Fibromyalgia sufferers are sensitive to a lot of things along with pain. Weather, stress, smell, and even the things they eat can affect them. Use of GMOs is the best among the things which can be of concern when you are trying to plan the diet for the best results while having fibromyalgia. The question arises whether GMOs can a play a role in worsening fibromyalgia symptoms or not.
GMOs refer to “genetically modified organisms”. It seems as one term but it actually has reference to a lot of different things as no rule is set on how the organism is modified genetically. This is the reason why fibromyalgia sufferers may find it a problem to use GMOs.
GMOs are the plants in which actual gene has been modified when it comes to crops like vegetables and fruits. It is usually not explained how they are modified. It could be modified through cross-pollination, cross-breeding or adding the chemicals directly to the plants.
If you think that you eat pork, beef and poultry from the animals that are fed with GMOs plants, you may also say that it is also considered that meat is also GMO if this meat comes from the animal who fed GMOs.
GMOs first use could be seen as a positive attempt. Areas in which foods like flood-ravaged states could not be produced; areas with drought-ridden swampland or areas of constant high or low temperatures were not have genetically modified plants in growth. People who might have starved were able to get the food by using GMOs.
The question has been asked as to whether chemical engineering usage has gone too far. This has caused the people to be encouraged in getting to purchase the organic food which is free of GMO and have foods that have a label of GMO. So people who have fibromyalgia can decide whether to take GMOs in their diet or not.
It is simply not easy to give a direct answer to this question because this term refers to a lot of different things. Has the food been genetically modified for it to adjust to some different land? Is it a cross-breed of different plants that are brought together? Or has it been grown with above the normal amount of herbicides and pesticides?
Whether GMOs can affect the fibromyalgia overwhelming pain and fatigue has the biggest factor which shows that we can’t define the GMOs as following one particular plan of the creation so it is not possible to pinpoint the health consequences.
For people with fibromyalgia, diet and chemical sensitivities play a huge role. There is a possibility that GMOs could be a problem in the health of people who suffer from fibromyalgia. With the GMOs, you don’t know exactly what you are eating and whether it will affect your fibromyalgia symptoms or not.
GMOs that would be taken under consideration are vegetables, fruits and legumes are grown for consumption, as well as GMOs that are given as a feed to animals who produce milk, lay eggs or being raised for consumption. As a result, a lot of possible sources of GMOs would occur which may or may not contain the substances that will affect fibromyalgia people’s health.
Unfortunately, no way is there by which we can know for sure about the substances that are an issue without knowing the beginning to finishing process of production of these foods, and for the consumer, that information is not available.
Currently, it is not necessary for the U.S to label the food that contains GMOs. Due to this fact, we all have consumed GMOs at some time somewhere.
The only way to avoid taking the food that contains GMOs is to stay away from the foods that may possibly have those in it, if the GMOs may make you sick. You would have to take the dairy products, meat labeled organic and have to purchase the prepared and canned food that is labeled as 100% GMO-free. Although it is not a legal requirement but a lot of companies have decided to put this on the labels.
You should try to purchase only organic foods for some time if you are having trouble in dealing with the symptoms of fibromyalgia-like muscle pain, severe fatigue, headaches and flu-like malaise under control, in order to see if helps in easing your health problems.
A new study suggests that using bad words can actually help in dealing with pain. If you are suffering from fibromyalgia, this may somehow benefit you in certain ways.
The study investigating the connection between swearing and pain was published in the journal NeuroReport. The experiment was conducted by comparing the amount of time in which participants can soak their hands in ice water.
67 students took part in the study. The students were also given an option of choosing their own expletive words and to repeat it at their own will. It has been found that when participants swear, they experience lesser pain. As such, they were able to keep their hands soaked in cold water for 40 seconds longer than those who didn’t swear.
Researchers believe that although cursing is not a socially accepted behavior, there is a reason to think that it actually comes with benefits. According to a psychologist, swearing is a common response to pain. Furthermore, he believes that there is an underlying reason why people would do it.
Although researchers are not certain how swearing helps fibromyalgia pain, they suggest that it may be due to that part of the brain affecting emotion. Previous studies have shown that the part of the brain linked to neutral language can be found in the left brain. On the other hand, curse words came from an ancient evolved instinct. Moreover, part of the brain that is responsible for such process can be found deep within the brain’s right hemisphere.
Researchers believe that amygdala is responsible for the reaction. Amygdala triggers the fight or flight response which increases heart rate. Hence it enables the body to be less sensitive to pain. Scientists of the aforementioned study have also backed this by explaining that the heart rates of students in the study increased when they swear. This therefore suggests that the amygdala indeed was aroused.
Experts suggest that if you suffer from pain as a result of fibromyalgia, you can try swearing. However, they caution that the words can begin to lose their emotional potency if they are being repeated excessively. Therefore, try to be creative by coming up with new bad words each time you feel pain due to fibromyalgia.
I can’t breathe, and there is an almost unbearable weight on my chest.
I feel like I’m being crushed and the pain is excruciating.
All I can hear is thump, thump, thump – although at this point I’m not sure if it’s the beat of my heart, or if it is more earth being thrown on top of me.
Fear has taken over every cell of my body as the panic rises within me, my face is burning hot, yet my extremities are as cold as ice.
The level of terror I feel should prevent me from moving. But, from somewhere deep inside of me, the will to survive surges through my very being and I desperately try to claw my way out, frantically scraping the earth away, exhausting myself in this seemingly futile effort.
Nevertheless, I continue through the haze of exhaustion. My clawing becomes slower and less effective. I can feel the will to go on slipping away from me.
And then I see it.
The smallest pin prick of light. It’s so far away that at first, I think I have imagined it.
But as it opens out to the size of a petit pois, I can’t deny it. Despite the pain and exhaustion, I get a surge of hope and this gives me just enough energy to go on.
The cycle repeats at varying intensity and intervals over time. Let me tell you what I mean.
When I was first diagnosed with fibromyalgia, I had already been through months – if not years – of searching for an answer. I was already exhausted and felt broken. But the diagnosis itself was hope for me because I thought that surely in this day and age, pain can be controlled…Can’t it?
Over the past five years, I have repeated this process of being buried alive more times than I care to remember. Sometimes the weight, pain and darkness have been so relentless that I didn’t even believe the light existed anymore.
I’m sure you get the picture of the things that can bring that suffocating darkness, but now let’s look at finding the light.
On the odd days, the pain is less – I can see the pin prick of light in the distance
The hope of a new therapy or treatment – allows some of the earth to fall away naturally
A friend or family member showing me love and compassion with kind words or by doing things to help make my life easier – this feels like they are shoveling the earth away from me.
