A PRACTICAL APPROACH TO FIBROMYALGIA: SYMPTOMS

The most common complaint in people with fibromyalgia is that they “feel bad”. One third to one half of patients with fibromyalgia relate the onset of the condition to a traumatic experience often can recount the day and time the condition started. Chronic widespread pain not associated with inflammation is considered the hallmark of the disease. Chronic fatigue, cold fingers and feet, impaired memory, frequency and awareness of urination, depression (stipulated as reactive and not clinical), sleep and balance disturbance, muscle twitching, muscles aches, pain, dry mouth, headache and sore throat are all common symptoms associated with fibromyalgia. Symptoms occur daily, but vary in severity. Patients are never symptom free, but at times may reach functional levels in which time they typically see no need for treatment. Symptoms of the condition and the body awareness eventually become a large part of the person’s life. Desires to get better and full awareness of the abnormalities differentiate this entity from depression. A search for normalcy and a focus on the symptoms often aggravate intrafamily relationships and get the affected individual labeled as an “emotional vacuum cleaner” and worsen otherwise minor family issues.

PRECEDING AND COMORBID CONDITIONS

Before the onset of Fibromyalgia a majority of patients reported symptoms of constant gas, bloated feelings, constipation, premenstrual dysphoric disorder or endometriosis, and a large majority reported a history of recurrent childhood ear nose and throat infections. It has long been noted that people with somatic syndromes such as irritable bowel disease, temporomandibular joint dysfunction, interstitial cystitis, multiple chemical sensitivities, and chronic fatigue syndrome have overlapping symptom complexes and the diagnosis they get largely depends on the physician who sees them first. Compared to patients with other rheumatologic problems people with fibromyalgia tend to have more lifetime surgical interventions, 66% of people with fibromyalgia suffer from allergic rhinitis There may be a relationship between fibromyalgia and hyperventilation syndrome hypoglycemia and hypotension. Although treatment of fibromyalgia may alleviate the symptoms of these comorbid conditions, oftentimes these conditions demand attention and treatment separate from fibromyalgia. canadian antibiotics

DIAGNOSING FIBROMYALGIA

It is difficult to diagnose a problem that has mostly subjective findings and few objective ones. Fibromyalgia is a diagnosis of exclusion. It takes an average of 5 years for the diagnosis to be made in a person because of the need to exclude so many other diagnoses. The two criteria that need to be met for the diagnosis of fibromyalgia to be made include pain on the left and right side of the body, both above and below the diaphragm. The pain must also be present for a minimum of three months. This ensures that the somatic syndrome is a whole body syndrome and can be called fibromyalgia and does not need to be relegated into one of the subspecialty somatic syndromes like migraine headache, irritable bowel, interstitial cystitis, chronic fatigue syndrome or one of the others. There should also be areas of tenderness checked in 18 areas of the body. Presence of tenderness with application of 4kg/pressure at eleven of these points confirms the diagnosis. These criteria were set up for research purposes and people who only have 6 areas of tenderness have also been shown to have fibromyalgia.

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