Working with Special Populations Part I: Fibromyalgia

Working With Fibromyalgia Part I: Fibromyalgia

Fibromyalgia (FM) is a chronic pain disorder characterized by widespread musculoskeletal symptoms including fatigue, muscle spasms, joint stiffness, cognitive dysfunction and sleep disturbances. FM affects approximately 5% of the population.[1]

It is estimated that up to 50 million Americans have some form of fibromyalgia, although it may affect individuals from any age group.[2][3] Approximately 20–30% of patients experience severe or debilitating pain at least once every year,[4] which increases with age.[5] The average life expectancy for those affected by FM is 15 years less than the general population, and many die before their 60th birthday[6].

The most common symptom of FM is fatigue, which can range from mild to severe and last for weeks, months or even years. Other symptoms include muscle aches, headaches, back pain, joint pain and other types of discomfort such as numbness or tingling sensations. Some people experience these symptoms without having any physical problems; others develop them after experiencing certain medical conditions.[7]

There are no known causes for FM. However, there are several theories about its origin. It can be congenital, or it can happen after an infection (such as a virus), trauma or stressful event. The most common cause is thought to be psychological stress, however it is now believed that this may be a result of the disease rather than a potential cause.

Some researchers believe that FM may be the result of a dysregulation in the body’s natural painkiller system.

It is also thought that several trauma, disorders or illnesses may trigger FM in people who are already vulnerable to developing the disease. Certain studies have indicated a link between autoimmune disorders and FM; others have suggested that cancer patients are more likely to develop the disease, however this could be explained by the fact that cancer patients receive higher doses of pain medication. It has also been suggested that pesticides, herbicides and other toxic chemicals may play a role in the development of the disease.

There are two accepted ways to diagnose fibromyalgia: using the 2010 ACR clinical diagnostic criteria or the 2011 MEAC clinical diagnostic criteria. The first set of criteria is used to identify people who have a combination of widespread pain and the 11 specific tender point criteria, while the second set focuses on diagnosing people with widespread pain without the presence of tender points. Other ways to diagnose fibromyalgia include checking a patient’s symptoms and ruling out other disorders that may produce similar symptoms.

There is no known cure for fibromyalgia; however, there are treatments that can alleviate the pain and other symptoms associated with the disease. The most common treatment is a combination of exercise, proper diet, sleep management and cognitive behavioral therapy. Other options include anti-depressants and opioid-based medication. Some patients are also given Botox injections to alleviate pain in the neck and shoulders.

Others require spinal injections and surgery. There is also a drug called Milnacipran that has been approved by the FDA to treat the depressive symptoms of fibromyalgia.

Some patients with FM choose to undergo a minor surgical procedure known as medial branch block, which involves injecting an anesthetic near the nerve that connects to the neck and shoulder. This interrupts the pain signals being sent from those areas to the brain. However, this method may not be successful in all patients.

Working with Special Populations Part I: Fibromyalgia - Image

There are also alternative treatments such as acupuncture, massage therapy, yoga, hypnotherapy and reflexology. Additionally, many patients use natural supplements like fish oil, vitamin D3 and magnesium to reduce pain and anxiety. Some may opt to use homeopathic or herbal remedies such as Devil’s Claw, passionflower or valerian. Aromatherapy can also help to relieve pain and promote relaxation.

Most people with fibromyalgia are able to perform daily activities, although many struggle with fatigue, stress and muscular problems. Patients must also learn how to manage stress in their lives since this can make symptoms worse. Additionally, it is advised that those with the disease stay physically active and exercise to promote overall health.

As of now, there is no cure for fibromyalgia and many patients face a slow, uphill battle to alleviate their pain. The condition must be constantly monitored since some symptoms may worsen over time. Patients must remain persistent in their fight and make lifestyle changes to improve the quality of their life.

Fibromyalgia is a chronic condition that affects millions of people. Although there is no known cure for the disease, many patients can manage their pain with proper treatment and self-care. Those who suffer from this condition must remain persistent in their fight against it and never give up hope.

~ Mental Health Facts ~

• 1 in 5 Americans aged 12 years or older experiences a mental illness in a year.

Sources & references used in this article:

Working with Special Populations Part I: Fibromyalgia by A Larsen –

Fibromyalgia and disability: Report of the Moss International Working Group on medico-legal aspects of chronic widespread musculoskeletal pain complaints and … by F Wolfe, T Aarflot, D Bruusgaard… – Scandinavian journal …, 1995 – Taylor & Francis

Multidisciplinary rehabilitation for fibromyalgia and musculoskeletal pain in working age adults by KA Karjalainen, A Malmivaara… – Cochrane Database …, 1999 –

Sexual and physical abuse in women with fibromyalgia syndrome by MH Boisset‐Pioro, JM Esdaile… – Arthritis & Rheumatism …, 1995 – Wiley Online Library

Effects of COMT Genotypes on Working Memory Performance in Fibromyalgia Patients by D Ferrera, F Gómez-Esquer, I Peláez, P Barjola… – Journal of Clinical …, 2020 –

NSCA’s Essentials of Training Special Populations by PL Jacobs – 2017 –

Effects of lifestyle physical activity on perceived symptoms and physical function in adults with fibromyalgia: results of a randomized trial by KR Fontaine, L Conn, DJ Clauw – Arthritis research & therapy, 2010 – Springer

A population study of the incidence of fibromyalgia among women aged 26-55 yr. by KO Forseth, JT Gran, G Husby – British journal of rheumatology, 1997 –

The Value of Transcranial Direct Current Stimulation in Improving Working Memory in Neurotypical and Special Populations by J Utterback – 2020 –