Fibromyalgia is a common medical disorder seen in females. It is characterized by chronic, long-term, generalized pain and localized tenderness in the joints, muscles and tendons. The disorder has been linked to chronic fatigue syndrome, morning stiffness, inability to sleep, headaches, depression and anxiety. The symptoms of fibromyalgia are generally confused with other medical disorder like rheumatoid arthritis, lupus, depression, Hypothyroidism or degenerative disc disease.

Fibromyositis, Fibrositis, Myofascial pain syndrome.

The cause of the disorder remains unknown. It is believed that physical or psychological stress, sleep disturbances, emotional problems and post traumatic stress play a major role in the etiology of this syndrome. Most studies indicate that the chronic pain which is a key feature of this disorder is due to either abnormal nerve impulses or hypersensitivity of the pain receptors.

Despite the fact that numerous metabolic and electrolytes changes have been speculated to cause fibromyalgia, there is no evidence to point to that fact and medical investigations todate remain normal. So far, no virus, bacteria or any other organism has been found to associated with fibromyalgia.

So far, no direct genetic linkage patterns have been identified to indicate that fibromyalgia is an inherited disease. The disorder is most common in the 2-5 decade of life and more common in females. Among ethnic groups, Caucasian women seem to be the most prone.

The classic feature of fibromyalgia is generalized body pain with well defined tender points. These tender points are located all over the body and cause constant pain which radiates. The pain is aching in nature, constant and occurs without any pressure, manipulation or touch. The pain occurs at night and most individual are unable to sleep. For some patients, pain improves during the day and worsens in the evening. Pain generally increases with any activity, cold or damp weather, anxiety, and stress.

Fibromyalgia pain can mimic the pain that occurs with arthritis. However, the swelling, destruction, and deformity of joints seen in rheumatoid arthritis are not seen in fibromyalgia. The soft-tissue pain of fibromyalgia is described as deep-aching, radiating, gnawing, shooting or burning, and ranges from mild to severe. Fibromyalgia sufferers tend to wake up with body aches and joint stiffness.

Besides pain, individuals with fibromyalgia will also have the following features:

• Localized tenderness in muscle/ joints, or back of the neck, shoulders, chest, lower back, hips, shins, elbows, knees
• Chronic tiredness
• Inability to sleep
• Constant muscle pain
• Decreased ability to exercise
• Depression

Diagnosis of fibromyalgia requires a history of least three months of widespread pain, and pain and tenderness in at least 11 of 18 tender-point sites. These tender-point sites include soft tissue, muscles or joints of:

• Neck
• Shoulders
• Chest and Rib cages
• Lower back
• Thighs
• Knees
• Arms (wrist and elbows)
• Buttocks

Laboratory and X ray tests are only done to rule out other disorders that many mimic fibromyalgia. Other disorders which may present like fibromyalgia include rheumatoid arthritis, chronic fatigue syndrome, Lyme disease and irritable bowel syndrome.

In the early mild cases, symptoms may disappear with relief of stress, change in life style and education. Some individuals may require pain control with medications, physical therapy and behavioral counseling. Numerous support groups are available today.

Various classes of drugs have been used to treat fibromyalgia. Some individuals respond to one class of drugs better than others. The most effective drugs have been the tricyclic antidepressants. These medications can decrease pain, help decrease anxiety, relieve the depression and improve sleep patterns.

Other medications used include anti-inflammatory pain medications and medications that may affect pain nerves such as Gabapentin.

Proper nutrition, avoiding excess caffeine, adequate sleep, exercises and may help reduce the severity of the symptoms. Lifestyle measures to improve the quality of sleep can be effective for fibromyalgia.

Improved fitness through exercise is recommended. Walking, swimming, stretching and muscle strengthening exercises may help to relieve the stiffness.

There are numerous herbs and vitamins postulated to treat fibromyalgia. None of these have any valid scientific data to support their use in treating fibromyalgia. All reports about their effective are anecdotal. There is a billion dollar industry marketing herbs for every type of ailment- the majority of these pills are based on the science of quackery- so buyer beware.

Severe cases of fibromyalgia may require a referral to a pain clinic. Pain clinics have opened up all over the country and offer various types of pain control relief, ranging from pills to local injections to small mini pumps implanted for continues pain relief.

Unfortunately, fibromyalgia is a common and chronic problem. The symptoms do improve in some patients, but relapse is common. The symptoms may continue for months and even years, despite treatment. The most important aspect of treatment for fibromyalgia is to see continue follow up with a health care professional who can monitor and follow the disease. Despite being a chronic disorder, fibromyalgia does not decrease the life expectancy.

Todate, there are no treatments to prevent fibromyalgia. The condition is now better managed today with a multidisciplinary approach.

The treatment of fibromyalgia by the chiropractor involves a multi facet approach to the disorder. The chiropractor will focus on the over health, lifestyle, diet, exercise and amount of pain. This integrated approach helps determine the best treatment for your fibromyalgia.

Your chiropractor is uniquely qualified to restore the health. Special chiropractic techniques may relieve the pain and may involve trigger paint therapy, massage ultrasound guided pain relief, acupuncture, acupressure. Other treatments may include massage, traction, or stretching and strengthening exercises. Your chiropractor can discuss these with you.