A coworker or manager understands and offers kind words of support.
Constantly looking for beauty or hope is like clawing away some of the dirt.
All in all, we cannot rely on nor predict the good days or opportunities for new therapies. The only constants can be our own search for beauty, hope and the kindness of others to help us keep the darkness at bay.
If you know someone with a chronic illness don’t be afraid to ask how you can help. Often helping the person to feel validated and valued can be enough. Other times we may need help with something simple, like opening a bottle or writing a paragraph. So often those of us with chronic illnesses are terrible at asking for help, and just the offer of help is enough to remind us that the light still exists.
Fibromyalgia is a complex chronic pain syndrome which comes with many symptoms and complications that we do not expect. For example, one of the less known symptoms that fibromyalgia patients would often suffer from is fibroma. Fibroma is basically an enlarged and benign growth on the skin, which is often painful and can sometimes be dangerous.
Fibromas are basically growth tissues in the body. However, the term could cover a wide range of growths and nails down to what is causing the fibroma so difficult.
If you have heard of the term “skin tag”, then you may be familiar with fibromas. Skin tag, which is a small growth of the skin, is a type of fibroma. These are fairly common especially for seniors. This kind of fibroma is not dangerous and can be removed easily. Moreover, skin tags are not often painful, but this is not really the case for all sorts of fibromas.
Fibromas are more common among people who suffer from fibromyalgia. However, the reason behind this has not yet been fully understood.
What is known is that fibromas are common for those who are suffering from chronic diseases such as diabetes and autoimmune conditions. This barely explains why fibromyalgia will make you more susceptible to skin tags in the same manner. Yet, it is hardly surprising since anyone who has fibromyalgia is aware how the condition will seem to trigger endless complications.
As of the moment, fibromas are among those conditions that lack proper medical research so it is hard to tell why it is closely being linked to fibromyalgia.
The good news is that fibromas are normally benign. This means that they are not dangerous for you at all. However, the bad news is that there is not a proper way to treat them through medications.
Of course, it would be great if there were medications that could help to shrink and then eventually eliminate them. However, for most people, the only option would be surgery. On a good note, the surgery involved is a simple procedure and can be done as an outpatient procedure, especially for cases of skin tags.
During the surgery the growth is usually cut away using a scalpel. The surgeon will then use a laser to seal the blood vessels instantly, making the procedure almost bloodless and extremely safe for the patient. Thus, the surgery can be done in about fifteen minutes and will only leave behind a small scar. Moreover, it also makes the procedure to be extremely safe for the patient.
In most cases, skin tag growths do not really need to be taken off. However, they can be unsightly and embarrassing for the patient and this is why those who have this will tend to suffer from stress, not to mention the other symptoms that come with fibromyalgia.
Living with fibromyalgia can make every day a challenge. Chronic pain and severe exhaustion are the two most common symptoms. However, people who suffer from the condition often experience other symptoms, like depression, headaches, memory loss, sleep disturbances, irritable bowel syndrome, and more. These can make it very difficult to go to work every day, which leaves many people wondering, “Is fibromyalgia a disability?” Depending on the situation, it can be, but it comes with some caveats. Read on for details about fibromyalgia disability benefits you may qualify for and how to apply for them.
When people ask if fibromyalgia is considered a disability, they’re typically referring to workplace accommodations under the Americans with Disabilities Act (ADA) or Social Security disability claims. Not that this post should not be taken as legal advice, as it only scratches the surface of what you should know when it comes to benefits, work status, and qualifications. You can read more about chronic pain and disability benefits here.
The ADA doesn’t maintain a list of medical conditions that constitute a disability. Instead, there is a general definition of disability that you must meet. According to the ADA, you must have a physical or mental impairment that substantially limits one or more major life activities. This includes people who have a record of impairment, even if they do not currently have a disability. It also includes individuals who do not have a disability, but are regarded as having a disability.
The Social Security Administration (SSA), on the other hand, defines a disability as “a severe “medically determinable impairment,” also known as an MDI. We’ll discuss what qualifies as an MDI in further detail below.
Based on this information, the short answer is yes, fibromyalgia can be a disability in the way it affects your everyday life. But as for applying for and receiving Social Security benefits or ADA modifications, the answer will be based on factors related to your personal symptoms and overall health condition. While one person with fibromyalgia may be suffering with debilitating symptoms, another may find work and other daily activities more manageable. Fibromyalgia is a condition that can vary greatly from person to person, so the answer to the original question is also unique to that person.
Depending on the severity of your condition and the work you do, it may or may not be possible to work. Many people with fibromyalgia experience extreme tenderness when pressure is applied to the knees, thighs, hips, elbows, and neck.
For this reason, it is best to do a job that doesn’t require you to stay in one position for too long. Both standing and sitting for extended amounts of time can lead to more pain. Further, any job that requires heavy lifting or intense physical movement may also be too demanding in most cases.
If you wish to continue working, work with the Human Resources contact at your for the best methods on how to accommodate your fibromyalgia symptoms. Through ADA guidelines and recommendations, HR can work with you to offer several ways to make you more comfortable while you’re at work.
These are just a few possible fibromyalgia accommodation:
Alternative lighting, flexible scheduling, or a modified break schedule for attentiveness/concentration issues
Chairs with head support, standing desks, or stand-lean stools for daily movement
Reducing any physical requirements of the job
Counseling, therapy, or even a support animal for stress management
Walkers, scooters, or wheelchairs, as needed
This is just a sample of the many options that could allow you to continue working. Your HR team will determine the best solution on a case-by-case basis.
In order to make your condition best understood, you’ll need to provide a full explanation of your current diagnosis, symptoms, treatments, and limitations from your doctor. This documentation should be similar to what you’d provide in an application for disability.
The Social Security Administration maintains a list of adult impairments that may qualify for disability benefits. Unfortunately, fibromyalgia isn’t included. While it is one of the harder disability claims to win, it isn’t impossible. In order to qualify, you must prove to medical examiners that you’re suffering from a severe “medically determinable impairment,” also known as an MDI.
Social Security may consider fibromyalgia an MDI if both of these are true:
You have evidence of widespread chronic pain that has lasted at least three months
Laboratory testing, mris, and X-rays have ruled out other possible conditions
In addition, one of these must be present in your case:
Ongoing occurrence of at least six fibromyalgia symptoms, such as fatigue, cognitive/memory issues (also known as fibro fog), waking up exhausted, irritable bowel syndrome, depression, and anxiety
Positive tender point sites in at least 11 of 18 tested areas, above and below the waist and on both sides of the body
It’s important to note that even if you meet these requirements, you will still have to prove that you’re disabled. That means documenting reasons why you’re incapable of maintaining employment in any capacity, whether at your previous job or any other job.
