Fibromyalgia

Diagnosis

Previously, doctors used to examine 18 specific points on a person’s body to determine the number of painful points when pressed firmly. However, the American College of Rheumatology’s recent guidelines do not mandate a tender point exam for diagnosing fibromyalgia. Instead, the primary criterion for diagnosis is the presence of widespread pain in the body for a minimum of three months.

You must experience pain in four or more of the following five places to meet the requirements:

• Left upper region, including shoulder, arm or jaw
• Right upper region, including shoulder, arm or jaw
• Left lower region, including hip, buttock or leg
• Right lower region, including hip, buttock or leg
• Axial region, which includes neck, back, chest or abdomen

Tests
Your doctor might wish to rule out additional illnesses that could present with same symptoms. Blood testing could consist of:

• Vitamin D
• Celiac serology
• Thyroid function tests
• Complete blood count
• Rheumatoid factor
• Erythrocyte sedimentation rate
• Cyclic citrullinated peptide test
• Anti-nuclear antibody

Your doctor might advise an overnight sleep study if there’s a risk that you have sleep apnea.

Treatment

Treatments for fibromyalgia typically combine medicine with self-care techniques. The focus is on reducing symptoms and enhancing overall health. While there isn’t a single cure for all symptoms, using a number of approaches can help in the long run.

Medications

Medication can help with pain relief from fibromyalgia and sleep improvement. Typical choices are:

• Pain relievers. Painkillers sold over-the-counter, such as acetaminophen, ibuprofen, or naproxen sodium, may be beneficial. Opioid drugs are not advised because they can create serious adverse effects, dependence, and will eventually make the pain worse.
• Antidepressants. Milnacipran with duloxetine could reduce fibromyalgia-related fatigue and pain. To aid in promoting sleep, your doctor may advise amitriptyline or the muscle relaxant cyclobenzaprine.
• Anti-seizure drugs. Certain types of pain can frequently be reduced with the use of medications used to treat epilepsy. Pregabalin was the first medication licensed by the Food and Drug Administration to treat fibromyalgia symptoms, while gabapentin is occasionally effective in easing the condition’s symptoms.

Therapies

Numerous treatments are available to assist lessen the impact that fibromyalgia has on your body and your life. Examples comprise:

• Physical therapy. Engaging with a physical therapist can aid you in learning exercises that can enhance your strength, flexibility, and endurance. Exercises performed in water may provide particular benefits.
• Occupational therapy. If you are experiencing physical strain from your work or certain tasks, an occupational therapist can assist you in modifying your work environment or altering your approach to those tasks in order to reduce the strain on your body.
• Counseling. Speaking with a counselor can boost your self-confidence and offer you coping mechanisms for difficult circumstances.