Fibromyalgia is a condition affecting 5 million Americans over the age of 18. It is associated with fatigue and muscle pain including tender points, which hurt when pressure is exerted on them. Spots are specific to the neck and shoulder areas, back, hips, and extremities.
Fibromyalgia can occur in previously healthy individuals or coupled with other chronic pain disorders such as interstitial cystitis, inflammatory bowel disease, temporomandibular joint disease (TMJ), or vulvodynia, in addition to chronic fatigue syndrome, lupus, rheumatoid arthritis and spinal arthritis. As a result, getting the proper patient education to determine the cause may require visiting more than one doctor.
The cause of this condition is unknown, although it has been seen more frequently with stress, trauma, certain diseases and repeat injuries. It has also been postulated that a gene may be involved that lowers pain thresholds in susceptible individuals.
Doctors Who Treat Fibromyalgia - Patient Education
As fibromyalgia is diagnosed, treated and managed, you may encounter the following team of doctors and specialists.
Rheumatologists - Focus on diseases of the bones, joints, tendons and muscles.
Neurologists - Deal with health and disease of the nervous system.
Pain Management Physicians - Provide various treatment options to decrease pain.
Orthopedists - Concentrate on the health of the musculoskeletal system, including joint problems and replacements.
Chiropractors - Use non-surgical therapies like spinal manipulation to treat individuals suffering from strains, back pain, headaches, arthritic and muscular pains.
Helpful adjuncts in the team include:
Psychologists - Provide therapy for patients through counseling and psychotherapy.
Psychiatrists - Medical doctor focusing on health and disorders of the mind and mood. This doctor may prescribe medications in addition to the psychotherapy needed.
Holistic Practitioners - View the body as a whole, considering physical, mental and spiritual components. Herbs and nutritional supplements are considered in addition to meditation, cleansing, diet and exercise programs.
Physiatrists - Concentrate on rehabilitation therapy and physical medicine to restore the functions of the patient. They assess and treat those suffering from pain, disabilities and lack of function
Nurse Practitioners - Focus on prevention, wellness and education of patients about health and health choices.
Occupational Therapists - Formulate new techniques to perform daily activities so that there is less joint stress and increased ability to perform tasks.
Nutritionists - Devise diet plans to maximize the health of the individual along with the appropriate vitamins and supplements.
How to Prepare for Your Fibromyalgia Doctor Visit
Having made your appointment with a healthcare provider, there are certain actions that you need to take in order to maximize the benefit of your fibromyalgia doctor visit. Read more in this patient education guide.
Try to compile a list of the following:
- All past medical conditions or illnesses along with dates
- All medications including vitamins, herbs, supplements
- Pain log
- Pain or sensitive points and when they became tender
- Any other symptoms
- Allergies
Blood tests will also be drawn for which fasting is unnecessary.
Questions to Ask Your Doctor About Fibromyalgia
From your initial diagnosis throughout your treatment and care, you will have questions about your fibromyalgia. Below is our patient education guide which lists questions to discuss with your doctor to help you make informed decisions about your condition.
Questions About My Fibromyalgia Diagnosis
- What is the difference between fibromyalgia and chronic fatigue syndrome?
- Are there other medical conditions that fibromyalgia can be mistaken for?
- What tests will confirm that I have fibromyalgia?
- How serious is this condition? Does if affect other organs in the body?
- Does this condition progress? Is it debilitating? Will I become bed-ridden?
- Will this prevent me from working?
Questions About My Fibromyalgia Treatment
- Is there a cure for this illness? Is there medication to treat this condition?
- Will I always need to take medication for my fibromyalgia?
- What are the side effects of this medication?
- Are there herbal treatments that are effective? Alternative therapies that you'd recommend? Are there any clinical trials that I can participate in?
Questions About My Lifestyle and Family
- Does this run in families? Can my children get this?
- What foods should I avoid? Is there a diet that will help me?
- What exercise plan do you advise?
- Should I enroll in a counseling program?
- Are there biofeedback or stress relief programs available?
- Will I still be capable of performing sexually?
- Can I still work? Can I drive?
- Is there printed patient education information that I can share with my family? Is there a support group in the community?
Common Tests or Labs to Diagnose Fibromyalgia
Although there are no blood tests specific to fibromyalgia, it is crucial to rule out other disorders with similar symptoms masquerading as fibromyalgia. Therefore, blood tests typically done are:
- Complete blood count
- Erythrocyte sedimentation rate (ESR)
- Thyroid function tests
Three criteria used by the American College of Rheumatology in diagnosing fibromyalgia include:
- Diffuse pain of at least three months duration
- Minimally 11 positive tender points out of 18
- No other condition causing the pain
Anti-Polymer Antibody (APA) Assay
With newer technologies, the first laboratory test has just been developed for fibromyalgia - the Anti-Polymer Antibody (APA) Assay. Patients have blood drawn from the arm and analysis confirms a type of antibody called IgG anti-polymer antibody in human serum.
It is not known why the antibody is present or rises with more severe fibromyalgia, but it is the first exam that objectively confirms and quantifies the doctor's diagnosis, allowing for appropriate medical treatment.
Read more in this patient education guide.
Commons Medications and Treatments for Fibromyalgia
Until recently, there were few choices available to alleviate fibromyalgia, which is a chronic condition. New breakthroughs have been developed and approved to help manage this condition. Read more in this patient education guide.
| Drug Category |
How the Medication Works? |
| Anti-seizure |
- Calms hyperexcited nerves that transmit pain
- Lessens pain
- Decreases insomnia
|
| Serotonin-norepinephrine reuptake inhibitors |
- Inhibits pain signals by excited nerves
- Increases neural transmitters
- Decreases pain
- Lessens fatigue
- Improves memory
|
| Cannabinoid |
- Decreases nausea
- Increases appetite
- Decreases pain
- Improves sleep
- Mood elevator
- Decreases pain
|
Alternative/Complementary Medical Options
Two natural herbal supplements seem to have beneficial affect to fibromyalgia patients:
| Supplement |
How it Works? |
| Melatonin |
Natural hormone
Relieves fatigue and insomnia
|
| 5-HTP (Hydroxytryptophan) |
Decreases pain
Increases deep sleep
Decreases depression symptoms
|
Exercise programs, acupuncture and biofeedback have also been recommended for symptomatic relief of fibromyalgia and causes relaxation.
Additional therapy options include:
- Therapeutic massage
- Water therapy
- Light aerobics
- Myofascial release therapy
- Yoga
- Aromatherapy
- Deep breathing exercises
- Imagery and deep relaxation techniques
