Frequently Asked Questions
Fibromyalgia
| Q. Is fibromyalgia a progressive crippling and life threatening condition? Will I end up bedridden? |
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A. Although the pain and fatigue of fibromyalgia can be quite severe, this condition is not associated with development of deformities. There is no actual destruction of muscle or deterioration of bones in joints. Thus, patients do not end up being completely bedridden by this condition, although they may be incapacitated by it. Fibromyalgia tends to frustrate the patient because of its persistent and widespread pain, but certainly is not life threatening and does not involve the internal organs of the body in any significant manner that would result in a shortened lifespan. By controlling pain and maintaining a general fitness and exercise program, an individual generally is able to care for their basic daily needs, even though on occasion they may not be able to continue to hold a steady job. With a good treatment program, an individual may learn to cope and adjust to this condition. With proper medication and exercise, the patient may be able to maintain continued functional independence. |
| Q. I have trouble remembering things and I am unable to concentrate. Does fibromyalgia cause Alzheimer's or senility? |
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A. There is no evidence that fibromyalgia causes Alzheimer's disease or senility, but fibromyalgia may affect one's ability to calculate or think clearly. Sometimes patients will complain of "cloudy thinking." Thus patients will complain of problems with memory and concentration as well as alertness and ability to perform calculations. There is no progressive or permanent brain damage, however, associated with this condition. |
| Q. How do I know if it's my fibromyalgia or another disease when I feel sick? |
| A. Since fibromyalgia is associated with widespread pain as well as significant fatigue, it is often difficult to know whether symptoms are related to fibromyalgia or another medical condition. This is why it is important to follow up with your primary care physician or rheumatologist regarding any new symptoms you are experiencing. Your physician can then assess your history as well as your physical examination and laboratory testing to determine the exact cause of your symptoms. You should not take for granted that everything that you are feeling or experiencing is from fibromyalgia alone. Simply because you have been diagnosed with fibromyalgia, this does not exclude the possibility of a second medical problem. Therefore, the best advice is to always get a checkup with your physician when in doubt. |
| Q. Is there a cure for fibromyalgia? |
| A.There is no specific cure for this condition. Since the exact cause of fibromyalgia has not been identified, it is unlikely that any kind of cure would be found in the next few years. On the other hand, fibromyalgia may be controlled with a complete program including medication, exercise, lifestyle changes and education about this condition. As more research uncovers new information about the underlying causes of this condition, we will hopefully have better treatments available for patients in the coming years. |
| Q. Is fibromyalgia a mental condition? |
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A. Fibromyalgia does have some psychological and even psychiatric aspects associated with it in up to approximately half the patients with this disorder. The most common problems include anxiety and depression. Patients are sometimes told that this condition "is in their mind." This is not fair to the patient nor accurate. The patient actually feels diffuse and widespread musculoskeletal pain as well as significant fatigue. These are real symptoms to the patient. It only frustrates the patient more when it is implied to them that this is "an imagined" condition. Any symptoms of depression or anxiety need to be addressed and treated as part of the overall management of this condition. |
| Q. What are some other diseases that may be associated with fibromyalgia? |
| A. Fibromyalgia may occur in conjunction with other rheumatic conditions. This may include rheumatoid arthritis or systemic lupus erythematosus, as well as other connective tissue diseases. It may also commonly be seen in hypothyroidism, and thus it is important to test thyroid function in any patients complaining of diffuse muscular pain and fatigue. Polymyalgia rheumatica generally affects the proximal muscles with aching more commonly than distal muscles. Polymyalgia rheumatica is most commonly associated with a markedly elevated sedimentation rate, whereas in fibromyalgia, the sedimentation rate is normal. Hepatitis C infection may also sometimes be associated with muscular type symptoms, and therefore, testing for this along with liver function tests may be part of a patient's laboratory evaluation. |
| Q. What is the best exercise for fibromyalgia? |
| A. Stretching type exercises may be helpful in fibromyalgia in order to avoid the muscle spasm and tension that sometimes go along with this condition. Thus, yoga or prolonged stretches may be beneficial. Patients do not tend to do well with high-impact type activities. Thus, low impact exercise is preferred. This may include simple walking. Aquatic exercise in a heated pool may be highly beneficial. Some patients may also tolerate a stationary bicycle. It is important to gradually work up to a higher level of activity and not start off too aggressively at first. A physical therapist may be helpful in establishing a proper exercise regimen for the individual patient. |
| Q. What alternatives are available to help my pain besides pain pills? |
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A. Regular massage therapy may help work out some of the muscle tension and spasm that are often present. This should be done on a weekly basis with a massage therapist who is familiar with fibromyalgia. At first, the massage therapist needs to start off slowly because of the tender points that may be present. If too much pressure is applied in these areas, it can be quite painful for the patient. When there is severe spasm present, physical therapy may also be beneficial. This may include the use of a transcutaneous nerve stimulator (a TENS unit), which provides pulses of electrical stimulation that may help relieve the pain. Cognitive behavioral therapy may be helpful in helping patients learn how to cope with their illness. This may include relaxation therapy as part of this program. Some patients may benefit from seeing a psychologist or psychiatrist, particularly if they are having extreme anxiety or severe problems with depression. They also may receive some guidance in dealing with other aspects of coping with their daily situational problems. Patients may also be trained in self-hypnosis to deal with the pain or how to utilize biofeedback techniques.
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