May 11, 2010 > Could Your Symptoms Be Fibromyalgia?
Could Your Symptoms Be Fibromyalgia?
Learn More At Upcoming Women's Center Class
Your body has ached all over for the past several months. You're having trouble sleeping, and you feel tired all the time. You've experienced frequent headaches and stomach problems. You're feeling stressed out, anxious and depressed. Yet even after consulting several doctors for these various complaints and undergoing basic blood tests and X-rays to try to figure out what's wrong, you're still left with no answers.
If this sounds all too familiar, it's possible you may have fibromyalgia.
"Fibromyalgia is a chronic pain disorder that causes widespread muscle and joint pain as well as fatigue and other symptoms," says Barry Shibuya, M.D., a rheumatologist at Washington Hospital. "While fibromyalgia is not the same as arthritis, it is a rheumatic condition that causes diffuse aches and pains. Although fibromyalgia is not a form of arthritis, it is more common among people who have arthritis. It also is more prevalent in women, who are five to 10 times more likely to get the disease than men."
To help people in the local community learn more about fibromyalgia, the Washington Women's Center will be offering a special "Lunch and Learn" class featuring Dr. Shibuya. The class is scheduled for Thursday, May 20 from noon to 1 p.m. in the Washington Women's Center Conference Room at 2500 Mowry Avenue in Fremont.
"We don't really know what causes fibromyalgia," Dr. Shibuya says. "We believe it's one of many neuropathic pain syndromes in which the brain and peripheral nerves produce abnormal pain perceptions. Pain usually is a normal body function that protects us from harm. But sometimes our pain-sensing system can become abnormal or 'sick.' For example, if you take a shower every day with the water at the same temperature, that same shower will feel hotter and more painful if you have a sunburn because your nerves are more sensitive due to inflammation and irritation of the nerves caused by the sunburn.
"Anther example of neuropathic pain syndrome would be diabetic peripheral neuropathy, which occurs when diabetes damages the nerves, usually starting in the feet," he adds. "Shingles - which is caused by the same herpes zoster virus that causes chickenpox - is another such syndrome. The virus inflames the nerves, and even after successful treatment with antiviral medicines, the patient can experience ongoing pain because of nerve damage."
Dr. Shibuya notes that a multidisciplinary approach to treating fibromyalgia with medications, physical therapy, exercise and other lifestyle changes can dramatically improve the quality of life for people with fibromyalgia. But first, you must get an accurate diagnosis.
"It's important to make sure the diagnosis is correct because other conditions can mimic the symptoms of fibromyalgia," he says. "Some of those conditions might include sleep apnea, severe arthritis, hypothyroidism - when the thyroid doesn't produce enough hormones - and polymyalgia rheumatica, which is an inflammatory condition that causes pain and stiffness in the neck, shoulders and hips. These conditions will not improve with medications that are used to treat fibromyalgia, but they can be diagnosed with tests and treated effectively with other medications."
Fibromyalgia is often misdiagnosed as chronic fatigue syndrome, arthritis or some other condition because there are no laboratory tests or X-rays that confirm you have fibromyalgia. The diagnosis is basically a process of elimination, conducting a thorough physical examination and using lab tests and X-rays to rule out other conditions that can look like fibromyalgia.
"A few clinical research trials are now being conducted, using 'functional' MRI scans to discover where the abnormal nerve function of fibromyalgia occurs in the brain, but the tests are not yet available to the general public," Dr. Shibuya notes.
Once a diagnosis of fibromyalgia has been made, the patient's physician may prescribe one or more of the three medications for fibromyalgia currently approved by the U.S. Food and Drug Administration (FDA):
* Lyrica - an anti-epileptic or anticonvulsant drug used to treat seizures. With fibromyalgia, Lyrica affects chemicals in the brain that send pain signals throughout the nervous system, thereby reducing pain and improving sleep.
* Cymbalta - an antidepressant that allows more of the "calming" neurotransmitter chemicals of serotonin and norepinephrine to flow through the brain to boost the patient's mood, ease pain and reduce fatigue.
* Savella - another serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant that works much in the same way as Cymbalta.
In addition, the physician may recommend the over-the-counter analgesic acetaminophen (Tylenol) and perhaps a prescription muscle relaxant medication.
"While fibromyalgia is not a life-threatening condition, it can dramatically decrease the patient's quality of life," Dr. Shibuya says. "There currently is no cure, but these medications can often help improve the patient's function and quality of life.
"Fibromyalgia patients also often need other therapies, including evaluation and treatment for sleep disorders, depression, anxiety or stress management," he adds. " We may refer patients for sleep lab tests to check for obstructive sleep apnea that can add to their level of fatigue. We also work with the arthritis exercise class at the Women's Center to help patients improve their physical functioning."
Register for This Class Online!
To register for the May 20 class, visit www.whhs.com or to learn more information about upcoming "Lunch and Learn" topics, visit www.whhs.com/womenscenter.