Fibromyalgia, "It's like getting run over by a Mack truck."
You feel achy and sore, like every muscle in your body has been overworked or pulled. You can't focus; you've been having trouble sleeping and you wake up several times a night. It hurts to sit up in class, it hurts to move, and it hurts whenever someone touches your back or your shoulders. You've been experiencing mood swings and depression and, on top of all that, your stomach hurts. So what's the deal? It might be fibromyalgia.
Fibromyalgia is a chronic pain disorder that affects the muscles, ligaments, and tendons—the soft, fibrous tissues of the body. Pain occurs in areas of one’s body where pressure is applied, commonly the back of the head, the neck, back, chest, elbows, hips, and knees. The pain is constant, for months at a time, and is often accompanied by stiffness. “The pain of fibromyalgia has no boundaries” (1). It can be stabbing, throbbing, or generally aching. Many patients with fibromyalgia experience muscle twitches, tingling or burning sensations in the affected regions of their body.
Fibromyalgia is also characterized by fatigue, a “brain fatigue,” where patients feel totally drained of energy. Also, trouble concentrating and trouble with memory, commonly called “fibro fog,” is another symptom of fibromyalgia (2).
Most fibromyalgia patients have an associated sleep disorder called the alpha-EEG anomaly. Patients can fall asleep fairly quickly, but their deep level (stage 4) sleep is often interrupted by bursts of awake-like brain activity. Fibromyalgia patients appear to spend the night half-asleep and half-awake. "If you wake up feeling as though you've just been run over by a Mack truck—what doctors refer to as unrefreshing sleep—it is reasonable for your physician to assume that you have a sleep disorder" (2).
A variety of other symptoms occur in those with fibromyalgia, including headaches, irritable bowel syndrome, depression, painful cramping during menstruation, and heightened sensitivity to light, odor, and touch (1).
Fibromyalgia affects 1 in 50 Americans, 80-90% of them women. Most people are diagnosed in middle age. Fibromyalgia can occur by itself, but often occurs with other pain disorders like rheumatoid arthritis and other types of arthritis (3).
So here’s the hundred dollar question. What causes fibromyalgia? No one really knows. Suggested causes include: immune system problems, physically unfit muscles, disturbance in brain chemistry (clinical depression), sleep disturbances or insomnia, food allergy, emotional stress, nutritional deficiencies, or even anemia (4).
There are some “triggers” that seem to exacerbate systems in fibromyalgia patients. These include: overexertion, stress, lack of exercise, anxiety, depression, lack of sleep or sleep disturbances, trauma, or infectious illness (4).
Diagnosis of fibromyalgia is difficult, but is typically based upon two criteria. The patient must have chronic, widespread pain lasting more than 3 months, present on both the left and right sides of the body as well as above and below the waist. The patient must also have the presence of tender points. The body has 18 possible tender paints and, in order for a diagnosis of fibromyalgia, the patient must have 11 or more (3).
Treatment for fibromyalgia is also difficult, but is usually focused on treating the symptoms. The pain is often treated with Acetaminophen (Tylenol), sometimes in conjunction with an NSAID, like Ibuprofen. Depression and sleeping disorders are treated with anti-depressants like amtriptyline or paroxetine. Eating better, getting enough sleep, exercising regularly, and reducing stress will all help improve the symptoms of fibromyalgia (1).