Haims: Challenges of understanding pain management for fibromyalgia
Although recent scientific and medical breakthroughs have transformed many people’s lives, there is still quite a bit we do not understand about the human body. One of the areas researchers are still attempting to understand is pain.
Currently, fibromyalgia is a medical conundrum. While it presents itself with widespread pain that often feels like it’s bone-deep, it also presents itself with chronic fatigue, sleep disturbances, and cognitive dysfunctions. Adding to this is the association of anxiety, concentration/memory, depression and headaches. With such diverse symptomology, medical providers are often challenged to understand and diagnose the cause.
There is no widely accepted medical test to diagnose fibromyalgia. Instead, diagnostic tests are performed to see if another condition could be causing the symptoms. Often, associated medical conditions like osteoarthritis, rheumatoid arthritis and lupus may contribute to the likelihood of the condition. As well, fibromyalgia is diagnosed in women more frequently than in men.
Fibromyalgia is a diagnosis of exclusion and patients must be thoroughly evaluated for the presence of other disorders that could be the cause of symptoms before a diagnosis of fibromyalgia is made. Blood tests are usually ordered to rule out conditions with similar symptoms. Some of the conditions that may mimic fibromyalgia are celiac disease, Lyme disease hypothyroidism, rheumatoid arthritis and osteoarthritis.
Diagnosis is complicated by the fact that fibromyalgia cannot be detected through X-rays or common blood work. Further, as mentioned above, its symptomology is diverse. Often, ailments wax and wane over time, and they affect people physically, mentally and socially differently. Unfortunately, as with almost all ailments, stress often worsens the related problems and symptoms.
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Until somewhat recently, diagnosing fibromyalgia focused on the symptoms of pain and the presence of tender points. Medical providers have used diagnostic guidelines from the American College of Rheumatology to look for various pain points on both sides of the body where pain was identified when firm pressure was applied to specific areas called tender points. In the past, at least 11 of 18 of the tested tender points had to test positive for tenderness to diagnose fibromyalgia.
Treatment
Until recently, treatments involved both medication and self-care strategies. Medical providers traditionally treated people with pain relievers, antidepressants and anti-seizer medications. Physical therapy, occupational therapy and counseling have also been used.
Currently, researchers are looking at changes in nerve transmission as the mechanism of cause. It is now believed that fibromyalgia amplifies painful sensations by affecting the way our brain and central nervous system process pain signals. Advances in brain imaging technologies such as single photon computed tomography, positron emission tomography, and functional magnetic resonance imaging are aiding researchers greatly in understanding the pain matrix of the brain.
According to a recent , research is indicating the efficacy of hyperbaric oxygen therapy for fibromyalgia. Researchers believe that hyperbaric oxygen therapy may assist with disrupting signals of how the brain and central nervous system process pain. As well, a new therapy called, treatment is showing promise in reducing pain caused by fibromyalgia. A study of this product by the American Academy of Neurology indicated that “Fibrolux laser therapy has a positive impact on both the widespread pain index and pain intensity in fibromyalgia patients.”
Researchers need more time to solve the mystery of fibromyalgia. However, while further research is needed, the prospects of new treatments may be found in the relatively near future. If fibromyalgia is a concern and serotonin鈥搉orepinephrine reuptake inhibitors medications like Cymbalta and milnacipran are not proving effective, hopefully, these new treatments may provide relief.
Judson Haims is the owner of Visiting Angels Home Care in Eagle County. He is an advocate for our elderly and is available to answer questions. Connect with him at jhaims@visitingangels.com.
