Fibromyalgia is a chronic medical condition characterized by generalized pain, fatigue, sleeplessness, and mood problems. It commonly affects young or middle-aged women, but it can affect people of any gender regardless of age (1). Fibromyalgia patients might be more vulnerable to pain than non-fibromyalgia patients due to abnormal processing of pain perception.
Fibromyalgia affects around 4 million individuals in the United States, accounting for approximately 2 percent of the total number of adults in the United States (2). Fibromyalgia has no recognized cause, however, it can be treated effectively and controlled. This article will discuss in detail fibromyalgia, including its causes, risk factors, symptoms, diagnosis, treatments – including newer complementary medicine such as fibromyalgia yoga, and fibromyalgia VA ratings.
Causes Of Fibromyalgia
Healthcare providers and researchers are yet to provide an exact cause of fibromyalgia. The most recent study indicates that genetic predisposition along with one or more factors such as infection, and stressful events appear to be the cause.
The persistent and widespread pattern of fibromyalgia pain across the body is also poorly understood by experts although a theory also suggested that the brain decreases the threshold for pain. Over time, stimuli that were not painful in the past now become extremely painful.
Another theory also suggests that the brain and nerve cells may perceive typical pain signals incorrectly or overreact to them. These individuals become more sensitive to the point that they inflict pain that is either unneeded or excessive. The suggested causes of fibromyalgia are highlighted below:
- – Gene: Fibromyalgia frequently runs in families. One is more likely to get this ailment if there is a family history of the disease.
- – Infections: A previous disease may have triggered fibromyalgia or worsened its symptoms. Infections that may be associated with fibromyalgia include:
- – Lung infections
- – Common cold
- – Diarrhea disease resulting from bacterial infections such as Shigella and Salmonella.
- – Trauma: Fibromyalgia may occur in those who experience significant physical or mental trauma. A connection between illness and PTSD has been shown.
- – Stress: Stress may have similar long-lasting consequences on your body as trauma. Hormonal changes brought on by stress may play a role in fibromyalgia (3).
Risk Factors Of Fibromyalgia
The following are risk factors that can predispose a patient to fibromyalgia:
- – Children can be affected by fibromyalgia, as can adults of all ages. However, the majority of cases are discovered by middle age and the chances of developing fibromyalgia increases.
- – Rheumatoid arthritis or lupus. There is a higher risk of developing fibromyalgia if there is an associated systemic lupus erythematosus or rheumatoid arthritis (RA).
- – Sex. Fibromyalgia is twice as common in women as it is in men.
- – Traumatic or stressful occurrence: This includes vehicle accidents, past stressful events, and long-standing wounds. Injuries caused by a joint experiencing repeated stress, such as repetitive knee bending, obesity, and sickness.
Symptoms Of Fibromyalgia
A person can have symptoms at any point in their lives, but between the 4th and 6th decade is when they most frequently manifest. The severity of the symptom(s) and response to treatments are the two important factors used to assign a fibromyalgia VA rating to a patient. Pain is the primary feature of fibromyalgia and it is usually described as widespread across the body. Such pains are described below:
- – Chest pain: The discomfort experienced during an event of a heart attack might be comparable to the discomfort of fibromyalgia when the pain is located in the chest. The cartilage that attaches chest ribs to the breastbone is the primary site of chest discomfort in people with fibromyalgia. The pain could be felt in the arms and shoulders as well. A heart attack symptom is often described by those who experienced it as a stabbing or burning feeling that makes it seem like troubled breathing.
- – Backache: This is one of the most typical locations to experience discomfort in fibromyalgia. The majority of people have low back discomfort throughout their lives. However, other conditions like arthritis and or strained muscle can mimic the back pain of fibromyalgia.
- – Leg pain: The leg muscles may hurt from fibromyalgia. Fibromyalgia Leg pain associated with fibromyalgia can be described as similar to either the stiffness of arthritis or even the discomfort of a strained muscle. Intense, burning, or throbbing are some possible words used to describe this discomfort. Leg fatigue might occasionally be felt as well. The legs may feel as though they are being supported by heavy weights (3).
Other symptoms associated with fibromyalgia are;
- – Headaches with generalized pain
- – Fatigue and weakness
- – Problem with sleeping
- – Memory problems
- – Vision difficulties
- – Chest discomfort
- – Weight increase
- – Depression
- – Anxiety
- – Abnormal sensation in the hand and feet
- – Tiredness (2)
Progression Of Fibromyalgia
Fibromyalgia frequently progresses in an unusual fashion. The majority of patients with fibromyalgia go through a period of intense manifestation and reduced remission of symptoms at various times. While fibromyalgia symptoms may not be completely curable, most people may lessen their symptoms with medication and lifestyle modifications.
