A PRACTICAL APPROACH TO FIBROMYALGIA

Fibromyalgia

INTRODUCTION

The fibromyalgia syndrome is seen amongst all socioeconomic classes in most countries, most ethnic groups, and in all types of climates. It is a common condition frequently seen in primary care settings. An estimated 6 million Americans have fibromyalgia, and between two and six percent of people presenting to a primary care physician’s office will have the illness. Making an accurate diagnosis of fibromyalgia is important, patients are often relieved that there is a diagnosis which reduces anxiety and tension. Once diagnosed, consultations and laboratory tests can be used in a more judicial manner.

Patients with fibromyalgia are high utilizers of health care resources. Studies have shown patients with fibromyalgia see their primary care provider anywhere from 10 to 22 times a year and have additional visits to alternative medicine providers. Fibromyalgia patients’ average one inpatient admission every three years, Prescriptions are written for patients with fibromyalgia at the rate of 2.7 every six months.
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Fibromyalgia is a noninflammatory pain syndrome of unknown etiology. There is no long-term target organ damage in fibromyalgia. Women are mostly effected but men do get the condition, and it is more common in young to middle age people.

Patients with fibromyalgia have a heightened somatosensory ability. Which is characterized by a sensitivity and hyperawareness to touch, sounds/lights, vibration and smell. Such sensations are often no more than minor in most individuals, but become “danger signals” in fibromyalgia patients that need immediate attention. If the body does not feel that an adequate response has been made to these stimuli, anxiety occurs and a fixation on the area of disturbance results.

HISTORY OF FIBROMYALGIA

Muscular pain that limits activity, but have no observable cause has been noted in the medical literature since 1736, when Guillaume de Baillou published Liber de Rheumatismo describing a case that is currently accepted to be consistent with fibromyalgia. The term fibrositis was officially coined in 1904 but not accepted by the medical community as a condition worthy of their attention or medical treatment. The term fibrositis was first used in the medical literature in 1976 and accepted by the medical community in 1981. It wasn’t until 1986 that the American College of Rheumatology established a committee of physicians to determine diagnostic criteria for the syndrome. In 1990, the concept of inflammation as the cause of the pain was deleted as there was no support, and the name of the syndrome was changed to fibromyalgia with tender points located in specific areas (see Table 1).

Table 1. Fibromyalgia Synonyms

  • Fibrositis
  • Myofascial Pain Syndrome
  • Neuromyasthenia Neurashenia
  • Psychalgia
  • Muscular Rheumatism
  • Myofasciitis Myodysneuria
  • Chronic Rheumatism Pressure
  • Point Syndrome

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