The process of applying for fibromyalgia disability benefits is complex. Even if you are formally diagnosed, there are a number of factors you must be able to prove in order to qualify. This usually takes multiple visits with your doctor over a long period of time.
The following gives a brief overview of what you can expect, but it’s best to work with an attorney who is experienced with disability claims. They can give you exact guidance about how to apply for and receive benefits appropriate to your case.
Here’s what you can expect to do during the process.
The more documentation you can gather about your medical history, the better your application will be. First, a confirmed diagnosis will be necessary. Due to the nature of fibromyalgia, which typically has no confirmed cause, doctors often diagnose it when they can’t find any other cause of your ongoing pain. This is why it’s important to have a specialist diagnose you based on lab tests and the current fibromyalgia diagnostic criteria.
Furthermore, a Residual Functional Capacity (RFC) about your impairments is necessary for a thorough application. This is an overall evaluation of your capacity to complete certain job-related activities, including your ability to:
Lift or carry weight, and how often you’re able to do so
Stand, walk, or sit during a normal eight-hour work day, and how long you’re able to do so
In addition to a formal application, your diagnosis, and an RFC, there may be a few other things that will be critical to your success. You may need to include:
Contact information for all of your doctors, as well as the dates of your appointments, treatments, or hospitalizations
Health records of lab tests, psychological evaluations, and prescribed medications
A summary of your job history
The Social Security Administration will take everything you provide into consideration, so provide a very clear picture of your day-to-day challenges. A journal (paper or mobile-app based) is a great way to do this. Spend time each day jotting down how you felt and how symptoms limited your activities. This can help you paint a picture of what you’re coping with on a daily basis.
After you’ve gathered all of your materials, there are a few ways to file your application:
In person at your local social security office
Online
By phone at 1-800-772-1213 -or- TTY 1-800-325-0778 if you are deaf or hard of hearing
On average, it can take three to five months to hear back regarding disability benefit claims. In some cases, you may have to supply additional evidence or documentation.
During the application process, a team of doctors for the Social Security Administration will do a thorough review of your application. A psychologist on this team may also evaluate whether your case of fibromyalgia has resulted in any mental impairments. These are based on:
Once they’ve reviewed your application, they’ll determine if you receive disability benefits or not. You can typically appeal this decision, if they’ve denied your claim. An appeal is an additionally complex process, on top of an already complicated task. Work with your local health advocates or an attorney when undergoing an appeal.
Much like the other disability benefits we’ve discussed, fibromyalgia long-term disability benefits can be difficult to obtain. Most long-term disability insurance companies deny or limit these requests since the condition is usually based on self-reported symptoms. Many insurance companies specifically exclude fibromyalgia from coverage. Others consider it a mental disorder in order to limit payments to one or two years. Examine your policy carefully to understand if it is possible to receive benefits for fibromyalgia, and for how long. Work with your Human Resources team if you’re unsure about any of the language or policy coverage.
As previously discussed, if you plan to apply for these types of benefits, you will need to be prepared with as much documentation as possible. You should be seeking medical treatment from a specialist and keeping a detailed record of your symptoms. It will also help to have written opinions from your doctors regarding your limitations and current condition.
Only you and your medical team can determine if seeking disability benefits is the right course of action for you. These are a few questions you should ask yourself before seeking fibromyalgia disability benefits.
Before applying for disability, it’s important to take a look at your finances. Allsup provides a free online calculator to estimate how much you may receive on disability.
Ask yourself if you’re comfortable with this amount of monthly income. Will it be enough for you to continue living in the same home? Will you have enough for groceries, a car payment, and any other monthly costs? Evaluate whether it’s financially possible for you to leave your job.
A job provides much more than just a paycheck. It often gives us a sense of purpose and fulfillment. It’s even a form of socialization. Co–workers become friends that you confide in and enjoy spending your days with.
Some people are surprised by the fact that they feel lonely and bored when they stop working. Others need the time and space to focus on healing.
Perhaps you would like to continue working, but can’t continue doing your current job because of physical or mental limitations. What are your other job options?
Take a look at your skillset and capabilities and research what else is out there. Ask your employer about other opportunities within the company, workplace accommodations they can make, or search for new jobs that allow you to work from home.
If you’re eager to continue working, there are treatment options that could give you the relief you need to do so. From chiropractic care to physical therapy, there are non-invasive options that can improve your comfort level.
If these remedies don’t work, there are currently three medications approved by the Food and Drug Administration. Lyrica, Cymbalta, and Savella may reduce pain and improve function in some people with fibromyalgia. Talk to your doctor about all of your treatment options.
Social Security benefits can be complicated. For this reason, it’s often beneficial to hire a disability attorney who can help you file the right forms and gather the information for your case. A skilled attorney who specializes in disability and other insurance benefits will be able to guide you through the process of completing applications. If your initial case is denied, your lawyer will be able to prepare you for an appeal that may require you to go before a judge.
For ADA accommodations, you’ll likely have to work closely with your company’s Human Resources team to create the best plan moving forward. While companies look to the guidance provided through federal resources, they will still have their own unique set of rules and regulations to work from.
Back pain is, unfortunately, a very common condition. According to NIH, lower back pain alone afflicts at least 80% of adults at some point in their lives. Some back pain causes can even lead to symptoms in other parts of your body. There are many reasons why this happens, and one of them is foraminal stenosis. That’s quite a mouthful, but what does this condition really mean for you and your health? Read on to learn what foraminal stenosis is, what it feels like, how it’s diagnosed, and how you can treat it if you do have it.
Your spine is made up of 33 small bones called vertebrae. Between each vertebra is a small space, or foramen, that allows nerves to thread through your spine. In a healthyspine, the foramen are large enough to comfortably accommodate these nerves. But sometimes, for a variety of reasons, a foramen becomes compressed. The bones press closer together, potentially putting pressure on the nerves between them.
Foraminal stenosis is a type of spinal stenosis, which occurs when the spinal column narrows and puts pressure on the spinal cord. But there are differences between the two conditions. As already discussed, foraminal stenosis, also called neural foraminal stenosis, occurs when a foramen (rather than the spinal column) narrows. This can happen anywhere in your spine, from your lower neck all the way down to your lower back.
The location of the compression will determine where in your body you feel symptoms—assuming you feel any symptoms at all. Neural foraminal stenosis can be asymptomatic; you might not realize you have it unless and until a nerve gets caught in the narrowed foramen.
However, you may see this condition referred to by more specific names depending on whether the affected nerve is, such as your:
The most common of the three is lumbar foraminal stenosis.
