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Abstract
Fibromyalgia is a muscular disorder characterized by pain, sleep disturbance, and fatigue. In case of pain, certain “tender points” can develop in the body, which are highly sensitive to any kind of pressure. This disorder is most commonly found in women as compared to men. Patients of rheumatoid arthritis and autoimmune disorders have more chances of developing the disorder. It is often difficult to diagnose as the symptoms are vague and generalized. Although, exact cause of the disorder is not clear, increased sensitivity to the signaling of central nervous system, genetic factors, and psychiatric aspects are thought to have an important role in the development of fibromyalgia. It is still untreatable, but medicines can be used to treat the symptoms associated with the disease. Along with medicines, cognitive-behavioral therapy and multicomponent therapy are used. Moreover, sufficient eating, exercise including aerobic exercise, Tai Chi, and sleep can also help in alleviating the symptoms of the disease. This paper deals with various biological aspects of the disorder including the etiology, pathology, and management of the disorder.
Fibromyalgia is a muscular problem leading to the pain in muscles, sleep disruption, and fatigue. This disorder results in the development of “tender points” such as neck, back, shoulders, arms, hips, and legs. These tender points result in pain, when some pressure is put on them. Fibromyalgia can develop in any person and its prevalence ranges from 1% to 2%. It is most commonly reported in middle-aged women as compared to men, i.e. women have a prevalence of about 3.4% and men have a prevalence of about 0.5%. Moreover, patients of rheumatoid arthritis as well as other such autoimmune disorders have more chances of developing the disease (Bellato et al., 2012; National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2016).
Symptoms of fibromyalgia
Symptoms of fibromyalgia may include difficulty in sleeping, morning stiffness, painful menstrual periods, headaches, tingling sensation or numbness in hands as well as feet, and problems in memory and thinking; a situation also known as “fibro fog” (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2016). This problem can also result in mood disorders, and additional symptoms of this syndrome may include irritable bowel disease, Raynaud's phenomenon, sicca symptoms, and intolerance towards heat and cold (Bellato et al., 2012).
Diagnosis of fibromyalgia
Fibromyalgia diagnosis is often difficult as the symptoms of the disease are very much generalized and vague in nature. In spite of the difficulty in diagnosis, three main symptoms, pain, sleep disturbance and fatigue, are usually considered in every patient. Pain of the patient is migratory in nature and may come and go. According to American College of Rheumatology (ACR), a detectable sign of the disorder is the existence of tender points. In some conditions, additional symptoms may also be considered such as restless legs, morning stiffness, cognitive disturbance, and cold and heat intolerance (Bellato et al., 2012).
Causes of fibromyalgia
Exact cause of fibromyalgia is not clear. However, central sensitization is thought to have an important role in the development of fibromyalgia. Central sensitization refers to increased sensitivity of body parts to central nervous system (CNS) signaling. This central sensitization is caused by increased neuronal excitation and the activity of several neurotransmitters such as serotonin, dopamine, and norepinephrine. Moreover, genetic factors and psychiatric aspects are also thought to be involved in the development of fibromyalgia (Bellato et al., 2012).
Management and Treatment of fibromyalgia
Fibromyalgia is still untreatable, and the lack of knowledge about its exact cause is one of the reasons that it is still not curable. However, medicines can be used to treat the symptoms associated with the disease. Usually, medicinal treatment starts with the use of analgesics to treat the pain. Tricyclic antidepressants, sleep modifiers, and dopaminergic agents may also be used to treat the symptoms (Fitzcharles et al., 2013).
Along with pharmacological management of the disorder, cognitive-behavioral therapy and multicomponent therapy can also be used (Bellato et al., 2012). Moreover, sufficient eating, exercise, and sleep can also help in alleviating the symptoms (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2016). In order to enhance the adherence of patients to exercise, home-based or group-based programs can be started for aerobic exercises or strengthening exercises (Fitzcharles et al., 2013). Tai chi has also been found to be of sufficient help in reducing the symptoms of the disorder. Studies show that 12 weeks to 24 weeks of Tai Chi can provide effective benefits (Wang et al., 2015).
References
Bellato, E., Marini, E., Castoldi, F., Barbasetti, N., Mattei, L., Bonasia, D. E., & Blonna, D. (2012). Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment. Pain research and treatment, 2012.
Fitzcharles, M.-A., Ste-Marie, P. A., Goldenberg, D. L., Pereira, J. X., Abbey, S., Choinière, M., . . . Proulx, J. (2013). 2012 Canadian guidelines for the diagnosis and management of fibromyalgia syndrome: executive summary. Pain Research and Management, 18(3), 119-126.
National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2016). Fibromyalgia. Retrieved from https://www.nlm.nih.gov/medlineplus/fibromyalgia.html
Wang, C., McAlindon, T., Fielding, R. A., Harvey, W. F., Driban, J. B., Price, L. L., . . . Schmid, C. H. (2015). A novel comparative effectiveness study of Tai Chi versus aerobic exercise for fibromyalgia: study protocol for a randomized controlled trial. Trials, 16(1), 34.
