PT Weekly: Fibromyalgia in Women

Fibromyalgia(FM) is also called fibromyalgia syndrome. A syndrome is a group of symptoms that happen together. Fibromyalgia is a syndrome of unknown etiology characterized by chronic wide spread pain, increased tenderness to palpation and additional symptoms such as disturbed sleep, stiffness, fatigue and psychological distress

The condition affects both sexes, although women are far more likely to develop fibromyalgia than men. While anyone can get fibromyalgia, hormones are thought to be a possible explanation for this gender bias.

Causes and Risk Factors

The causes of fibromyalgia are unclear. Researchers are not sure exactly what causes fibromyalgia. Studies has shown that fibromyalgia may be caused by a problem in the brain with nerves and pain signals. In other words, in people with fibromyalgia, the brain misunderstands everyday pain and other sensory experiences, making the person more sensitive to pressure, temperature (hot or cold), bright lights, and noise compared to people who do not have it. Fibromyalgia unlike arthritis does not cause redness and swelling, or damage to the joints.

Since the disorder primarily occurs in women, being female is a risk factor. Other risk factors that increase the chances of developing fibromyalgia may include:

• Familial history. Fibromyalgia may run in the family.
• Anxiety or Long term stress
• Depression.
• Painful diseases such as arthritis.
• Physical abuse.
• Physical trauma such as a road traffic accident
• Physical inactivity.
• History of serious infections

How is Fibromyalgia Diagnosed?

Chronic fatigue syndromes (CFS) and fibromyalgia are basically diagnosed using elimination process. In other words, several conditions (Differentials) that may present almost the same symptoms with fibromyalgia will be ruled out one after the other by your doctor or Rheumatologist, as no single test confirms the condition.

Conditions that can present the features of fibromyalgia include an underactive thyroid (hypothyroidism), vitamin D deficiency, rheumatoid arthritis and even sleep apnoea.

Fibromyalgia Symptoms

General Symptoms of fibromyalgia may include the following:

• Widespread body pain
• Sensitivity to temperature drops, loud noises, and bright lights
• Trouble remembering and concentrating
• Headaches, including migraines that cause nausea and vomiting
• Restless legs syndrome, a creepy, crawly feeling in the legs that disturb sleep.
• Fatigue
• Temporomandibular joint disorders
• Feeling nervous or depressed
• Constipation
• Numbness in face, arms, and legs

Symptoms of fibromyalgia specific to women:

• Stronger menstrual pain

Menstrual period cramps can be mild or painful, depending on the woman. In a report by the National Fibromyalgia Association, women with this condition have more painful periods than usual. Whether or not something else is going on during the menstrual cycle, it’s likely that normal discomfort associated with the period is worse for someone with fibromyalgia.

Most women with fibromyalgia are also between the ages of 40 to 55 years old. Fibromyalgia symptoms may feel worse in women who are postmenopausal or are experiencing menopause.

Menopause with fibromyalgia may increase feelings of:

• crankiness
• soreness
• achiness
• anxiety

The body produces about 40 percent less estrogen after menopause. Estrogen is a huge player in controlling serotonin, which controls pain and mood. Some fibromyalgia symptoms can mirror symptoms of perimenopause, or “around menopause.”

These symptoms include:

• pain
• tenderness
• lack of quality sleep
• trouble with memory or thinking through processes
• depression
• Endometrosis

Some women with fibromyalgia also have endometriosis. In this condition, tissue from the uterus grows in other parts of the pelvis. Fibromyalgia can also increase the discomfort that endometriosis causes on its own.

• Increased bladder pain and bowel problems

Fibromyalgia can make worse other issues related to Chronic Pelvic Pain Disease, such as irritable bowel syndrome (IBS) and painful bladder syndrome (PBS). Studies show that IBS is also more common in women. Roughly 12 to 24 percent of women have it, while just 5 to 9 percent of men have IBS.

IBS and PBS can cause:

• pain or cramps in the lower abdomen
• pain during intercourse
• pain during urination
• pressure on the bladder
• Increase frequency of urination

Fibromyalgia and Physiotherapy

Physiotherapy plays an important role in the management of fibromyalgia. While medication mainly focus on pain reduction, physiotherapy is aimed at disease consequences such as pain, fatigue, de-conditioning, muscle weakness and sleep disturbances and other disease consequences.

Part of the treatment is education. Understanding symptoms of fibromyalgia and how it impacts your life can help you reduce anxiety. Relaxation and mobility exercises are also incorporated in the treatment programs. These exercises seek to show proper posture, reduce muscle tension, and improve flexibility. Along with appropriate exercises, you can also improve your eating and sleeping habits. This translates to better physical and mental health.

Basically, the treatment can be divided into 2 main types.

Both can help prevent painful fibromyalgia flare-ups.

Passive treatments, such as massage, thermotherapy etc

Active treatments, such as flexibility exercises.

Passive Treatments for Fibromyalgia

• Deep tissue massage: A massage therapist uses pressure to decrease muscle tension and muscle spasms.
• Heat therapy: Heat deeply relaxes your muscles and gets blood to flow to the painful area faster. This therapy can be used with dry heat (eg, a dry, hot towel) or moist heat (eg, hydrocolator pack).
• Hydrotherapy: This treatment involves reducing your pain using water. For example, you may sit in warm water to relieve pain and muscle stiffness.
• Transcutaneous electrical nerve stimulation (TENS): This treatment decreases fibromyalgia-related pain by blocking pain signals from reaching your spinal cord. It also reduces muscle spasms and triggers the release of endorphins (natural pain killers your brain produces).
• Ultrasound: Using sound waves, this treatment produces a gentle heat that enhances blood flow to deep tissues. Ultrasound can help decrease pain, inflammation, stiffness, and muscle spasms.

Active Treatments for Fibromyalgia

• Low-impact aerobic exercise: This type of exercise is gentle yet highly effective. An example of low-impact aerobic exercise is water aerobics.
• Strengthening and flexibility exercises: These exercises help build muscle strength and improve your range of motion.

At PCA, our physical therapist will design a physical therapy program to fit your needs. While there seems to be no single best treatment option, physical therapy seem to reduce disease consequences.

A multidisciplinary approach in a well balanced program may be the most promising strategy and is currently recommended in the treatment of fibromyalgia.

Call us today on 0813 028 0496 to find out more!