In most cases, symptoms only manifest on the side of your body where the nerve is compressed. But in cases of bilateral foraminal stenosis, the nerve is pinched on both sides of the spine, so you will experience symptoms on both sides of your body.
There are many reasons why this condition develops. You might already have an idea of what the cause is in your case; for example, if you’ve been diagnosed with a bone condition, such as arthritis in your back, that could be the reason.
But regardless of whether you have a strong suspicion or no idea at all, it’s important that you go to a doctor for an examination and a formal diagnosis. We will discuss the diagnosis process and why it is so important later in this post.
Here are a few of the most common foraminal stenosis causes.
Arthritis is one of the main culprits behind foraminal stenosis. This condition can affect your vertebrae in numerous ways. It is best known for causing joints to become inflamed, but it can also weaken the bones, as is the case with osteoarthritis.
Weak bones are more likely to move out of place than strong ones. Also, sometimes arthritis leads to bone spurs. These are bony protrusions that grow over existing bone. When they develop in the spine, they may block the foramen.
If you have suffered trauma to your back—for example, if you were in a car accident, or if you hurt yourself while playing a sport—you may be at increased risk for foraminal stenosis.
There are numerous conditions that can affect the bones in your spine and that, in turn, can lead to foraminal stenosis. Herniated discs (where the cushioning spinal disc between vertebrae slips out of place) and degenerative discs (where the vertebrae themselves move out of alignment) can both put pressure on spinal nerves. Spondylolisthesis occurs when a vertebra in your lower back shifts down onto the one beneath it.
As with foraminal stenosis itself, all of these conditions may be completely asymptomatic unless and until the vertebra or spinal disc starts to press on a nerve.
Some illnesses can increase your risk of foraminal stenosis. Various bone diseases—including Paget’s disease of bone, when your body produces bones that are weaker than they’re supposed to be—can lead to a narrowed foremen.
Tumors have also been known to cause this condition, but try not to worry too much about that. Only in very rare cases is foraminal stenosis caused by cancer.
Symptoms will vary depending on your condition’s severity and the location of the affected foramen. Your symptoms may ebb and flow, and they may never go away entirely.
Four of the most common foraminal stenosis symptoms are:
Other symptoms include muscle spasms and trouble with walking or maintaining your balance.
In cases of cervical foraminal stenosis, your symptoms will likely be focused in your upper body, particularly your arm and hand. You may feel pain, tingling, or numbness radiating down the affected limb.
Thoracic foraminal stenosis symptoms will manifest all the way around your upper torso. Symptoms may worsen during or immediately after performing certain activities.
The symptoms of lumbar foraminal stenosis often radiate from the lower back into the leg, foot or glute.
And finally, in cases of bilateral foraminal stenosis, whatever symptoms you have will manifest on both sides of your body.
The good news is that this condition is typically very manageable. Symptoms are usually controlled well with conservative therapies. We’ll discuss some of the most common treatment methods later on.
There are some rare cases where foraminal stenosis becomes serious enough to warrant a reevaluation of your treatment regimen. Your symptoms may get worse over time, necessitating more drastic treatments to keep symptoms in check.
Dealing with a worsening medical condition can be difficult and upsetting, and you should keep your doctor updated on how you’re feeling so that they can guide you towards better, more effective treatments. However, gradually worsening symptoms do not generally require an emergency trip to the doctor. By contrast, if your symptoms begin to rapidly get worse, seek medical help immediately.
Sometimes, lumbar stenosis leads to cauda equina syndrome. The symptoms of this serious condition include:
If you are experiencing these symptoms, get help immediately. Delaying treatment of cauda equina syndrome can result in permanent nerve damage, including paralysis.
Only a physician can formally diagnose you. If you suspect you have this condition, let your doctor know and explain what symptoms you have been experiencing.
Your doctor will review your medical history and run tests to determine if you do have foraminal stenosis. These tests may include one or more of the following:
A magnetic resonance imaging (MRI) scan uses magnetic fields and radio waves to create a picture of your internal organs.
An X-ray utilizes radiation to create a picture of your bones, enabling your doctor to see your spine without surgery.
A computed tomography (CT) scan also utilizes X-rays, but a CT scanner will take many different X-ray images and combine them into a more detailed picture than a single X-ray could produce.
A bone scan involves injecting a radioactive tracer into your bloodstream. This will make the resulting image clearer so any abnormalities are easier to spot.
A myelogram is another kind of X-ray. Your doctor will inject a contrast agent into your back before taking the X-ray. As with the tracer used in the bone scan, the contrast agent will result in a better image.
An electromyograph determines if there is damage to your nerves or muscles. Your doctor will first apply electrodes and then needles to the affected area to test how your muscles and nerves interact with each other.
Your doctor will decide which of these tests is right for you. The types of tests they run will depend on several factors, including your health, other medical conditions you have, and where in your body you are experiencing symptoms. Some of these tests will help your doctor directly diagnose foraminal stenosis, while others will eliminate other potential causes of your pain.
Even if you already feel completely sure that you have foraminal stenosis, it is important to let your doctor perform their own examination and tests. This way, they can rule out potentially life-threatening pain causes, including cancer.
Once you have an official diagnosis, you and your doctor can discuss which treatment options are right for you. Foraminal stenosis treatment options range from holistic methods you can do on your own at home to more interventional measures performed in a clinical setting. Always check with your doctor before starting any treatment regimen, as not all treatments are safe for all patients in all situations.
One critical treatment is exercise. Certain exercises can ease pain and strengthen the body, making it better able to cope with illness and injury. Medications, either over-the-counter or prescription, may help relieve pain as well. If these treatments are not enough to relieve your pain, you can also try heat/cold therapies and physical therapy.
In extreme cases, as a last resort, your doctor may recommend either injections or surgery to relieve foraminal stenosis pain. Injections deliver medication, such as corticosteroids, directly into the painful area. Your doctor may also suggest performing a temporary spinal nerve block. Spinal nerve blocks may treat chronic pain that doesn’t respond to other kinds of treatments. The temporary type usually involves a surgeon injecting an anesthetic directly into the affected area.
When it comes to surgery, your doctor may decide to perform either a permanent spinal nerve block or a foraminotomy. Unlike the temporary spinal nerve block, the permanent type involves surgically cutting off or damaging the affected nerve. A foraminotomy is when a surgeon physically enlarges the foramen to relieve the pressure on the nerve.
Again, both surgery and injections are not first-line treatments for foraminal stenosis pain. In the overwhelming majority of cases, you will find pain relief with at-home or conservative treatments.
