After osteoarthritis, the second most common musculoskeletal condition that affects a lot of people is fibromyalgia, which is very often misdiagnosed and misunderstood. Fibromyalgia occurs in the form of fatigue, joint pain and widespread muscle pain among other symptoms. It can easily develop into something that causes social isolation and depression.

What is Fibromyalgia syndrome?
A set of symptoms is known as a syndrome and when they exist together, they point towards the presence of a specific disease or an increased chance of the disease developing in the system.

• Decreased pain threshold
• Sensitive tender points
• Depression
• Social anxiety
• Widespread pain
• Debilitating fatigue

It has been observed that nearly 12 million Americans are diagnosed with fibromyalgia; it has also been noted that women are ten times more likely to contract this disease as compared to men, and they usually fall in the age bracket of 25 to 60 years.

Fibromyalgia symptoms
The most common symptom of fibromyalgia is constant ache all over the body and crippling fatigue. One of the most common symptoms is feeling fatigued even after a whole night’s sleep. There may be specific tender points on the body that may be painful to touch and deep and restful sleep cycles may also be punctuated by disturbances because of mood swings. Depression is also a common indication of fibromyalgia.

Regarding muscles, it often feels like the muscles are pulled or overworked even without any strenuous exercise. Muscles may also burn, twitch or experience deep stabbing pains. Some people suffering from fibromyalgia may also experience achiness and pain around the back, shoulders, necks, joints, and hips, making it difficult to exercise or sleep. Some other symptoms that are common to other illnesses but may also indicate towards fibromyalgia are:

• Dryness in eyes, mouth, and nose
• Abdominal pain
• Numbness or tingle sensation in feet and fingers
• Hypersensitivity to cold or heat or both
• Chronic headaches
• Incontinence
• Irritable bowel syndrome
• Fibro fog or inability to concentrate
• Overall stiffness

The signs of fibromyalgia are very similar to those of tendinitis, osteoarthritis, and bursitis, which are often classified by experts under a type of arthritis and its related disorders. The pain and stiffness of fibromyalgia are widespread and not centered as it is localized in other disorders like tendinitis and bursitis.

Tests to diagnose Fibromyalgia
A comprehensive physical exam and medical history are required to make an accurate diagnosis of fibromyalgia. Specific blood tests may also be required to rule out other treatable or more serious illnesses and disorders. A complete blood count or CBC test may be required, blood chemistry to mark out levels of different enzymes, nutrients, and calcium in the blood may be required. Since an underactive thyroid often causes fatigue like symptoms similar to fibromyalgia, a thyroid test is done to rule out the problem.

Other laboratory tests that are usually done to rule out serious illnesses include rheumatoid factor (RF), Lyme titers, erythrocyte or red blood cell sedimentation rate, calcium levels, antinuclear antibodies ANA, and vitamin D levels.

A diagnostic criterion for fibromyalgia syndrome has been put in place by the American College of Rheumatology, and most doctors follow the guidelines to see if the symptoms match the given criteria. A persistent widespread pain for 3 months or more is included in this criteria and can refer to pain on both left and right sides of the body, including the mid and lower back, chest, sides, neck, etc. Tender points of the body formerly used to diagnose fibromyalgia are also an important factor.

The doctor also needs to evaluate the severity of other related symptoms like sleep disturbances, mood disorders and fatigue that can help measure the impact of fibromyalgia disorder on the emotional and physical functioning of the patient.

Treatment for Fibromyalgia
Presently, no cure has been found for fibromyalgia. There is also no comprehensive treatment that can handle all the symptoms of fibromyalgia. This often difficult syndrome is best dealt by combining different treatments, both alternative and traditional, to manage the disorder effectively. A combination of exercises and medications that help with aerobic conditioning and strengthening along with behavioral techniques may be required.

Drugs to Treat Fibromyalgia
In case of fibromyalgia, drugs usually only treat the symptoms, as stated by the American College of Rheumatology. Three drugs have been approved by the FDA:

• Cymbalta
• Lyrica
• Savella

Savella and Cymbalta are a class of drugs referred to as serotonin and norepinephrine reuptake inhibitors (SNRIs) while Lyrica is also used in cases of diabetes, shingles and spinal cord injuries for nerve and is also known to help with fibromyalgia pain for certain patients. Opioid pain drugs are usually avoided as they can cause drug dependency issues in the long run. Consult a doctor if any of the symptoms are experienced and before taking any medications.