Fibromyalgia is a syndrome characterized by chronic widespread pain at multiple tender points, joint stiffness, and systemic symptoms that include but are not limited to mood disorders, fatigue, and sleeplessness. Unlike myofascial pain syndrome, fibromyalgia may be partially a result of central sensitization that occurs in the central nervous system (brain and spinal cord). Patients with fibromyalgia are susceptible to a phenomenon called “wind up” in which the body responds with increasing pain to a persistent stimulus. Patients who suffer from fibromyalgia may be susceptible to increased inflammatory markers that prolong spinal cord firing of pain. Appropriate and accurate diagnosis of fibromyalgia requires an experienced pain physician who sees patients with this condition and can recognize the wide array of symptoms and signs this may entail. Although it is no longer regarded as a diagnosis of exclusion, more common conditions should be judiciously ruled out for more definitive diagnosis.
The three main symptoms endorsed by patients with fibromyalgia are pain, fatigue and sleep disturbances.
The goal of fibromyalgia treatment is to alleviate pain, increase restorative sleep, and improve physical function through a reduction in symptoms. At Capitol Pain Institute, our approach to fibromyalgia is based in both nonpharmacological pain management strategies and medication management. There are several FDA approved medications for the treatment of fibromyalgia which are part of our multimodal approach to treatment.
Take home points:
- Fibromyalgia is a complex pain syndrome that is often difficult to diagnose
- A multidisciplinary approach is optimal and your pain physician must consider both pharmacological and non pharmacological treatment as well as interventional techniques that may aid in pain relief
- A history and physical examination will help determine a likely cause of your pain
- The goal of treatment is to alleviate pain, increase restful sleep, and improve physical function