Fibromyalgia is a set of symptoms characterized by widespread pain, but the disorder brings with it a signature symptom known as fibro fog. Fibro fog affects cognitive function, leading to feelings of exhaustion and mental cloudiness, even after a full night’s sleep. Researchers still aren’t sure about the causes or biological underpinnings of fibromyalgia itself, let alone one of its symptoms, but fibro fog is nevertheless a very real problem experienced with the disease. Here’s what you should know, and how to manage this classic symptom of fibromyalgia.
Fibro fog gained its name from the general feeling of mental confusion or inability to focus it imposes on those experiencing it. Along with it may come immobilizing exhaustion. This isn’t the type of fatigue that’s alleviated by a nap or sound night’s sleep. To the contrary, people with fibro fog often feel this way despite a full night’s rest. You can’t sleep fibro fog off because it stems from workings deep inside the brain.
Fibro fog makes it difficult to move through the day, concentrate on things that need to get done, or corral the energy necessary for work, school, or life tasks. It makes carrying on with normal life incredibly difficult. People who need sharp minds for their jobs may suddenly have trouble completing detailed assignments, according to the National Fibromyalgia Research Association (NFRA).
Episodes of this fogginess feeling may come intermittently. It can last anywhere from several hours up to several weeks or possibly the entire duration of a fibromyalgia flare, NFRA says.
While researchers aren’t exactly sure what causes fibro fog, this is an area of hot research and scientists have several hypotheses. One theory is that fibro fog is caused by a mix of depression and sleep deprivation, but studies so far haven’t found that to be true, reports Arthritis Today.
Another possible cause could be a lack of oxygen. Brain scans of those with fibromyalgia have revealed that some parts of patients’ brains receive insufficient amounts of the life-giving element. The same faulty nervous system firings that may play a role in causing fibromyalgia could also impact blood vessels in the brain, ultimately leading to fibro fog, according to Arthritis Today.
Yet another theory centers on the idea that chronic pain itself damages the brain, which may lead to fibro fog. A type of brain scan has found chronic pain sufferers tend to display excess activity in a part of the brain linked to emotion. This region is essentially always on, wearing out associated neurons and causing unbalanced brain chemistry, according to Arthritis Today.
Living with fibro fog can be challenging, but not impossible. Finding a few key anchors and strategies can help you reduce your pain, increase your own abilities, and improve your overall quality of life. There are some specific ways to manage the fog. Try some of the recommendations below to find what works for you.
Some people may be tempted to chain drink coffee in an attempt to caffeinate their way through the day. Ultimately, this causes more harm than good. First, caffeine is a diuretic, which could lead to dehydration, especially when drank in large quantities.
Second, you may have the misfortune of drinking too much coffee late in the day, making it difficult to sleep, exacerbating the seemingly endless mental fog you’re already in. Copious amounts of coffee could also lead to an energetic roller coaster marked by highs and lows throughout the day.
Skip the coffee and drink water instead, which helps the body function at its maximum potential. Staying well-hydrated could also help you minimize fatigue.
Navigating through life without mental clarity can be frustrating and confusing. Reduce the amount of information you must remember by writing everything down.
Consider investing in a good planner complete with a calendar and plenty of space for writing lists of appointments, to-dos, and other things you must remember. If you’re technology-savvy, you may want to use the calendar application in your cell phone or an app like Remember the Milk. Phones also typically have functions that allow you to enter tasks and even set reminder alerts.
Even simple things can be made easier with technology. Put dinner in the oven for 30 minutes? Ask your phone to remind you to take it out. This way, you have a little helper and don’t need to rely so much on your foggy brain. You might also consider setting a monthly cell phone reminder to pay your bills, and pay them all at once or as they come in, whichever you find easier.
This is easier said than done, but stress may worsen fibro fog and pain. Practices like breathing deeply and visualizing peaceful images like the ocean or a forest can greatly help manage stress.
Take a few minutes every day, or even several times a day, to lie down in a quiet place and regroup your thoughts. Focus on your breath and let all outside stimuli go. You may even consider creating a special corner or room in your house that’s relaxing for you with a comfortable chair or floor pillows and perhaps some flowers or other ornaments, but that’s generally free of clutter and conducive to relaxation. A Zen space.
Living life through the lens of fibro fog can itself be stressful and make you feel like you’ve lost something valuable. It’s difficult, but try to take it all in stride, perhaps seeking help from a support group either in person or online.
Although you probably wish you were functioning at 110%, the reality is that you’re not. Be kind to yourself and expect less. Simplify your life to conserve energy, prioritize so that you do the most important things and spend time with the most important people first.
Also, consider this change in perspective: you’re always functioning at 100%. It’s just that some days 100% looks a little differently than others. Do the best you can today and let the rest go.
Exercise is incredibly healthy, both for your body and mind. This one may be hard for you to fathom in a fatigued state, but exercise often helps people feel better. Start with low to moderate exercise when you move into a new program, and work extensively with your doctor to find an activity level that’s best for you.
Start slowly and build up to more moderate levels of activity over time. Most importantly, understand your limitations each and every day. Once you find an exercise program that works for you, it can decrease anxiety and depression, improve circulation, and help you stay functional.
Try a yoga class or bike ride. Perhaps do the elliptical at the gym or take a walk. Do something where you control the pace and amount of exertion, but getting the blood flowing will help you feel better and could alleviate the troublesome symptoms of fibro fog. Working out also helps to relieve stress.
Changes in cognition can be scary, but fortunately there are some options for working those brain pathways and keeping your mind in good shape.
Crossword puzzles and other games can challenge the brain and also help keep it in good shape. Engage with things and creative projects that excite you. During low pain days, you can try painting or coloring to give your brain a creative outlet.
Get involved in your treatment plan by becoming a part of your healthcare team. Ask questions. Research different treatment options. Be willing to make decisions specific to your needs. This also may mean joining fibromyalgia support groups or organizations.
Rather than becoming overwhelmed, getting involved will help you feel less like a patient and more like a person.
Decide what’s most important to you by setting specific goals for improvement and priorities to guide you when fibro fog flares up. Your pain and other symptoms may be different every day, so make sure to monitor your own abilities and make allowances for them on that day.
By looking past the daily fibro fog and pain and to a larger goal, however, you can better cope with your daily symptoms. You may not be able to do everything that you did before. However, there are many low intensity activities and hobbies that can fulfill those same needs. These may include photography, dancing, gardening, or writing.
Find time for self-care. This may mean using hot and cold therapy to help reduce pain. Try hot patches, freezer packs, heating creams, or cooling gels.
Sleep aids, such as body pillows or electric blankets, can also help you maintain better quality of sleep. Beyond these, find tools that help you minimize pain around the home. This may include recliners, shoe sole inserts, braces, shower seats, or lumbar support pillows.
