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Fibromyalgia (FM) is a medical condition or physiotherapeutic condition which expresses itself in form of a widespread pain and an increased painful response to pressure. It may also be expressed by other symptoms such as excessive fatigue, problems with sleeping, sensitivity to noise, lights and temperature and numbness. FM is a condition which is commonly associated with cases such as depression, anxiety and Post Traumatic Stress Disorder (PTSD).
Fibromyalgia is a condition which affects about 2-8% of the population. It is known to be a more common condition in women as it affects twice the number of women as men. Fibromyalgia was initially defined as a medical condition in 1990, with a more recent update in its criteria in 2011. There are a lot of uncertainties concerning the classification, diagnosis and treatment of FM. Some set of researchers consider the diagnosis of fibromyalgia to have a negative effect on an individuals, while others consider it to be beneficial.
The cause of fibromyalgia is still quite unclear but it is believed to be cause by a combination of genetic and environmental factors. Both factors are considered to contribute equally to the causes. It is a condition which occurs in families and there is cause to belief that it involves a lot of genes. The environmental factors leading to fibromyalgia include psychological stress, trauma and certain infections. The pain experienced in FM is believed to as a result of processes in the central nervous system and this condition is known as a “central sensitization syndrome”. A lot of medical institutes are looking into the case of fibromyalgia and how to diagnose it. Presently, diagnosis involves the elimination of other potential causes and verification of the symptoms present.
Due to the circumstances surrounding the understanding of fibromyalgia, its treatment can be quite difficult. There are however some recommendations which include; getting enough sleep, regular exercise and healthy diets. The use of Cognitive behavioural therapy has also been found to be useful. Medications such as duloxetine, milnacipran or pregabalin are also sometimes used.
It is however important to note that despite the longevity of fibromyalgia, it does not result in death in death or tissue damage.
Issues relating to Fibromyalgia will be explained in detail in this article.
Classification of Fibromyalgia
Fibromyalgia is classified as a disorder of pain processing resulting from abnormalities in the pain receptors of the Central Nervous System. Despite the fact that some mental health conditions are commonly associated with fibromyalgia, such as anxiety, depression, irritable bowel syndrome, and chronic fatigue syndrome, they are to be diagnosed separately.
These differences and differences in the psychological and autonomic profiles among affected person may result in classification into fibromyalgia subtypes. A 2007 review group individual suffering from fibromyalgia into four groups. These groups are;
- Extreme sensitivity to pain but no associated psychiatric conditions
- Fibromyalgia and comorbid, pain-related depression
- Depression with concomitant fibromyalgia syndrome
- Fibromyalgia due to somatization
Symptoms of Fibromyalgia
The most popular symptoms of fibromyalgia are chronic widespread pain, fatigue, sleep disturbance, and heightened pain in response to tactile pressure (allodynia). Some of its other symptoms may be tingling of the skin (paresthesias), prolonged muscle spasms, weakness in the limbs, nerve pain, muscle twitching, palpitations, and functional bowel disturbances.
A lot of people are also known to experience a condition known as fibrofog which is a cognitive dysfunction. Fibrofog is sometimes expressed in affected persons as by impaired concentration, problems with short and long-term memory, short-term memory consolidation, impaired speed of performance, inability to multi-task, cognitive overload, and diminished attention span.
Some other symptoms which have become attributed to fibromyalgia may be as a result of a condition known as comorbid disorder. These symptoms include myofascial pain syndrome, diffuse non-dermatomal paresthesias, functional bowel disturbances and irritable bowel syndrome, genitourinary symptoms and interstitial cystitis, dermatological disorders, headaches, myoclonic twitches, and symptomatic hypoglycemia. Despite the fact that fibromyalgia is classified based on presence of chronic widespread pain, the pain may also be found in specific body parts such as the shoulders, neck, low back, hips etc. A lot of people suffering from the condition have also been known to experience a number of varying degrees of myofascial pain. Study has shown that about a certain percentage (about 20-30%) of people suffering from rheumatoid arthritis and systemic lupus may also be suffering from fibromyalgia.
Causes of Fibromyalgia
The causative agent of fibromyalgia may still be quite uncertain, but a set of hypotheses have been developed which includes Central Sensitization. This theory states that persons suffering from FM possess a lower threshold for pain due to the heightened reactivity of the pain sensors in the central nervous system.
Below is a list of possible causative agents;
Genetics: The mode of inheritance for fibromyalgia is unclear but it is proposed to the polygenic. Research and study has indicated that fibromyalgia is potentially connected with polymorphisms of genes in the serotoninergic, dopaminergic and catecholaminergic systems. This polymorphisms are however not associated with fibromyalgia only.
Lifestyle: Stress has seemingly become an important precipitating factor associated with fibromyalgia. Fibromyalgia is commonly associated with stress-related disorders such as chronic fatigue syndrome, posttraumatic stress disorder (PTSD), irritable bowel syndrome and depression. Poor lifestyles such as smoking, obesity and lack of physical activity have been said to increase the risk of fibromyalgia.
Some authors have proposed that, because exposure to stressful conditions can alter the function of the hypothalamic-pituitary-adrenal (HPA) axis, the development of fibromyalgia may stem from stress-induced disruption of the HPA axis.
Sleep disturbances: A consistent disruption of the stage IV sleep in young individuals has been shown to cause an increased level of muscle tenderness. This has increased speculation that sleep disturbances in young persons may lead to future cases of fibromyalgia.
Psychological factors: Due to the fact that fibromyalgia is known to be associated with psychological and mental conditions, there is a higher risk of fibromyalgia in people with serious psychological conditions.
Non-celiac gluten sensitivity: Non-celiac gluten sensitivity (NCGS) may be an underlying cause of fibromyalgia symptoms but further research is needed.
Physiotherapy and Fibromyalgia
Role of Physiotherapy in treating Fibromyalgia
Physiotherapists are trained with background knowledge in anatomy and kinesiology (which is the study of movement). A therapist will be able to develop specific movements and exercises to suit individual fibromyalgia needs.
The use of Physiotherapy to treat Fibromyalgia
There may be no known cure for fibromyalgia but physiotherapy has been proven to help ease the pain. It is also quite essential in the reduction of stiffness and fatigue. Asides exercise; physiotherapists have a lot of tools at their disposal to ease Fibromyalgia patients. These tools effectively help fibromyalgia patient in the use of their muscles and their general mobility.
Physiotherapy also allows an affected individual work with a physiotherapist to design a movements and exercises to deal with fibromyalgia. The therapist then records the progress of the patient and determines if the individual is employing the use of good therapy habits, alignments, and movement patterns when alone.
Physiotherapy equips the patient with the tools to perform certain treatments and exercises even when the physiotherapist is absent, therefore improving the overall condition.
Through certain simple modifications, there are certain exercises which can be used to boost your energy, reduce pain and stiffness and therefore improve overall mobility of the fibromyalgia patient.
Physiotherapeutic tools used to deal with Fibromyalgia. The physiotherapist may employ the use of different types of tools with fibromyalgia patients including:
- Deep tissue massage
- Low-impact aerobic conditioning (water aerobics)
- Pain relief exercise
- Stretching and strengthening exercises
- TENS units (transcutaneous electrical nerve stimulation)
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