Fibromyalgia is a chronic and often misunderstood condition that affects millions of individuals worldwide. The condition has puzzled healthcare providers and patients alike for ages and all because it doesn’t really have a cure.  The only remedy for fibromyalgia is except effective management of the disease with treatment typically involving various therapies, exercises, medication to treat symptoms and behavioural therapy. Despite of no cure, treatment ensures the condition doesn’t worsen over time. In fact, those who learn to manage their symptoms can experience improvement, which of course is the silver lining.

What is Fibromyalgia?

Medical understanding of fibromyalgia has evolved over the years and today we have both drug and non-drug treatment options to manage it.  It is a persistent and widespread musculoskeletal pain and tenderness accompanied by symptoms like fatigue, sleep disturbances, headaches, stiffness, and even trouble thinking clearly – something affectionately termed “fibro fog.” Although its exact cause is still not fully understood, researchers believe it involves a complex interaction of genetic, environmental, and neurological factors. Fibromyalgia often coexists with conditions such as irritable bowel syndrome, chronic fatigue syndrome, and mood disorders like depression and anxiety.

Studies have found fibromyalgia affects almost 2.7% of the world’s population. In India, there is no definite figure to gauge the severity of fibromyalgia in the country although reports state 1.4 crore people are affected by it among which 80% were women.  Surprisingly, almost .5% cases go undiagnosed. Statistics have also revealed how the disease is typically diagnosed in middle age, and women are twice as likely as men to develop it.

How Does Fibromyalgia Develop?

Fibromyalgia has been found to develop after events such as physical trauma, accidents, surgery, infection, or significant psychological stress. In some cases, the symptoms gradually manifest over time without any trigger event.  The exact cause of fibromyalgia remains elusive, but it has been widely believed that the condition is due to the brain and spinal cord misinterpreting body signals, transforming normally harmless signals into painful ones. The altered signalling in neural pathways also contributed to the extended symptoms of cognitive disturbance, sleep disorders and fatigue.

However, in 2021, collaborative research between the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, in collaboration and the University of Liverpool and the Karolinska Institute, found something new that has changed the perception of fibromyalgia. The research found how it was antibodies that were increasing the activity of the pain sensing nerves throughout the body. This meant that it was not of cerebral and neurological origins but an autoimmune disease. This makes victims of the conditon experience hyper touch sensitivity and genetics might be playing a role in it too. The debate still rages on as to what fibromyalgia really is?

Diagnosis

Diagnosing fibromyalgia can be tricky as it lacks clear-cut lab tests or X-ray results. It often involves ruling out other conditions with similar symptoms. Physicians typically rely on a combination of patient history, physical examination, and specific diagnostic criteria set by organizations like the American College of Rheumatology. These criteria include assessing the presence of widespread pain and tenderness in specific “tender points” across the body.

To diagnose, healthcare providers look for widespread body pain lasting more than three months, fatigue, stiffness, sleep problems, cognitive issues, and pain and tenderness in 11 or more of 18 possible “tender points” throughout the body.

Symptoms of Fibromyalgia

While pain and tenderness are hallmark symptoms, the condition includes a wide range of symptoms that can vary among individuals. Some common symptoms are:

• Widespread Musculoskeletal Pain: The main symptom of fibromyalgia which manifests as a bilateral occurrence involving both upper and lower parts of the body. The pain may be localized initially, commonly in the neck and shoulders. While the main complaint is muscle pain, some patients may complain of joint pain as well. The pain is often characterized by aching, burning, or throbbing sensations.
• Fatigue: Profound and often debilitating fatigue that is not relieved by sleep, resulting in decreased energy levels and difficulty performing everyday tasks.
• Sleep Disturbances: Individuals with fibromyalgia frequently experience sleep disruptions, including difficulty falling asleep, staying asleep, or achieving restorative sleep.
• Cognitive Difficulties: Often referred to as “fibro fog,” patients have difficulty with focus and attention, memory, and performing tasks that require rapid changes in thought.
• Sensitivity to Stimuli: Heightened sensitivity to touch, noise, light, and temperature changes, which can exacerbate discomfort.
• Stiffness: Morning stiffness and muscle stiffness after prolonged periods of inactivity are common complaints.
• Depression and Anxiety: Mood disorders are frequently observed with this condition impacting mental well-being.