Getting support from family members and friends may simply mean finding the courage to ask for it. You have the right to ask for help, find alternative ways of doing things, and share your feelings with those close to you.
Support groups can also provide another level of support and empathy from others with fibromyalgia. Lastly, look online for blogs and websites that talk about fibromyalgia. Websites with resources for pain management are available, but there are also personal blogs by others suffering from fibromyalgia, such as Felicia Fibro. Knowing that others struggle with fibro fog and other symptoms can help you feel less alone.
Hip and leg pain is a broad category of conditions that can range from acute soreness due to a minor injury to long-term chronic pain that can be the result of a disease or disorder. Because of the varying causes of hip and leg pain, there are a number of possible treatments as well, all dependent on the cause and severity of the condition.
It is estimated that nearly two million people in the United States seek emergency room treatments for sports injuries each year. Sports injuries are most often associated to injuries to the legs.
Basketball injuries top the list, with over 90% of individuals seeking treatment after an injury in this sport being men. Bicycling, football, and baseball were the next three most common sports causing injuries on the list. Children between the ages of six and 19 made up 20% of all sports injury related emergency room visits.
However, not all sports injuries are treatable by emergency room visits and some more minor injuries can be treated with rest and at-home care. There are also other conditions that can lead to hip and leg pain. Many of these are related to the hip itself.
The hip joint is a ball and socket joint, where the femur connects to the pelvis. The top of the femur is a round ball, which fits into the socket (acetabulum) formed by the pelvic bone.
The ball is allowed to glide and rotate within the acetabulum because a group of ligaments and muscles support the joint and inhibit over extension or malrotation from occurring. Also, within the joint is a synovial lining, which provides lubricating fluid to decrease friction, produced when the joint is in motion.
Any condition that irritates or inflames this joint, like arthritis, can also lead to pain.
The hip joint is a large weight-bearing joint attaching the leg bone to the pelvis. It allows the body to walk, run, and sit. The most common causes of pain in the hip and leg include:
Muscle cramps are a common condition that can be persistent and painful. They are often referred to as a “Charley Horse” when felt in the calf muscles. Caused by an involuntary contraction of the muscle, the sensation of a muscle cramp is a muscle that will not relax. You may even feel spasms in the affected area. Muscle cramps can occur after a sports injury and they are often related to nutrition and hydration.
When exercising, running, or playing sports, it is important to stretch the muscles properly before beginning and stay hydrated throughout the activity. To relieve a muscle cramp as it is happening, you may want to stretch the muscle, apply heat, drink more water, or take an over-the-counter pain reliever.
Typically a muscle cramp will go away on its own, but if the pain persists, there may be some concern about nerve damage or another malfunction that is causing the muscle cramps. If the cramps reoccur frequently, you should talk with a doctor about them.
The diagnoses of sprains and strains are among the most common sports injuries, but what do these terms really mean?
A sprain is the stretching or tearing of the ligaments that connect our bones. It is generally caused by some trauma, directly or indirectly, that stretches or ruptures these ligaments. This can be the result of a fall, a blow to the body from another player, or overstretching the leg during the game. Sprains will usually heal with rest and self-care. This may include compression, ice, and elevation as well as the use of over-the-counter pain medications. If an injury is more severe, surgical correction may be necessary.
A strain is an injury of the muscle or the tendons that connect the muscles to bones. Strains are more commonly caused by a repetitive motion or overuse of the muscles in the leg. To prevent a strain, athletes and individuals exercising are advised to take the proper breaks. Strains can also be caused by falls and contact with other players. Strains are treated similarly to sprains with compression, ice, and elevation.
The primary sign of a shin splint is an aching or throbbing in the shin, the front area of the lower leg just above your foot. They can be caused by swollen and irritated muscles, a stress fracture, or flat feet. They are most common for runners or dancers.
In general, shin splints will heal on their own. You can treat them at home with:
If the pain persists, you may want to talk to a doctor and have them do a complete physical examination of the area to determine if there any additional underlying problems. They may also recommend physical therapy.
A leg breaks when a force great enough to break the bone is applied to the limb. It is a common sports injury, but can also occur due to a car accident or a fall. The treatment for a broken leg will depend entirely on the severity of the break.
A leg fracture can occur in the femur, located in the thigh, or the tibia and fibula which are the two bones that make up your leg from the knee to the foot.
There are several categories of fractures, including:
Open or compound: The bone ruptures the surrounding muscles and skin
Stress and hairline fractures will generally heal on their own without the use of a cast. For more severe breaks, medical intervention is required to set the bone and allow it to heal properly. Some broken legs will require surgery if the break is extreme.
Diagnosing patients with hip and leg pain is never straight forward and is often difficult, as many of the symptoms are similar to other conditions. The first step is taking a comprehensive history and physical exam.
Several aspects will be covered in the history and some of the most common questions your doctor will ask you are:
What were you doing when you first noticed the pain?
Is there anything you can do that alleviates the pain?
Are you currently taking any medications for the pain? Do they work?
Is there any family history of arthritis or other autoimmune diseases?
After conducting a full history and physical exam your doctor may want additional studies, including radiological films and blood work. Imaging techniques are useful because your doctor is often able to see pathology inside the affected joint.
Common imaging techniques to evaluate hip and leg pain include:
X-rays: A diagnostic test using an electromagnetic energy ray to produce images of internal tissues.
CT scans: A diagnostic test that combines X-rays with computer technology to produce cross sectional views of the body. This is helpful because it helps to visualize detailed images of the body, including the bones, muscles, and organs.
MRI scans: A diagnostic image that uses large magnets and a computer to produce detailed images of the structures within the body. This is even more detailed than the CT scan or an X-ray.
Your physician may also request a blood test, and may need to evaluate the consistency of the fluid accumulation in the joint.
Most of these leg injuries fall under the category of acute pain. These conditions will heal on their own without lingering, long-term effects. Acute pain can be treated at home, as discussed previously, or with medical intervention.
Once the injury heals, you can normally resume full activity. However, if any pain from an injury continues for longer than three months it has crossed classification from acute to chronic pain. Patients dealing with chronic leg pain after an injury may need to seek more advanced treatment to stop or alleviate the pain long-term.
If you have experienced a sports-related injury, such as a muscle strain or a shin splint, talk with your doctor about the best care for your situation. If home care and rest doesn’t improve the condition, discuss more advanced treatment plans.
The most common and recommended methods for treating arthritis are conservative alternative therapy provided by a pain specialist. Staying active and physical therapy have also proven to be beneficial.
Physical therapy has been noted to significantly improve postural stability in patients suffering from hip osteoarthritis.
