Tuesday, January 10, 2012

Fibromyalgia Unveiled – Signs and Symptoms

We have seen that the 1990 ACR criteria classified fibromyalgia by using mainly two classifiers: chronic widespread pain and highly painful tender points, which also is called allodynia. It was understood though that other symptoms were present, too, like fatigue, non-restorative sleep, morning stiffness, and others as well. But aren’t there more signs and symptoms? There are of course as we know nowadays. Actually you might hardly find symptoms that might not be associated with fibromyalgia.

Let’s go through some of these signs and symptoms:

Joints: might be painful and stiff in the morning, lots of patients complain about lacking the right grip so that things like a cup fall out their hands.

Muscles: might ache, twitch, and feel exhausted even after a light exercise. Sometimes fibromyalgia patients suffer at the same time from myofascial pain syndrome (this disease is characterized by trigger points, not to confound with tender points).

Tendons: might feel too short.

Skin: might feel bruised (“as if I had a boxing match all night long”), Stroking might lead to pain (allodynia), or it feels tinglish.

Heart: might feel like beating irregular, be palpatating, or be painful, and the cardiologist tells the patient: everything’s fine.

Lungs: fibromyalgia patients might feel out of breath without exercise.

Bowels: there might be functional bowel disturbaces like irritable bowel syndrome.

Urinary tract and reproductive system: problems urinating, even stress incontinence, interstitial cystitis, dysmenorrhea.

Eyes: might feel dry though patients might weep and produce profuse tears (doesn’t contradict!).

Sensory organs: might be hyperirritable, e.g. noise, bright light, odours.

Systemic symptoms: might include cold symptoms like rhinitis or cough with normal inflammatory lab tests or weight gain without eating more than usual.

Central symptoms: might include cognitive dysfunction (e.g. having to start again after reading only two pages – the term for this condition is fibrofog), impaired concentration, problem with short memory, sleep disorders, dizziness, headaches, depressive mood, anxiety, catastrophizing.

All in all, fibromyalgia started as a pain disorder, but as it turned out fibromyalgia is much more. The severity of symptoms might bring the patient to seek assistance with other specialists like the cardiologist and might lead to an odyssey within the medical system.

Take home message: pain might be the principle complaint in fibromyalgia, but it is much more.

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