Health & Medical Pain Diseases

Understanding the Musculoskeletal Pain Syndrome - Fibromyalgia and Back Pain Part II

Fibromyalgia is one of two conditions known collectively as the musculoskeletal pain syndrome.
The constellation of symptoms expressed by fibromyalgia patients is often referred to as the fibromyalgia syndrome.
Fibromyalgia symptoms are found in approximately two percent of the population, it affects vastly more women than men, with reports of ratios are as high as ten to one, women to men.
Fibromyalgia, while difficult to diagnose, is usually found in individuals as early as childhood but predominantly in patients from twenty years of age to fifty.
Significantly, pregnant women are affected by this disorder in greater numbers than the remainder of women in the population.
The most notable symptoms of this widespread, often debilitating condition include: deep and throbbing low back pain; chronic, non-specific pain; painful trigger points, areas tender to the touch; and stiffness, sometimes known as morning stiffness.
Additionally, fibromyalgia is known to produce sleeplessness and sleep dysfunction, extreme fatigue, and even anxiety and depression.
In the previous article, "Understanding The Musculoskeletal Pain Syndrome: Fibromyalgia and Back Pain Part I," we discussed in some detail the various symptoms associated with the fibromyalgia syndrome.
In this article, we will specifically address fibromyalgia-related pain, its consequences, and possible treatment strategies.
Fibromyalgia pain is widespread and prevalent in more than ninety-seven percent of all patients with the disorder.
Fibromyalgia back pain, unlike other expressions of neck pain, back pain and/or sciatica is generally widespread and difficult, if not impossible, to pinpoint.
The pain may be felt in the tendons, the muscles, and even the ligaments surrounding the joints.
It has been described as ranging from slight and mild to acute and throbbing.
Other adjectives used to describe the pain are deep, sharp, dull, aching, tender, throbbing, sore, annoying, gnawing, burning, and many others.
For many fibromyalgia sufferers the pain is transitory, it comes and goes and may express itself at a variety of locations on or in the body.
In addition to deep and throbbing muscle aches and pains, individuals suffering from fibromyalgia may have what is referred to as "pain to the gentle touch" or allodynia.
This type of pain is expressed at various trigger points or specific locations sensitive to the touch.
The fibromyalgia trigger points are generally found at or near the joints.
Interestingly, it's the area around the joints that is the most sensitive.
In these areas, it may be at skin level and is not generally associated with the deeper, throbbing pain.
Once again, the pain associated with these trigger points may also be described as prickly or needle-sharp pain, rather than deep and throbbing in the body.
It must be understood, that while this pain is localized, and generally triggered by a "gentle touch" or allodynia, it is still extremely painful to the fibromyalgia sufferer.
Unfortunately, no one knows the etiology or cause of fibromyalgia.
Fibromyalgia is debilitating and often disabling, and patients often present with such significant levels of pain that it is almost impossible for them to function without accommodation.
The pain is found in the muscles, tendons, ligaments, joints, and, what has been referred to as, deep skeletal pain.
Pain associated with the fibromyalgia syndrome often varies in level and location from day to day.
While it is unclear what causes fibromyalgia, some possible explanations include some sort of physical or stress-related trauma or event, a psychologically or emotionally upsetting or stressful event, and/or a catastrophic illness or related immune disorder.
While researchers are still searching for the ultimate explanation, many believe that fibromyalgia is the result of any abnormal amount or imbalance of certain chemicals in the brain, particularly substance P, norepinephrine, dopamine and, perhaps most significantly, serotonin.
Consequently, pain levels usually in check for the "normal" individual are out of whack or out of proportion for the fibromyalgia sufferer.
It has been suggested, that fibromyalgia patients have their pain "volume control" set on high.
Finally and as stated previously, fibromyalgia pain is characterized as one of two types of pain, pain affecting the soft tissue and particularly the muscles, tendons, and ligaments around the joints, and the existence of trigger points at skin level, particularly around the joints.
As suggested in the previous article on this topic, and noted above, treatment should be holistic in nature bringing to bear the various disciplines and subdisciplines of medicine required to treat this controversial and little understood syndrome.
A combination of medications, particularly NSAIDs and antidepressants, along with behavioral therapy to deal with stress and anxiety-related conditions, as well as the depression, alternative medicine, and a thorough and complete, individualized and medically supervised exercise program should all be part of the treatment strategy.
Neck pain, back pain, and sciatica, as well as pain levels expressed at other areas the body, may remain problematic until a specific cause for the syndrome can be found and treated.
The prognosis can be good, depending on a number of factors, including but not limited to the individual fibromyalgia syndrome sufferer's motivation and adherence to the treatment strategy prescribed.
Any program must include a complete exercise program to help overcome the neck pain, back pain, and sciatica, and a program of education, both self and group administered.
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