Local lifestyle columnists

Learning about the elusive fibromyalgia

By From page C4 | April 13, 2014

Many medical diagnoses are fairly straightforward: Symptom A plus symptom B equals condition C.

Fibromyalgia, however, is an exception. It’s only after several other diagnoses are taken off the table that people consider fibromyalgia, because it remains the only option.

Fibromyalgia is often described as chronic pain and fatigue. Sufferers often complain of hurting all over and being tired all the time. As more research has occurred, we’re learning fibromyalgia may overlap with other physical findings, such as irritable bowel syndrome, tingling in the hands and feet and cognition issues.

About 60 to 70 percent of fibromyalgia cases occur in women, and the typical age range is 30 to 45. The true prevalence of the condition is unknown since many cases go undiagnosed but it’s estimated that 4 to 5 percent of the United States population probably has it.

Many women who have fibromyalgia typically put everyone else in their lives first. They take care of husbands, children and even friends, relegating themselves to last in line and not expecting validation of the way they feel.

Some people seem to be “hard-wired” in a way that makes them susceptible to suffering from fibromyalgia. Recent research has shown that people with fibromyalgia suffer from a mild defect in their central pain processing. A number of external triggers also exist, including emotional stress, depression and anxiety disorders such as post traumatic stress disorder, but it’s not understood if those lead to fibromyalgia or vice versa.

Suggested preventive measures include cognitive behavior therapy, a type of biofeedback/stress management, and exercise, especially more “thoughtful” physical disciplines like Tai Chi and yoga. Exercise and therapy may also be recommended as treatment, but when that fails to alleviate the symptoms, other behavioral and drug options exist.

If it’s determined a sleep disorder may be leading to fibromyalgia symptoms, eliminating factors that may be causing the problem, such as caffeine and alcohol, may be recommended. Anti-depression agents such as Cymbalta or Savella, both of which have been shown to alleviate fibromyalgia symptoms in many patients, may also be prescribed.

Communication with your physician is often key to a successful course of treatment, but this is even truer for someone with fibromyalgia. Since many symptoms are difficult to quantify – like headaches, aches and pains throughout the body, and a feeling of always being tired – you have to be as specific as you can with your doctor and allow him or her to rule out other causes of your discomfort.

If fibromyalgia is indicated, its management can be challenging for you and your physician. You need to accept the diagnosis (many people want a different answer); be open to investigating its underlying cause, which can be emotional; and determine how much pain and fatigue you’re willing to tolerate.

Dr. George Stock is a board-certified rheumatologist who’s affiliated with Sutter Medical Foundation and Sutter Medical Group, Solano, partners with Solano Coalition for Better Health.

George Stock, M.D.


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