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Sensitivity, Pain, Fatigue… Is It Fibromyalgia?

March 09, 2012

Lunch and Learn Program Discusses Disease Process, Treatment, Self-Help

Do you suffer from chronic pain throughout your body, along with “tender point” areas that are particularly sensitive to touch or pressure? Do you have trouble sleeping and wake up unrefreshed or experience frequent fatigue? If so, there’s a chance you may have a common health disorder called fibromyalgia.

According to the American College of Rheumatology, fibromyalgia affects two to four percent of the population, with women being much more likely to develop the disorder than men. Some patients with fibromyalgia also may experience symptoms such as depression, anxiety, frequent headaches, digestive upsets, irritable or overactive bladder, and memory or cognitive problems.

“We’re not really sure what causes fibromyalgia, but it appears to be a disorder of the pain processing centers in the brain and nerves,” says Barry Shibuya, M.D., a rheumatologist on the medical staff at Washington Hospital. “The central and peripheral nerves seem to be more sensitive and irritable in people with fibromyalgia, so they sense pain more easily and acutely than other people.”

To help women in the community learn more about fibromyalgia, as well as the latest treatment options and self-help strategies, the Washington Women’s Center is hosting a Lunch and Learn session featuring Dr. Shibuya on Wednesday, March 14 from noon to 1 p.m. Washington Women’s Center Coordinator Kathy Hesser, RN, will facilitate the group discussion. The center is located at 2500 Mowry Avenue, Suite 150, in Fremont.

Making an Accurate Diagnosis

“Unfortunately, fibromyalgia can be difficult to diagnose because no specific blood tests, X-rays or CT scans can detect it,” Dr. Shibuya says. “There have been some studies using ‘functional’ MRI scans of the brain with radioactive glucose to measure pain reactions in the brain, and areas of the brain associated with pain seem to light up at lower levels of pain in people with fibromyalgia. This technology is still in the research phase, however.”

Diagnosing fibromyalgia is further complicated because other conditions can cause some symptoms similar to those associated with fibromyalgia.

“Blood tests and X-rays can be used to help rule out other painful conditions such as arthritis and inflammatory diseases such as spondylitis and lupus,” Dr. Shibuya explains. “Another health problem that can mimic the symptoms of fibromyalgia is sleep apnea, which is characterized by abnormal pauses in your breathing while asleep. Sleep apnea can cause fatigue, and if your sleep is constantly interrupted, you also can develop similar aches and pains like fibromyalgia. It’s also important to note that you can have other arthritis problems and still have fibromyalgia as well.”

Because diagnosing fibromyalgia is a complicated process, people who suspect they may have the condition should seek an evaluation from a physician who has experience in treating the disorder.

“Patients and their doctors always want to have a clear and definitive diagnosis, but that’s difficult with fibromyalgia because you can’t ‘see’ the problem,” Dr. Shibuya says. “For example, with a painful condition like shingles, we can actually see the rash. Or in people who have diabetes, we know that they can experience painful peripheral neuropathy. So we need to make sure that fibromyalgia is properly diagnosed, ruling out other conditions and following the screening criteria developed by the American College of Rheumatology.”

Lifestyle Modifications Can Alleviate Symptoms

There currently is no cure for fibromyalgia, so treatment emphasizes minimizing symptoms and improving the patient’s general health.

“In our society, people have been groomed to believe that there is a pill to cure just about everything, and as physicians we need to do a better job of educating patients about the importance and effectiveness of making lifestyle modifications to improve their health,” Dr. Shibuya says.

“Over-the-counter analgesics such as acetaminophen and ibuprofen may ease the pain and stiffness of fibromyalgia,” he notes. “Plus, there are three prescription medications approved by the FDA to treat the symptoms of fibromyalgia – duloxetine, milnacipran and pregabalin. These medications may be helpful, but they are most effective when used in combination with lifestyle modifications such as improving your diet, getting more exercise, improving your sleep habits and reducing your stress level since stress can exacerbate the symptoms of fibromyalgia.”

At the Lunch and Learn session, Dr. Shibuya and Ms. Hesser will be offering guidance on how people with fibromyalgia can be more proactive in managing this chronic condition. They also will discuss the benefits of exercise classes offered at Washington Women’s Center, including the Arthritis Foundation Exercise Program and an Arthritis Foundation Tai Chi program that was introduced last fall. Both classes are open to patients with fibromyalgia.

“Because they are in pain, people with fibromyalgia may be resistant to doing exercises,” Dr. Shibuya says. “While it may be difficult at first, regular exercise often reduces symptoms of pain and fatigue, and also improves sleep. The key is to start out slowly and gradually increase your level of activity. Over the long run, the more effort you put into making lifestyle modifications, the better the result will be.”

For more information about classes offered at the Washington Women’s Center or to register to attend the upcoming Lunch and Learn session on March 14, visit www.whhs.com/womenscenter.

 

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