Intra-articular joint injections are also rapidly gaining popularity and use in the treatment for arthritis because of their success, minimally invasive nature, and long-acting effects.
Speak with your pain physician today to determine the best way to improve your hip and leg pain. After conducting a full history and physical exam your physician may want additional studies, including radiological films and blood work.
Plantar fasciitis affects one in ten adults in their lifetime. The plantar fascia is a thick tissue that connects the ball of the foot to the heel and also supports the arch of the foot. When this muscle becomes strained or compressed, severe pain can result and become chronic. Heels can actually develop new bone and create painful heel spurs—bony projections that cause intense pain. This chronic pain condition can impact life every day, and if left untreated can become severe and require surgery.
The leading cause of plantar fasciitis is stress or strain on the plantar fascia that causes tiny tears in the ligament. These tears cause inflammation and pain, which makes walking or other activities difficult, especially in the morning. Not warming up or using proper conditioning techniques are other causes of plantar fasciitis, as is starting a new physical activity after long periods of rest or inactivity. These activities may cause microscopic tears that are only found once a diagnosis of plantar fasciitis is made.
People with very flat feet or very high arches are prone to plantar fasciitis due to the shortening or lengthening of the tissue and the strain that causes.
For athletes, training repetitively on hard surfaces with improper footwear can cause plantar fasciitis. A rapid increase in the intensity of a workout, or the length of a workout can also trigger painful symptoms. Some patients report that symptoms worsen over time, but others say that their symptoms occurred suddenly.
Men between the ages of 40 and 70 are most likely to experience the pain of plantar fasciitis, but people of all ages can develop this condition. Some behaviors can increase the risk. A genetic history or family record of plantar fasciitis is a primary risk, as is simply getting older.
Although everyone who walks on the planet is capable of developing plantar fasciitis, there are a few specific risk factors that can increase your chances of developing it.
Increased weight means increased daily pressure on the feet. This additional daily strain can cause all kinds of problem in the lower extremities, including swelling and pain in the feet.
A person with liver disease, diabetes, or thyroid issues may have issues with their circulatory systems that put them at risk for plantar fasciitis. These metabolic conditions may result in not enough blood and oxygen to the feet, which can cause pain in the plantar fascia.
Smokers and those who have a history of overuse of alcohol may be more at risk for developing plantar fasciitis. This may be closely linked to inactivity, and obesity may be a contributing factor as well.
Getting older is a primary risk factor for plantar fasciitis. Men between 40 and 70 years of age are the demographic most likely to be diagnosed with this condition.
Many of these risk factors deal with metabolic issues and may be related to the circulation of blood in the feet. There are some physicians who believe that this condition is a result of high acidity in the body, and they point to the variety of those affected as proof. Patients with plantar fasciitis can be marathon runners or couch potatoes. They can be in good health otherwise or be obese with an unhealthy diet. There are multiple risk factors that have not been explored deeply at this point, but there are also a variety of treatment options.
Physicians diagnose plantar fasciitis with a combination of patient interviews and examination. Doctors will especially focus on onset and any activities that may have caused the pain.
If bone spurs are suspected, doctors may order X-rays to confirm that diagnosis.
To prevent plantar fasciitis, a warm-up is essential. Beyond shoes, many athletes ignore their feet when they begin to workout. Here are a few stretches that can be done to get the blood flowing in the feet before beginning.
With feet bare, grasp toes with one hand and the heel with the other. Bend the toes back with one hand as the other hand pulls the heel back. Hold for 30 seconds.
Still with bare feet, start in a squat with your toes spread wide. Lean forward slowly and bring your knees to the ground so that your toes are still flexed underneath you. Sit back on your heels as far as you can. This is a very intense stretch, so go slowly and back off if it becomes painful. Hold for at least one minute.
Place hands on a wall, shoulder height. Step the left foot straight back so there is about two or three feet between your left toe and right heel. Move your hips forward, keeping your left heel down, until you feel a stretch in the calf. Don’t bounce, just hold for 30 seconds. Release, and do the same with the right foot.
You can also use a tennis ball to massage the arch of your foot. Add pressure as you can, but go slowly. This should relieve pressure and feel good. You can roll the tennis ball all over the foot, putting weight onto it to increase the depth of massage. If you need a deeper massage, switch to a harder ball with less “give.”
The initial treatment options are easy to comply with and generally non-invasive. A period of rest and icing to the affected area can help with pain and inflammation, as can over-the-counter non-steroidal anti-inflammatory drugs (nsaids). If the plantar fasciitis is due to injury or repetitive motion, then rest is essential, with as little strain put on the foot as possible.
Depending on the extent of your pain, you may also need to try some other treatment options. These are discussed below.
For severe cases, doctors may recommend a boot or other immobilizing support, but in milder cases, shoes with orthotic insoles or firm arch support will be adequate.
Patients will be instructed on specific stretches and movements to loosen and condition the plantar fascia. Plantar stretches may include placing the foot on the opposite knee while seated and flexing the feet strongly while pulling back on the toes.
While working the plantar fascia like a muscle may seem odd, new research has found that doing so can actually improve recovery times. A recent study published in the Scandinavian Journal of Medicine and Science in Sports found that plantar fascia has a job that is similar to the Achilles tendon in both load bearing and function. Researchers studied the effect of this specific tendon in a randomized group of 48 patients with plantar fasciitis. They wanted to see if high-load strength training, typically utilized to develop muscles and stretch tendons in the lower leg, would offer superior results to traditional plantar stretches.
One study group completed plantar stretches ten times for ten seconds, three times per day, and the other group completed unilateral heel raises using a towel under the toes. Study participants stood on a raised platform and placed their toes on a rolled-up towel. Patients took three seconds to raise up on tiptoe, paused for two seconds, then took three seconds to slowly lower down. Patients performed the activity with one foot at a time, starting with three sets of 12 repetitions. They gradually added weight by filling a backpack with books. The repetitions were decreased but the number of sets was increased as weight was added to the backpack.
The result? The high-load strength-training group achieved short-term pain relief more quickly than the group that completed traditional plantar fasciitis stretches. While both groups had similar levels of pain at the six and 12-month mark, the pain-relieving effects of high-load strength training were immediate.
Research presented at the Society of Interventional Radiology’s Annual Scientific Meeting has indicated that ultrasound imaging and targeted ultrasonic energy is an effective way to not only break up and remove tissue damaged by plantar fasciitis but to also allow healthy tissue to regenerate in its place. One hundred patients treated with this therapy starting in 2013 have reported positive, long-lasting relief.
