Fibromyalgia: You and your Physician

Fibromyalgia: You and your Physician

If you are experiencing fatigue, pain, and disruptive sleep you may be concerned that you have fibromyalgia. Fibromyalgia syndrome is a chronic disease that is difficult to diagnose, has no known cause, and is not curable. However, it is treatable. Your primary care physician is the point person in the first steps of your successful management of this condition.

What is Fibromyalgia?

Fibromyalgia syndrome is a common disease that affects up to five percent of the population

[1] Patients with fibromyalgia report the following symptoms:

  • Fatigue
  • Disruptive sleep
  • Memory problems
  • Anxiety and depression
  • Tenderness and soreness of muscles and joints
  • Pain

While there is no defined cause of the disease, current research is pointing to disruptions in the central nervous system’s pain processing ability. This research describes how the brain in a fibromyalgia patient processes pain signals abnormally, due to alterations in the central nervous system. The abnormality in brain function causes the pain levels in fibromyalgia patients to increase.

The Treatment of Fibromyalgia

Your primary care physician will diagnosis and treat your fibromyalgia. Every fibromyalgia patient is different and no one treatment works for all fibromyalgia symptoms. Your treatment plan will be individualized and based on your medical history and lifestyle factors as well as your disease.

A key component to your treatment normally includes completion of the Fibromyalgia Impact Questionnaire. This simple questionnaire will help your physician assess your level of pain.[2] The doctor will use this questionnaire, along with your medical history, a physical exam, and other diagnostic tests in making a diagnosis.

Physicians use a variety of approaches to treat fibromyalgia. Your treatment may include medications, sleep therapy, cognitive and behavioral therapy, and diet and exercise changes. In addition, you must be active in the treatment and work with your doctor to manage your care.

Your primary care physician will treat you in three major areas:

Pharmacotherapy: Your physician will implement the use of medicines to help alleviate pain and other symptoms associated with fibromyalgia syndrome. Common medicines used to treat this condition include over-the-counter anti-inflammatories, prescription pain medications, and anti- depressants.[3] New medications are now available that treat depression and pain. These medications are working well for many fibromyalgia patients.

In addition to prescribing your medications, your primary care physician will work with you to ensure you are receiving the right dosages and the medications are working as they should. You may go through a trial and error period before you hit on the right medications.

Your pharmacist will become a member of your health care management team. He or she will work with you and your physician to discover the proper dosages of medications.

Non-pharmacological Treatments: In addition to medicine, your primary care physician will ‘prescribe’ other treatments to help ease your symptoms. You can expect to implement an exercise routine and make changes to your current diet. You may begin visits to a physical therapist, a rheumatologist, or other health care professional.

One of the best treatment recommendations for fibromyalgia your physician will give you is exercise. Fibromyalgia patients report more pain when they are at rest than when they are active. Your physician will encourage you to start exercising at a slow rate and work up to a moderate exercise program level two to three times per week.

Sleep disorders are also common in fibromyalgia patients and can be treated without medication. If you have non-restive sleep you may be asked to seek help from a sleep therapist. You physician will encourage you to place a priority on getting sleep every night and give you advice on how diet and exercise can play a positive role in healthy sleep.

Associated Conditions: There are many conditions that are frequently associated with fibromyalgia syndrome. Depression, stress, anxiety, weight gain, migraines, and other health problems are common complaints of patients with fibromyalgia.

If you suffer from any of these conditions your primary care physician will treat the symptoms and/or refer you to a health care professional who specializes in the symptoms. For example, a large number of fibromyalgia patients suffer from mood disorders and benefit from seeing a psychiatrist.

Stress is another common symptom in fibromyalgia patients. One of the best methods of dealing with stress is group therapy. You physician may suggest you attend a fibromyalgia support group or group therapy sessions.

Expect to visit your primary care physician frequently during the diagnosis and early treatment stages of your condition. Once you and your physician have developed a management plan you will visit the office for regular appointments to monitor your progress. The goal of your treatment is to lessen your symptoms and to allow you to be as pain free as possible.

References

[1]  Fibromyalgia. (n.d.). Retrieved from Centers for Disease Control: www.cdc.gov/arthritis/basics/fibromyalgia.htm

[2]  Bennett, R. (n.d.). The Fibromyalgia Impact Questionaire: A Review of It’s Development, Current Version, Operating Characteristics, and Uses. Retrieved from Koenig Wellness: www.koenigwellness.com/clients/1084/documents/FMS_Impact_Questionnaire_Instructions.pdf

[3]  Treating Fibromyalgia. (n.d.). Retrieved from American Family Physician: www.aafp.org/afp/2000/1001/p1575.html

This article was originally published on July 11, 2012 and last revision and update of it was 9/7/2015