Fibromyalgia is a common condition whereby the smallest sensory nerve endings in the skin cause pain amplification due to central sensitization. Pain amplification can be understood similarly to when your radio speakers’ volume is turned all the way up on the loudest setting. Central sensitization refers to when the nervous system undergoes a wind-up process and becomes regulated into a chronic state of high reactivity.
Fibromyalgia is not an autoimmune, inflammation, or primary joint or muscle disorder. As described, it is currently best described as a disorder of overactive nerve signal interpretation by the brain, also known as a “small fiber sensory neuropathy.”
What are symptoms?
Patients with fibromyalgia can have very varied symptoms. Symptoms can present all over the body such as head-to-toe pain in response to light touch, unexplainable fatigue and feeling ‘hit by a bus,’ muscle and joint pain, cognition and memory problems. Fibromyalgia can commonly co-exist with other conditions such as migraines, anxiety, depression, temporomandibular joint (TMJ) dysfunction, and irritable bowel syndrome (IBS). It can also co-exist with urinary and pelvic problems such as interstitial cystitis and chronic pelvic pain.
How is Fibromyalgia diagnosed?
Fibromyalgia is a diagnosis of exclusion and the role of the rheumatologist to rule out potentially serious condition mimics such as lupus, myositis, or rheumatoid arthritis. As described above, this disorder of the nervous system is called “small fiber sensory neuropathy” and is verifiable via a skin biopsy performed by a neurologist. Another diagnostic test neurologists perform to diagnose small fiber sensory neuropathy is a process called thermoregulatory sweat testing.
How is it treated?
There is no cure for fibromyalgia and the best treatment is a multifactorial approach. Your rheumatologist can help sort out the diagnosis and also rule out primary rheumatologic illness, as well as coordinate with a neurologist who may recommend nerve pain medications. Lifestyle measures are also very important in managing fibromyalgia symptoms. This involves optimizing sleep hygiene habits, minimizing stressors, nutritious eating, and doing graded aerobic exercises. There has been research indicating that tai chi and aquatic therapy can be beneficial in improving fibromyalgia symptoms.
Schedule Your Appointment
You can schedule an appointment with Dr. Lomibao by calling our office or filling out our Request Appointment form. Lomibao Rheumatology & Wellness Care is a full-service rheumatology clinic with an on-site infusion lounge and telehealth services available for established patients. Lomibao Rheumatology & Wellness Care is currently accepting new patients, and we welcome you to join our family by contacting us today!
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