Welcome to Simple Traditions Family Health! Office of Dr. Paul Dibble MD, Dr. Pam Johnson MD & Alyson Van Tiem PA-C We are a direct-pay, family medicine (used to be called family practice) clinic in Magnolia, Texas, Montgomery County, providing excellent primary health care to infants, children, and adults. We can... more
FIBROMYALGIA – Part 1
Symptoms, Causes, Diagnosis & Associated Syndromes
Dr. Pam Johnson at Simple Traditions Family Health in Magnolia, TX treats fibromyalgia.
Fibromyalgia is a difficult condition to diagnose and treat. Symptoms include:
Fibromyalgia is difficult to diagnose because it affects different people in different ways. Women are more likely to suffer from fibromyalgia than men. People with fibromyalgia feel severe pain when pressure is applied to their muscles,. They often complain of generalized body pain, especially in the arms and legs. They can also complain of numbness and tingling in the arms and legs. They may have problems with memory, concentration, sleep, headaches, depression and anxiety. People with fibromyalgia can feel more pain when the temperature or lighting around them changes.
People with fibromyalgia often suffer from other common conditions:
- Migraine and Tension Headaches
- Autoimmune diseases
- Restless Leg Syndrome
- Irritable Bowel Syndrome
- Pelvic Pain and Bladder Irritability
- Depression and Anxiety
- Overweight and Obesity
What Causes Fibromyalgia?
It is not clear what causes fibromyalgia. Fibromyalgia seems to run in families so genetics appears to be a factor. Environmental factors may also contribute. Stress, physical trauma and infections may increase the chances of developing fibromyalgia. People with autoimmune disorders (e.g. rheumatoid arthritis, lupus erythromytosis, Sjogren’s syndrome, ankylosing spondylitis and irritable bowel syndrome) are more likely to suffer from fibromyalgia. That is why some people think that fibromyalgia is an auto-immune disorder. Autoimmune diseases occur when the body makes antibodies against its own tissues. The autoantibodies change or damage to these tissues.
Medical specialists have different answers to the question of what causes fibromyalgia. Neurologists generally believe that fibromyalgia is caused by signals from the central nervous system (the brain and spinal cord) to muscles. Abnormalities in the brain send signals to muscles that makes muscles feel more pain. Rheumatologists view the syndrome in the opposite direction. Pressure on muscles sends signals to the brain. These signals arouse pain centers in the brain and the fibromyalgia patient experiences more pain. Other specialists consider fibromyalgia to be a psychiatric disorder.
How is Fibromyalgia Diagnosed? There is no single test to diagnose fibromyalgia. Fibromyalgia affects 2-8 percent of the population. Women are twice as likely to have fibromyalgia than men. In women, fibromyalgia syndrome develops most often between the ages 25 to 60.
In 1990, the American College of Rheumatology described 18 points (9 pairs) on the body of fibromyalgia patients that are painful when pressed. Pressure on these trigger points may spread pain to other body parts. A person was diagnosed with fibromyalgia if he/she had at least 11 of these18 possible tender points.
In 2010, the American College of Rheumatology updated the criteria for fibromyalgia. This proposal included 19 general body areas of pain instead of points of pain. They also added the Symptom Severity Scale (SS) to help diagnose fibromyalgia. The scale measures the severity of a person’s fatigue, unrefreshed waking, and cognitive and general body symptoms. The higher the score, the more likely a person has fibromyalgia. The symptoms must be present for at least 3 months and other medical illnesses must be ruled out.
Fibromyalgia Flares: Fibromyalgia is a chronic disease but symptoms may change. A sudden increase in symptoms is called a fibromyalgia flare. Flares can include a sudden increase in muscle pain with spasms, joint pain, fatigue and an overall feeling of illness. Changes to the body can trigger fibromyalgia flares. Examples of triggers include an injury, a fall, increased stress, lack of sleep, changes in medications, changes in the weather, a dietary change, travel, dehydration and many more. It is important for people with fibromyalgia to understand what triggers their fibromyalgia flares. They should try to avoid these triggers and be equipped with a fibromyalgia flare action plan.
Upcoming: FIBROMYALGIA – Part 2.
Dr. Pam Johnson describes her approach to evaluating and treating fibromyalgia patients.