability.
Fear of the unknown is central to all chronic pain disorders. Fear of movement is a critical factor in all chronic pain patients because of a concern that this will result in an increase in disability and the maintaining of pain behaviors. However, the lack of exercise and movement over time will cause the Fibromyalgia patient to have more problem and pain. So “Feel the Fear & do it Anyway.”
Therefore, though fear can be adaptive or it can block one from being able to adapt to changing life conditions. This can be complicated because it is known that when people are faced with a crisis, it can bring up memories of past unresolved crises and problems. At the same time, there are things patients can do to help themselves manage their pain issues which can allow the person to life a functional life and reduce the pain.
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