Knee Pain

What is a Fibromyalgia?

Fibromyalgia is a chronic condition where there is persistent pain in muscle and joints, that occurs often and due to several reasons. It can also be described as an “arthritis-like” illness as it impacts joints and muscle movement. Here we talk about the details.

Dr. Niranjan Egandher (PT)
Written by Dr. Niranjan Egandher (PT)Senior Clinical Physiotherapist
Fibromyalgia: Symptoms, Causes, Diagnosis & Treatment

Fibromyalgia is a chronic condition where there is persistent pain in muscle and joints, that occurs often and due to several reasons. Fibromyalgia meaning is described as an “arthritis-like” illness as it impacts joints and muscle movement. However, it doesn't cause any damage to the joint or muscle. It does not cause any inflammation, but can increase how pain is perceived by the individual.

Types of Fibromyalgia

Hyperalgesia

It is a type where the person is more sensitive to pain on muscles. While there is no concrete evidence about what causes fibromyalgia, the assumption is that the brain is more sensitive to any kind of pain on muscles and joints, that are perceived intensely by the pain receptors.

Widespread muscle pain

It is a common type of fibromyalgia, where you feel like your whole body is hurting. This includes areas such as the lower back, the buttocks, arm muscles and your back. Pain can occur near the ribs, the shoulder and sometimes in the legs.

TMJ pain

It is a common type where the temporomandibular joint hurts. This is located near your jaws, and connects the jaw to the brain. It is often a dull persistent ache in the jaws, ear and temple region of your face.

Allodynia

It is when your skin is sensitive to any form of pressure, that is often mistaken for pain inducing factors by the pain receptors, and can cause pain. Even clothing straps can cause pain in the body. Doctors believe that this is because the nerves are oversensitive to touch receptors.

Neuropathic pain ‍

It is when there is a tingling sensation in the legs and arms, which can be painful at times. Feelings like a crawling or burning sensation can occur, leading to major discomfort of the individual.

Headaches

These are a common type of fibromyalgia, and people with migraine are also impacted by it. Dull, throbbing pain in the head,  which increases in intensity over a period of time are classic signs. It can also be aggravated due to stress or anxiety.

Abdominal pain

It is another common type, where people often have Irritable Bowel Syndrome, causing cramping, constipation and other forms of pain. Acid reflux can also be a signifier of this type.

Fibromyalgia Symptoms

While pain in general is an overarching symptom of fibromyalgia, often not a result of any physical injury, it has several other symptoms as well. Some of them are mentioned below.

Fatigue and tenderness of the body, often while doing daily activities such as walking, cooking, sleeping are signs to look out for. Some other signs are dizziness, reduced concentration, stress and disturbed sleep patterns. Muscle pain, joint aches, headaches are also some of the fibromyalgia causes to watch out for.

Fibromyalgia Risks

Some of the common risks of having Fibromyalgia is that the central nervous system is very sensitive to the perception of pain in the body. This means that any kind of movement or contact with an external source can result in oversensitive reception, intensive interpretation of the contact.

Since there is no concrete evidence of the cause or reasons, doctors also assume that genetics play an important role, as most recorded cases have a history of someone in the family having fibromyalgia.

Stress and anxiety can also aggravate the intensities of the pain receptors, or how the brain receives sensory information.

Intense physical activities, harsh working conditions where the body is often exhausted can also aggravate fibromyalgia.

Fibromyalgia Diagnosis

Diagnosis of fibromyalgia is often difficult, as there are not specific methods to be followed. However, with recent advances in the study of the illness, there are a  few ways of diagnosis that are mentioned below.

One of the most common ways is to understand a history of over three months of consistent forms of pain in the body, often with widespread muscles in the body. If the pain persists, with no other cause such as injury or an autoimmune disease, it can be fibromyalgia.

The American College of Rheumatology has established three criteria, which are:

Widespread Pain Index: 

This is where the areas of pain are noted, and the number of pain areas are recorded, over a week or two.

SS scale score:

This is where a scale is maintained to understand the intensity of discomfort over Fatigue, waking  unrefreshed and cognitive symptoms. The number of pain sites (WPI), the SS scale score, and the presence of associated symptoms are summed to give a final score between 0 and 31.

Conservative Treatment for Fibromyalgia

Since the goal of the treatment is to reduce the intensity of pain and help in normal function of the body, pain relievers, muscle relaxants and other forms of medication may be prescribed based on a medical test by a doctor. These are just some of the fibromyalgia treatment options. 

Physiotherapy for Fibromyalgia

Most physiotherapy for fibromyalgia is to relieve pain in the muscles and the joints of the person. This can be influenced by various movement exercises, flexibility exercises and relaxation exercises.

Transcutaneous electrical nerve stimulation (TENS)

It is done to block the pain receptors in the spinal cord, and prevent the oversensitivity of the nerves. It also helps reduce muscle spasms

Ultrasounds or ultrasound waves

This can help create gentle heat waves over the nerve sensors, which increases blood flow, helping reduce inflammation and reduce pain.

Heat therapy

It is another form of physiotherapy where the body is subjected to different levels of heat and warmth, that helps reduce pain, relaxes muscles and allows the nerves and skin to get used to touch or sensory information.

Deep tissue massage  

It can help reduce pain and improve movement, which is performed by a massage therapist.

Myofascial release

It involves gently exposing connective tissues to pressure, that eventually allows the body to understand the intensity and reduce response.

Low impact aerobic exercises

Exercises such as swimming, walking can help reduce the stimulus to the body and engage the body and its muscles and joints well.

Cognitive behavioral therapy

It can help reduce negative behaviors that influence certain actions. It helps bring a new perspective to the problem and allows a more positive approach.

Things to Remember for Fibromyalgia

It is important to keep in mind that fibromyalgia does not have a specific cause for the pain. However, it is important to visit a doctor, so that you can rule out any other possibility of illness that is causing these pains. It is also important to ensure you have a healthy lifestyle that balances out the pain and other discomfort.

Having a lifestyle management regime to deal with chronic illness can help ease daily activities. Regular doctor visits and physiotherapy can help reduce the discomfort.

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Hip Adductor Strengthening in Side Lying for strengthening the hip adductor muscles

This physical therapy exercise works best for hip adductor muscles, hip pain treatment, knee pain treatment. This physical therapy exercise useful for people...

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