Complications Of Fibromyalgia
One or more of the following complications might result from fibromyalgia:
- – Increased rate of hospitalization
Individuals diagnosed with fibromyalgia are approximately two times more likely than those without the disorder to be hospitalized. Fibromyalgia patients are said to have 10 outpatient services annually and 1 hospitalization every 3 years.
- – Obesity and physical inactivity
Physical deconditioning resulting from fibromyalgia can occur due to a lack of physical exercise, which promotes fast degeneration of the muscles, skeleton, heart, and blood vessels. Obesity is increased by deconditioning and a lack of physical exercise.
- – Metabolic Syndrome
Metabolic syndrome is a collection of comorbid medical problems that raises the chance of having type 2 diabetes, strokes, and cardiovascular problems. High glucose levels, hypertension, extra body fat around the waist, and elevated lipid or triglyceride levels are examples of these disorders.
- – Significant functional disability
Fibromyalgia is commonly accompanied by other symptoms such as tiredness, cognitive dysfunction fog, headaches, and insomnia, in addition to pain. These symptoms might make doing daily duties difficult.
- – Anxiety and severe depression
Fibromyalgia patients are nearly three times as likely as non-fibromyalgia patients to suffer from serious depression. Therefore, screening for sadness and anxiety is critical in this group of patients (4). Fibromyalgia yoga helps to focus the mind and reduces the emotional distress associated with the disease.
Diagnosis Of Fibromyalgia
During the examination, the doctor will also test the sensitive sites; if 11 of the 18 most frequent locations are painful and the patient has had generalized pain for a minimum of three months, a fibromyalgia diagnosis could be provided. Furthermore, to be termed generalized, fibromyalgia pain must impact both the left and right sides of one’s body, as well as above and below the waist.
Also, a proper diagnosis is made after fibromyalgia mimics such as lupus are ruled out. The department of veterans also requires a diagnosis of this disease by a rheumatologist before assigning a fibromyalgia VA rating (9).
Treatment Of Fibromyalgia
Fibromyalgia has no known treatment. However, both non-drug and drug-based therapies can be used to address the symptoms. Multiple sorts of therapies are frequently used to attain the greatest results. The use of complementary and alternative medicine like fibromyalgia yoga, tai chi, and qigong for the management of fibromyalgia has been employed more in recent times (8).
Non-Drug Therapies: Individuals suffering from fibromyalgia should combine any recommended medications with non-drug therapies.
- – Physical activity is the most effective therapy for fibromyalgia, according to research. Any drug therapy should be supplemented with physical activity. Regular aerobic workouts for patients are most beneficial. Fibromyalgia Yoga and Tai Chi are two more body-based treatments that help reduce fibromyalgia symptoms. Low-impact exercise will not hurt even when one feels to be in discomfort.
- – Cognitive behavioral therapy (CBT): The goal of cognitive behavioral therapy is to understand how beliefs and actions impact pain and other symptoms. Patients can learn various pain-relieving symptom management techniques with the use of CBT and associated therapies like mindfulness. Mindfulness is a non-religious meditation technique that helps to develop present-moment awareness. It trains patients to focus on the present environment. Fibromyalgia symptoms have been demonstrated to be greatly improved by mindfulness-based stress reduction techniques.
- – Acupuncture, chiropractic care and massage treatment are examples of complementary and alternative therapies (also known as CAM or integrative medicine) that can be effective in treating fibromyalgia symptoms. However, many of these therapies have not been well studied in fibromyalgia patients.
- – Sleep therapy: It’s essential to treat fibromyalgia risk factors and triggers, such as sleep apnea and mood disorders including stress, nervousness, panic disorder, and low mood. Other professionals like a therapist, psychiatrist, or sleep medicine physician may need to be involved in this.
Three medications have gotten the approval of the American Food and Drug Administration for the management of fibromyalgia. They include duloxetine marketed as Cymbalta and milnacipran marketed as Savella. These two medications alter some of the brain chemicals that regulate pain thresholds Fibromyalgia may also be treated with older medications that similarly influence these same brain chemicals. These include cyclobenzaprine and amitriptyline. Some people may or may not benefit from taking additional antidepressants. The medicine has different side effects.
