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  • Dr Ashleigh Bhanjan

Fibromyalgia, review with patient testimonial

Updated: Aug 25, 2023

Introduction


Fibromyalgia is a chronic pain condition that affects millions of people worldwide. It is characterized by widespread pain, fatigue, sleep disturbances, and cognitive difficulties.




The exact cause of fibromyalgia is unknown, but it is believed to be related to neuroinflammation and other factors. In this blog post, we will discuss the current concepts in fibromyalgia, including its symptoms, severity, and conventional treatment options.






We will also explore the role of neuroinflammation and other causes in the development of fibromyalgia. Finally, we will discuss the use of photobiomodulation therapy in treating neuroinflammation and fibromyalgia, including research articles and PubMed research and human trials.




 

What are the common symptoms of fibromyalgia

Common symptoms of fibromyalgia include:

  • Widespread pain throughout the body, which may be continuous and feel like an ache, burning sensation, or sharp, stabbing pain

  • Extreme sensitivity to pain

  • Stiffness

  • Fatigue and tiredness

  • Poor sleep quality

  • Cognitive problems, also known as "fibro-fog," which can include problems with thinking, memory, and concentration

  • Headaches, including migraines

  • Irritable bowel syndrome (IBS), which can cause pain and bloating in the stomach, as well as constipation or diarrhea

  • Numbness or tingling in the hands and feet

  • Dizziness and clumsiness

  • Mood problems, such as depression and anxiety

Symptoms of fibromyalgia can vary from person to person, and it can be challenging to diagnose because there is no specific test for it. Health care providers have to rule out other causes of the symptoms before making a diagnosis of fibromyalgia. Fibromyalgia can affect anyone, but it is more common in people assigned female at birth and people over the age of 40.


 

What are the tender points used in the American College of Rheumatology criteria for diagnosing fibromyalgia ?


The American College of Rheumatology (ACR) criteria for the classification of fibromyalgia include the presence of tender points in at least 11 of 18 specific locations on the body. The tender points are located in the following areas:

  • Occiput (back of the head)

  • Low cervical (neck)

  • Trapezius (shoulder)

  • Supraspinatus (shoulder)

  • Second rib (upper chest)

  • Lateral epicondyle (elbow)

  • Gluteal (buttocks)

  • Greater trochanter (hip)

  • Knee

The diagnosis is primarily based on the presence of widespread pain for a period of at least three months and the presence of 11 tender points. However, the official diagnostic criteria for fibromyalgia no longer requires a tender point examination. Instead, doctors use a widespread pain index (WPI) score and a symptom severity scale (SS) score to diagnose fibromyalgia.


 

Symptoms and Severity of Fibromyalgia


Fibromyalgia is characterized by widespread pain, fatigue, sleep disturbances, and cognitive difficulties. The pain associated with fibromyalgia is often described as a deep, dull ache that is present throughout the body. Other symptoms may include headaches, irritable bowel syndrome, and depression.



The severity of fibromyalgia can vary from person to person, with some individuals experiencing mild symptoms and others experiencing severe symptoms that interfere with daily activities.


 

How is fibromyalgia diagnosed ?

Diagnosing fibromyalgia can be challenging because there is no specific test for it, and the symptoms can vary from person to person. Health care providers have to rule out other causes of the symptoms before making a diagnosis of fibromyalgia. This is called making a differential diagnosis. The following are some of the tools that health care providers may use to diagnose fibromyalgia:

  • A medical history, including asking detailed questions about your symptoms

  • A physical exam to check for visible signs of other conditions

  • Tests to check for other conditions that have similar symptoms, such as urine and blood tests, X-rays, and other scans

  • Comparison of several conditions with related symptoms to make a diagnosis by a process of elimination

It may take visits to several different health care providers to get a diagnosis of fibromyalgia. Even though there is no specific test for it, a healthcare provider will diagnose fibromyalgia with a physical exam and discussion of your health history. They’ll ask about your symptoms and when you first noticed them. If you think you have fibromyalgia, you should see a GP, or Neurologist.

 

Conventional Treatment Options for Fibromyalgia


There are several conventional treatment options for fibromyalgia, including medications, physical therapy, and lifestyle changes. Medications that may be used to treat fibromyalgia include pain relievers, antidepressants, and anti-seizure drugs. Physical therapy may include exercises to improve strength and flexibility, as well as massage and other manual therapies. Lifestyle changes that may be helpful for individuals with fibromyalgia include getting enough sleep, eating a healthy diet, and reducing stress.


 

What are some anti-inflammatory foods that can be included in a fibromyalgia-friendly diet

Including anti-inflammatory foods in a fibromyalgia-friendly diet may help manage the symptoms. Here are some anti-inflammatory foods that can be included:

  1. Vegetables: Vegetables are a major element of an anti-inflammatory diet. Dark leafy greens, broccoli, and sweet potatoes are some examples.

  2. Fish: Cold-water fish such as salmon, sardines, and tuna are rich in omega-3 fatty acids, which have a strong anti-inflammatory effect.

  3. Poultry: Poultry is a good source of lean protein, which is important for building and repairing tissues.

  4. Beans: Beans are a good source of plant-based protein and fiber, which can help regulate digestion and reduce inflammation.

  5. Nuts and seeds: Nuts and seeds are believed to have anti-inflammatory properties and are a good source of healthy fats.

  6. Fruits: Fruits are typically low in calories, high in fiber, and rich in antioxidants and phytochemicals. Bananas, oranges, apples, grapes, blueberries, and strawberries are some examples.

  7. Whole grains: Whole-grain foods include barley, buckwheat, oats, quinoa, and brown rice. They are rich in fiber and other nutrients that can help reduce inflammation.

