Fibromyalgia

vwgirl · Mar 20, 2004

Fibro patients classically have "non-restorative sleep"; they rarely get into the deep sleep stage, no matter how tired they are. The diagnostic criteria for fibro as far as the aches and pains go are defined by 18 tender points that must be painful upon palpation with 4 kg of force. Just having regular ol' "muscle aches" after a hard day doesn't do it for a diagnosis.

teeituptom, BSN, RN · Mar 20, 2004

Very Interesting

teeituptom, BSN, RN · Mar 20, 2004

Very Interesting

Editorial Team / Admin · Mar 20, 2004

Thank you vwgirl. I personally haven't researched this, have only observed what my friend endures. Peace to all. :)

veetach · Mar 20, 2004

who else sees the direct correlation between Fibromyalgia and the Chronic Fatigue Syndrome that we dont hear about anymore?

Depression is a real condition, as for the other two, I am highly doubtful. I dont want to offend anyone, but usually these patients are very proud of their diagnosis. And they remind me of this many times while I am taking care of their "exacerbation".

molecule · Mar 20, 2004

my hunch is there are an array of auto-immune disorders triggered by stress. Our modern lives are wearing people out with poor diet, too little excercise, social isolation, toxic assaults and on and on. as is our way we will look to weaknesses in the individuals while neglecting the public health implications.

Brickman · Mar 20, 2004

Have there been any double blind studies treating Fibromyalgia with antidepressants?

CCU NRS · Mar 20, 2004

Fibro patients classically have "non-restorative sleep"; they rarely get into the deep sleep stage, no matter how tired they are. The diagnostic criteria for fibro as far as the aches and pains go are defined by 18 tender points that must be painful upon palpation with 4 kg of force. Just having regular ol' "muscle aches" after a hard day doesn't do it for a diagnosis.

Is this a new qualifier, I was under the impression that FM was basically Dx'd by R/O everything else?

I know that many people seem to have a Dx of depression first and C/O unrelenting/undefinded abd. pain that is only alleviated by narcs and these same people have usually been R/O for every possible GI ailment.

There is often a large correlation between abd. disorders and depression, IBS, reflux, etc. with these the chicken and egg theory has often been applied.

I personally tend to see FM Dx's when nothing will help with pain except narcotic intervention. Is this because there is FM or because there is no real problem except a need for narcs?

Pediatric Critical Care Columnist · Mar 20, 2004

The "tender point" diagnostic criterion has been in use for several years. An individual should have 11 or more of the 18 points elicit pain when pressed by an examiner, but not all tender points are painful all the time, so a number of exams are often needed. The pain I experience when my tender points are pressed is exquisite, but completely different from muscle strain pain. The worst ones are on either side of my sacrum. It's a very bad thing when my hubby is giving me a back massage and forgets... especially since I have had an occupational back injury and that's where it hurts when I aggravate it. I fortunately don't have a sensation of pain all the time, only when I'm very tired, but those tender points hurt whenever and however they're pushed. Since I started walking my dog daily and taking 5-HTP to help me get a better sleep, I feel much better. No narcs for me... if there's one thing I hate worse than pain, it's barfing! No TCAs either.

vwgirl · Mar 21, 2004

Is this a new qualifier, I was under the impression that FM was basically Dx'd by R/O everything else?
I know that many people seem to have a Dx of depression first and C/O unrelenting/undefinded abd. pain that is only alleviated by narcs and these same people have usually been R/O for every possible GI ailment.
There is often a large correlation between abd. disorders and depression, IBS, reflux, etc. with these the chicken and egg theory has often been applied.
I personally tend to see FM Dx's when nothing will help with pain except narcotic intervention. Is this because there is FM or because there is no real problem except a need for narcs?

The 18 tender points are the diagnostic qualification used by the American Academy of Rheumatology, which is the subspecialty that treats fibro patients. My friend who has fibro is a recovering drug addict with 15 years clean; her fribo did not manifest itself until she had over 8 years free of drugs and alcohol. But I do suspect that all the toxins she ingested over the years of active addiction could have blown her immune system. The research I did for my paper pointed strongly towards and autoimmune response being responsible for this disease. BTW, there is still no "definitive" answer as to what causes depression, which is finally recognized as a legitimate disorder. Just because we don't have all the answers doesn't mean we need to blow off that possibility that a disease process exists, painfull and debilitating.

teeituptom, BSN, RN · Mar 23, 2004

My sister who I love has been Dxed with FM

they have her on so many meds from antidepressants to narcotics. And she is a nurse.

But if she was a nurse here in Texas I would myself turn her into the BNE as an inpaired nurse.

ScarlettRN · Mar 25, 2004

about oh, 7 years ago, I had two separate anaphylactic reactions to first naproxin sodium and then to motrin. This has devistated me, because I had lived on motrin for years to take care of my endometriosis. In 99, I hurt my back and it just didn't get better. I had to take lortab as the lowest level pain reliever after regular tylenol. Between the endometriosis and the lbp, I could not catch a break. My doctor sent me to a "pain doctor" later the same year I got hurt and there I stayed, personally restricting how much narcotic was prescribed and more than once refusing oxycontin from him. Fast forward to last summer. After 5 abdominal surgeries in 2 years, I learned two things about my body. First, my pelvis was so twisted out of alignment my GP came into the room after seeing an actual X-ray of my back and pelvis,(first one in about 4 years) and asked me if my back always hurt. (duh) The second thing I learned was that there was so much scar tissue in my abdomen and it was wrapped around my bowel in the same general area as my back pain, that once the scar tissue was removed, the pain in my back lessened to a degree. It was this past summer that the pain doc told me I probably would not get better and called it FM for the first time. I sat down with one of the ER docs I trust and when I found out what FM was, I REFUSED TO ACCEPT the diagnosis. My insurance was not going to pay for it, so out of pocket I started going to a physical therapist who specializes in chronic pain. After a solid month of PT, we got my pelvis moved back where it needed to be, and all of a sudden, I didn't hurt any more.

The conclusion of this is that *I* had control over my health, ultimately. I was depressed about the pain and it was a viscious cycle that, once it was pointed out to me and I was sick enough of the way I was living, I got aggressive and dealt with it.

I still get back pain after working, but it isn't crippling. I am going to stay on antidepressants until I have been free of the chronic back pain for one year, then I will be FREE!!!!