Some pain medications also promote sleep, which helps with sleep issues. These include pregabalin (Pregabalin), amitriptyline (Elavil), gabapentin (Neurontin), and cyclobenzaprine (Flexeril) (Lyrica). Patients with fibromyalgia are not advised to take benzodiazepines or sleeping pills like zolpidem (Ambien) (5).
Fibromyalgia And Yoga
Significant musculoskeletal pain is a major symptom of fibromyalgia, which in turn affects sleep, thinking, and memory. Fibromyalgia is frequently seen by physicians as a form of arthritis. It hurts, much like common arthritic ailments do. But unlike arthritis, it doesn’t seriously harm the muscles or joints.
Although fibromyalgia can be treated with medications, there is evidence to support the benefits of exercise, movement and body awareness, and muscular strength training. All of these methods are combined in yoga, which may help with pain relief and muscular stiffness.
Several yoga positions have the potential to be of help to someone with fibromyalgia, however, a book published by Shoosh Crotzer titled ” Yoga for Fibromyalgia” suggests a few in particular. It is also important that before starting these forms of exercise, it is really essential to speak with a doctor. All of these postures have many modifications to accommodate patients’ skill levels.
It includes the following steps:
- – Lie on your back on the floor.
- – Bend your knees and place both feet flat on the floor.
- – Straighten the arms and, if feasible, clasp them beneath the body as you exhale and lift the tailbone off the floor, keeping the buttocks taut.
- – Maintain this position for 30-60 seconds.
- – Exhale softly as you roll your lower back and spine toward the floor
- – Place a rolled-up blanket beneath the shoulders to support the neck and prevent pain when laying face-up on the floor. Anyone who has had a neck injury in the past should avoid this position.
Standing forward Bend
It entails the following steps:
- – The first step is to place your feet hip-width apart.
- – From the hip joints, bend forward.
- – If feasible, place the palms or the tips of the fingers on the ground. People who are unable to touch the floor with their hands might instead rest their palms on their thighs or calves. After a minimum of 30 to 60 seconds, carefully roll your body up until you are standing straight. It may be preferable for someone with back pain to maintain their bent knees.
The cobra stance enables you to relax the chest muscles and stretch out fatigued legs. To achieve this position
- – Lie face-down on the ground with your palms facing up and your hands under your shoulders.
- – Reposition the elbows towards your body.
- – Take a deep breath in, press into your palms, and extend your arms until your upper body rises off the floor. Avoid raising the pelvis or feet off the ground.
- – Feel the lower back and the stretch over your chest.
- – Maintain the pose for 15–30 seconds, at which point you should drop it and go back to your initial position. Please note that this position should not be performed by anybody who is pregnant or suffering from carpal tunnel syndrome, or a lower back injury.
To perform the corpse stance, follow these steps:
- – Straighten out on your back.
- – Slowly inhale and exhale while picturing the body being filled with healing air.
- – As you inhale, see the energy reviving your body.
- – As you exhale, feel the stress and discomfort released.
- – Hold the position until you are ready to stop (6).
Fibromyalgia VA Rating
The severity of fibromyalgia in a patient determines the fibromyalgia VA rating by the VA. Percentages are used to represent disability ratings. The VA considers the following factors when determining disability rating:
- – Medical history
- – The outcome of the VA claim test, if one was necessary.
- – Any information obtained from outside sources such as called a Statement in Support of Claim
- – The Code of Federal Regulations, Title 38, 4.71a diagnostic code 5025, covers the VA disability ratings for fibromyalgia. Fibromyalgia may be classified as having a 40%, 20%, or 10% disability level.
- – Symptoms that are continuous or almost constant and fail to respond to treatment are assigned a rating of 40%.
- – Episodic symptoms that occur greater than a third of the time and are exacerbated or worsened by particular triggers are assigned a rating of 20%
- – Symptoms that necessitate ongoing medication are assigned a rating of 10% (7).
- 1. https://www.cdc.gov/arthritis/basics/fibromyalgia.htm
- 2. https://www.medicalnewstoday.com/articles/147083#treatment
- 3. https://www.healthline.com/health/fibromyalgia#tender-points
- 4. https://www.painscale.com/article/progression-and-potential-complications-of-fibromyalgia
- 5. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Fibromyalgia
- 6. https://www.medicalnewstoday.com/articles/315142#poses