Other symptoms may include:

• Tingling or numbness in hands and feet
• Pain in the face or jaw, including disorders of the jaw known as temporomandibular joint syndrome (also known as TMJ)
• Digestive problems, such as abdominal pain, bloating, constipation, and even irritable bowel syndrome (also known as IBS)

Management and Treatment

Fibromyalgia can be treated by rheumatologists and healthcare professionals specializing in the condition of other types of arthritis. A multifaceted approach to management is crucial to improving the quality of life for individuals with fibromyalgia. It’s important to note that there is no one-size-fits-all solution, and a personalized plan should be developed in consultation with healthcare professionals. Besides medication to treat symptoms, the most helpful treatment is a combination of self-care, physical activity and cognitive-behavioural therapy.

Pharmacological Treatments

The common medications usually prescribed in fibromyalgia include milnacipran, duloxetine and pregabalin, a combination of tramadol and acetaminophen, and armodafinil. To help with sleep, sedatives like zolpidem are usually prescribed by a doctor when needed. Taking in account an individual’s needs, other medication can include SNRI’s (Serotonin Norepinephrine Reuptake Inhibitors), Gabapentinoids, Selective Serotonin Reuptake Inhibitors (SSRIs) and Tricyclic Compounds. However, all of these come with benefits and risks and consumption of them should always be prescribed by a doctor.

Stem Cell Therapy

Stem cell therapy has emerged as a promising treatment option in recent years. Expanded mesenchymal stem cells (MSCs), are obtained from sources like bone marrow, umbilical cord, and adipose tissue, and then expanded (multiplied) in a laboratory to increase the dose amount. These expanded MSCs are then re-infused into the patient’s body, to promote healing, improve sleep, lower stress, and anxiety, improve quality of life, and reduce fatigue and inflammation.

Specialists believe that certain vitamin deficiencies, microelements and some molecules involved in stress and pain could be contributing to symptoms of fibromyalgia. In this case complementary treatment such as vitamins and supplements can be prescribed for management. These are:

• 5-HTP (5-Hydroxytryptophan)
• SAMe (S-Adenosyl-L-Methionine)
• Magnesium
• Melatonin
• St John’s wort

While oral consumption is the desired route, new infusion therapy of vitamins and minerals like magnesium could also work towards providing faster relief. Always consult a reliable IV wellness clinic in Bangalore for the purpose.

Non-Pharmacological Treatments for Fibromyalgia

In 2022, a new clinical study found a wearable neuromodulation system from NeuroMetrix reduced pain in at least 60% of patients. Called the Quell device and now approved by the US FDA, it is worn as a wraparound sleeve on the upper calf where electrodes attached to a band stimulate the sensory nerves in the leg to trigger the body’s pain relief response, reducing symptoms . It is now being imported for sale in India.Besides devices and medication, lifestyle changes contribute a great deal to improving the quality of life with Fibromyalgia.

Exercise Regularly

While moving may feel like climbing Mount Everest initially when you have this condition, research explains that gradual and consistent exercise can indeed dial down the pain. Exercises like yoga and Tai-Chi are gentle ways to get started. These exercises help to recalibrate the slightly off-kilter communication between your brain and body caused by this condition.

Stress Management

Stress can amplify symptoms which is why identifying stress triggers can be a game-changer. For stress, CBT (cognitive behavioural therapy) equips you with coping strategies for emotional stress and depression, thus helping you dodge the stress ninja! Practicing relaxation techniques such as deep breathing, meditation, yoga, and mindfulness can help reduce stress and manage pain.

Get Enough Sleep

Fibromyalgia causes pain and fatigue, which disrupt sleep, leading to more pain and fatigue. Here’s a simple solution: stick to a sleep schedule, minimize daytime naps, and exercise to keep your body in a rhythm. Establishing a consistent sleep schedule, creating a calming bedtime routine, and maintaining a comfortable sleep environment can promote better sleep quality.

Explore Alternative Treatments

The National Center for Complementary and Integrative Health’s research reveals that mind-body practices can be an asset in managing fibromyalgia. Techniques like tai chi, yoga, cognitive behavioural therapy, massage therapy, and acupuncture can be quite beneficial in alleviating pain, stiffness, fatigue, and depression.

Remember, There is No Magic Pill for Fibromyalgia

Most medical experts feel managing fibromyalgia is the same as dealing with other metabolic disorders like diabetes or asthma and autoimmune diseases. It requires an active lifestyle overhaul rather than solely relying on medication. A pill won’t solve everything because there is no cure for fibromyalgia; instead, it’s about embracing a multi-layered approach.

In a nutshell, managing fibromyalgia is about adopting a holistic lifestyle involving regular exercise, stress management, adequate sleep, and exploring complementary treatments. Understanding the condition identifying triggers and techniques that help you cope is the best way to fight this disease. For the elderly, finding a good healthcare center that helps with a comprehensive fibromyalgia treatment in Bangalore.