Commonly Misdiagnosed Illnesses - Fibromyalgia

January 2, 2012

Fibromyalgia (also known as Fibromyalgia Syndrome - FMS) is one of "those" diseases that many medical professions (and family members) say is "all in your head." Many sufferers will tell you of their journey to get medical help. It can be a long and winding road because it is difficult to diagnose. FMS is chronic and affects muscles and soft tissues.

Your symptoms may be deep muscle pain, painful tender points, morning stiffness, fatigue, anxiety, and problematic sleep. Other symptoms that may be experienced are depression, headaches, memory problems ("fibro fog"), painful menstrual cramps (endometriosis), swelling, tingling, numbness of hands, arms, legs, and feet. Some people have a past history of TMJ - temporomandibular joint disorders, urinary problems and still others have irritable bowel symptoms.

But the one symptom that makes you seek medical attention is pain (sharp, dull, throbbing or aching) that is felt all over your body. It comes and goes. Some patients say that their pain began after a physical trauma, a surgery, an infection or an incident of emotional stress. And sometimes, it just happens over time where no one thing set it off. Women seem to develop FMS than men.

One test the doctor can do in his office for Fibromyalgia is to apply firm pressure to specific tender points.

Where are those tender points? They are at the back of the head; between your shoulder blades; tops of your shoulders; front sides of your neck; your upper chest; outside of your elbows; top of your hips; sides of your hips; and inner sides of your knees.

Rule out all other medical problems. Common mimics include:

1) Rheumatic diseases - RA -rheumatoid arthritis, Sjogren's syndrome, CFS- chronic fatigue syndrome and lupus all can begin with all over aches and pain.

2) Mental health problems - depression and anxiety often come with pain.

3) Neurological disorders. The numbness and tingling of FMS can look like Multiple Sclerosis.

There is no one lab test to confirm FMS, your doctor should rule out other similar diseases. Blood tests: CBC (Complete Blood Count), ESR (Erythrocyte Sedimentation Rate), and Thyroid Function tests.

A diagnosis is usually made when your pain lasts more than 3 months and you have positive results on at least 11 of the tender points listed above.

There is no one "pill" that treats or cures fibromyalgia.

Besides pain, FMS fatigue can be life-changing. Not only do you feel exhausted and weak, but bed rest - although preferable -doesn't seem to help. You know you slept 8 hours but you awake feeling as tired as you were when you went to bed.

Exercise

Exercise is most important. Many people with FMS are physically unfit. They avoid exercise because they fear that it will make their pain worse. To the contrary, regularly scheduled light aerobic or conditioning exercise helps relieve pain and depression.

Starting slowly and gradually increasing exercise in half hour increments can help you enjoy the benefits of exercise without feeling more pain. It is wise to medicate with Tylenol or your analgesic of choice about a half hour before starting a session to help ease any pain you might have after exercising.

Reduce Stress

Avoid or limit emotional stress. If you have a friend or family member who is particularly stressful in your life, limit your exposure to them if you cannot cut them out of your life altogether. I know you can't tell your mother you don't want her to come over anymore, but put her on a schedule....say she can come visit for 2 hours once or twice a week (or whatever is comfortable for you) and stick to it.

Or if you go out to visit, time your outings so you do not get overtired and people don't stress you out. Once your friends and family get the hang of how you need to take care of yourself by imposing limitations on activities/visiting etc. they will become more considerate in time. Allow some time to yourself to relax every day. Learn how to say no....and DO NOT feeling guilty about it.

Keep to your routines because if you quit work or stop all activities, you could end up worse than if you remained active. Laying around never cured anyone of any illness. Try stress management techniques, deep breathing exercises and/or meditation.

Physical therapy helps relieve fibromyalgia pain and stiffness. Keeping to a regular schedule can increase your confidence with exercise, help relax tense muscles, and teach you more about what your body can endure. Using hydrotherapy (moist heat or ice packs, soothing hot tub) after physical therapy can help with pain management.

Some drugs may help ease the fatigue associated with fibromyalgia. In addition, light aerobic workouts/exercise can help ease fatigue, minimize pain, improve quality of sleep, and improve mood.

Medications can help reduce the pain of fibromyalgia and improve sleep. Here are some examples:

Analgesics. Acetaminophen (Tylenol, generics) can ease the pain and stiffness caused by fibromyalgia. You need to see how much works for your level of pain. Tramadol (Ultram) is a prescription pain reliever that may be taken with or without added acetaminophen. Your doctor may order nonsteroidal anti-inflammatory drugs (NSAIDs) — such as ibuprofen (Advil, Motrin, generics) or naproxen sodium (Aleve, generics) — in addition to other medications.

Antidepressants. Duloxetine (Cymbalta) and milnacipran (Savella) can help ease the pain and fatigue associated with fibromyalgia. Your doctor may prescribe amitriptyline or fluoxetine (Prozac) to help with stress.

Anti-seizure drugs. Some patients with FMS find Gabapentin (Neurontin - an anti-seizure drug) is helpful in dealing with their symptoms. Lyrica was the first drug approved by the Food and Drug Administration to treat FMS and many patients are finding some relief with this med.

You will always have good days and bad days. With effective treatment, including regular exercise, you can see relief of the degree of your symptoms in time. But if your life is stressful, the pain will come back and with a vengeance. Over time, you will learn what helps you deal with stress and how to limit or avoid it.

People who continue to stay physically and socially active seem to do well with pain management. Staying home, laying about the house, hoping the pain will settle down or go away rarely has a good outcome. You need medical intervention. Diet, exercise, counselling, and medication - they all work as a unit for treatment.

If you believe there is no help for you, you are going to stay stuck. Even if there is never a cure, the treatments listed here can really improve your quality of life.

After getting a diagnosis of fibromyalgia, you might go through the seven degrees of grief -- from anger to making deals with yourself and others. When you finally get to accepting your diagnosis, that's when you will realize there are limits to what medical technology can do.

You have to take your health into your own hands. Read as much as possible. Ask lots of questions of medical professionals and people who have already been diagnosed with FMS. Learn what they do for themselves to cope with pain, depression, fatigue, etc. Networking will probably yield you more information than a doctor's appointment with a top specialist. Join FMS groups - if you can't leave the house, do it on the internet. Support can come from the most unlikely places. :-)

You may very well be a perfectionist with high expectations of yourself. It can take months for you to accept your diagnosis and the changes in your life that you will need to make to remain a viable human being. Learn to relax. If you push through the pain and keep doing your regular activities without regard to treating your FMS, you will ultimately crash and burn. The recovery can be a long road to get back to your 'normal.'

If this describes you, then you need to realize that there's no magic surgery or pill that can fix this. You need to recognize that it is OK to ask for help with things and that it is OK to give yourself time for exercise, then rest and relaxation every day. And to not feel guilty about it.

You need to make your own health your Number One Priority.

Published by Anne DiGeorge, January 2, 2012

Updated by Rachael O'Halloran 3/17/2014 to replace pixelated photos and insert copyscape logos