  8. Healthy fats: Healthy fats such as those found in olive oil, avocado, and nuts can help reduce inflammation.

It's important to note that dietary changes are not part of the standard treatment for fibromyalgia. However, favoring some foods over others may help manage the symptoms. When in doubt, check with your doctor or a dietitian


 

Self-care strategies for managing fibromyalgia symptoms

Self-care is critical in the management of fibromyalgia. Here are some self-care strategies for managing fibromyalgia symptoms:

  1. Stress management: Develop a plan to avoid or limit overexertion and emotional stress.

  2. Sleep hygiene: Getting good quality sleep is essential for managing fibromyalgia symptoms. Practice good sleep habits, such as going to bed and getting up at the same time each day and limiting daytime napping.

  3. Exercise regularly: Regular exercise has been shown to help reduce pain and improve overall quality of life. Your GP may offer you an exercise program, depending on what’s available in your area. It may be a supervised exercise program either on your own or in a group.

  4. Pace yourself: Don't overdo it on good days, and rest when you need to.

  5. Maintain a healthy lifestyle: Eating a healthy diet, staying hydrated, and avoiding smoking and excessive alcohol consumption can help manage fibromyalgia symptoms.

  6. Adhere to your medication regimen: Take your medications as prescribed by your doctor.

  7. Manage your stress: Practice relaxation techniques such as deep breathing, meditation, or yoga.

  8. Take hot showers and baths: Hot water can help ease muscle pain and stiffness.

  9. Stretch regularly: Gentle stretching can help improve flexibility and reduce muscle tension.

  10. Find support: Joining a support group or talking to a therapist can help you manage the emotional and psychological aspects of fibromyalgia.

Incorporating these self-care strategies into your daily routine can help manage the symptoms of fibromyalgia and improve your overall quality of life.



 

Can mindfulness meditation be helpful for fibromyalgia

Yes, mindfulness meditation can be helpful for fibromyalgia. Here are some of the ways mindfulness meditation can be helpful:

  1. Alleviates symptoms: A randomized clinical trial found that mindfulness meditation can alleviate fibromyalgia symptoms in women.

  2. Complementary treatment approach: Mindfulness meditation may provide an effective complementary treatment approach for fibromyalgia patients, especially when combined with other reliable treatments.

  3. Reduces overstimulation: Mindfulness is a school of therapy that is thought to reduce the Sympathetic Nervous System overstimulation and has shown improvements in fibromyalgia symptoms.

  4. Relieves pain: Mindfulness can help relieve pain and improve quality of life. Mindfulness may lead to changes in the brain that provide benefits for those with fibromyalgia. Several studies examining the connection between mindfulness and pain have shown positive results.

  5. Inhibit the CNS’ ability to perceive pain: Mindfulness may inhibit the CNS’ ability to perceive pain.

  6. Reduce distressing thoughts and feelings: Mindfulness may reduce distressing thoughts and feelings that come with pain, which can keep the thoughts and feelings from making the pain worse.

  7. Enhance body awareness: Mindfulness may enhance body awareness, which may lead to improved self-care.

  8. Promote deep muscle relaxation: Mindfulness may promote deep muscle relaxation, which lessens tension and irritability.

There are also guided meditations available that are specifically designed for fibromyalgia patients. A guided meditation can help you focus your mind and relax your body, which can help alleviate fibromyalgia symptoms.


 

Role of Neuroinflammation and Other Causes in the Development of Fibromyalgia


Neuroinflammation is believed to play a role in the development of fibromyalgia. This inflammation can cause changes in the way that the brain and nervous system process pain signals, leading to increased sensitivity to pain.


Other factors that may contribute to the development of fibromyalgia include genetics, infections, and physical or emotional trauma.

 

Photobiomodulation Therapy in Treating Neuroinflammation and Fibromyalgia


Photobiomodulation therapy (PBM) is a non-invasive treatment that uses light to stimulate cellular function and reduce inflammation. Recent studies have shown that PBM may be effective in treating neuroinflammation and fibromyalgia. One study found that whole-body PBM treatment resulted in short-term improvements in pain, quality of life, and psychological factors in individuals with fibromyalgia.



Another study protocol is investigating the short- and long-term effects of whole-body PBM on pain, functionality, tissue quality, central sensitization, and psychological factors in a population suffering from fibromyalgia


Low-level laser therapy is a therapeutic factor that can target the whole hierarchy of mechanisms of pain origin and regulation.

Laser photobiomodulation therapy has been reported to be effective in the treatment of a variety of myofascial musculoskeletal disorders, including fibromyalgia.


The combination of laser therapy and the administration of the drug amitriptyline was found to be effective on clinical symptoms and quality of life in fibromyalgia

Gallium-arsenide laser therapy was found to be a safe and effective treatment that can be used as a monotherapy or as a supplementary treatment to other therapeutic procedures in fibromyalgia.


Evidence also supported the use of laser therapy in women suffering from fibromyalgia to improve pain and upper body range of motion, ultimately reducing.

 


Conclusion


Fibromyalgia is a chronic pain condition that affects millions of people worldwide. Although the exact cause of fibromyalgia is unknown, it is believed to be related to neuroinflammation and other factors.


Conventional treatment options for fibromyalgia include medications, physical therapy, and lifestyle changes.


Photobiomodulation therapy is a non-invasive treatment that uses light to stimulate cellular function and reduce inflammation.

Recent studies have shown that PBM may be effective in treating neuroinflammation and fibromyalgia. Further research is needed to fully understand the potential benefits of PBM in the treatment of fibromyalgia.



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