Rahul Razdan, M.D., one of the study’s researchers and an interventional radiologist at Advanced Medical Imaging in Lincoln, Nebraska, noted that this is the first treatment option that goes beyond short-term solutions:
“While standard treatments, such as pain medication and physical therapy, can offer some relief, there have been no permanent answers. It is important for patients suffering from chronic plantar fasciitis to know that they have treatment options. We have patients who are in so much pain they can’t even play with their kids or take their dog for a walk. This ultrasonic treatment can give patients their lives back and let them enjoy their lives.”
For inflammation that persists, doctors may prescribe corticosteroids for short periods of time. If pain persists, and a cast or a boot does not help with the pain and inflammation, then doctors may prescribe steroid injections. For the most severe cases that are not responding to treatments, doctors may try plantar fascia release where they cut into the connective tissue to ease the tension and stress that is causing the pain.
Fibromyalgia is a neurological disorder that affects approximately 12 million people in the U.S. This chronic disorder causes aches and pains in the body that are severe enough to impact normal activity and disrupt sleep. A person with fibromyalgia may feel pain in the muscles, tissues, joints, and tendons in different areas of the body. Along with these physical symptoms, people suffering from fibromyalgia also experience mental issues as a result of fibromyalgia, including depression and anxiety. Fibromyalgia can also cause deep fatigue and exhaustion, even with very little activity. Even with so many people suffering from fibromyalgia, it remains a difficult disorder to diagnose. One of the most valuable tools for diagnosis was defining fibromyalgia tender points.
Fibromyalgia is a term that has only been used in the last few decades to describe a condition of widespread pain throughout the body that also includes fatigue, poor sleep quality, and mood issues. It is possible, however, that mentions of a fibromyalgia diagnosis date all the way back to the 1600s.
Fibromyalgia has had many names throughout the years including:
Since physicians could not find any evidence of inflammation, these names were replaced with fibromyalgia in 1976. This translates from its Greek roots into “pain in the muscles and tissue.” While a fibromyalgia diagnosis is still difficult to establish today, there have been many recent advances. Research has led to promising tools and guidelines to help pain doctors and patients alike. One of the earliest was the fibromyalgia tender points scale.
Fibromyalgia affects about 4% of the U.S. population (~ ten million people) and is predominately found in women.
Fibromyalgia is not a condition of exclusion, but its symptoms are common in many other illnesses. To make things more complicated, fibro symptoms can appear on their own or in tandem with another disorder. Identifying the cause of each can be problematic. This situation is exacerbated since fibro is a waxing and waning condition, making patterns more difficult to recognize even with thorough tracking.
Although researchers agree that there is a neurological component to the disease, many previously believed that it was all in a person’s head. Some studies have pointed to risk factors such as a genetic predisposition to feeling pain more intensely. Other evidence connects the development of fibromyalgia to a stressful or traumatic event, repetitive injury, or other disease. Sometimes fibromyalgia has no clear cause or trigger and develops on its own.
Women are three times more likely to develop fibromyalgia as men, and people with certain illnesses already present may have an increased risk. Autoimmune disorders such as lupus and rheumatoid or spinal arthritis sufferers develop fibromyalgia at a higher rate than those without these conditions.
There is no simple, scientifically-supported test to identify if someone has fibromyalgia. According to the NationalFibromyalgia Association, it takes the average person five years to be diagnosed with fibro and this is generally after extensive other treatments have occurred. Misdiagnosis can still occur, but there are far more developed and data backed approaches that physicians use today.
In 1981, the first clinical study was published that confirmed that symptoms and tender points of fibromyalgia could be found in the body. This study also established the first data-driven criteria for this condition.
In 1990, the American College of Rheumatology (ACR) created the first set of guidelines to help diagnose fibromyalgia. These guidelines set forth the following formal criteria for a fibromyalgia diagnosis in a research context:
The patient must have a history of widespread pain lasting more than three months
This pain must affect both sides of the body and be present above and below the waist
Of the 18 tender points designated on the human body, at least 11 of them must be in pain
Before these guidelines were released, a fibromyalgia diagnosis was completely subjective and many were skeptical that the disorder even existed. Even with these new guidelines, fibromyalgia is a condition that can come and go, so using the fibromyalgia tender points criteria can be misleading or change from day-to-day.
Although most of the population has a spot or two on their body that may be more sensitive than others, people with fibromyalgia often experience excruciating tenderness in very specific locations that are spread across their body. Tenderness is generally mirrored on both sides of the body and is located at nine specific places on the body.
The nine fibromyalgia tender points locations are as follows:
Low cervical region: Front neck area just below the chin near the C5-C7 vertebrae
Second rib: Front chest area below the collarbone about 2 inches from the shoulder joint
Occiput: Back of the neck at the base of the skull
Trapezius muscle: Back shoulder area where this large muscle drapes over the top of the shoulder
Knee: Knee area on the inside where the fat pad sits
These nine areas are also sometimes called fibromyalgia tender spots. Because fibromyalgia cannot be diagnosed with a lab test, counting fibromyalgia tender points and taking a detailed patient history were often the best ways to get a clear diagnosis. Scroll to the infographic at the end of this post to see these.
To build on the fibromyalgia tender points scale, the Symptom Intensity Scale was developed using survey results from nearly 12,800 patients with osteoarthritis, rheumatoid arthritis, or fibromyalgia. These patients located pain in 38 anatomic areas of their body and then also completed a fatigue visual analogue scale. The fatigue analog scale requires a patient to mark their level of fatigue on a ten-centimeter line on the day they identified their pain symptoms.
In 2006, Frederick Wolfe and Johannes J. Rasker completed an evaluation of 25,417 patients using the Symptom Intensity Scale and found that it was the best and clearest diagnostic tool for fibromyalgia. They also found that higher Scale scores indicated increases in hospitalization, disability, serious medical issues, and death.
Because of this relationship, the Scale can be used to measure overall health and also predict outcomes for patients with a number of diseases. It uncovers “hidden” illness that accompanies the presenting illness, such as depression or anxiety in a patient with rheumatoid arthritis.
While the fibromyalgia tender points are still helpful, they’re not the only path to diagnosis for medical professionals. In 2010, the American College of Rheumatology published another set of criteria for fibromyalgia. It eliminated the fibromyalgia tender points count and replaced it with the widespread pain index (WPI) and symptom severity scale (SS).
The WPI calculates if a person has experienced pain in the last two weeks in 19 separate general body areas. Each body area is assigned a one if there is pain or a zero if there is no pain and these are added together to reach a score between 0 and 19.
The SS measures the severity of the person’s fatigue, sleep quality, cognitive symptoms, and somatic symptoms. Each of these four categories is given a score of 0 – 3 and added together for a total possible score of 12.
Using these new scales, the ACR changed the diagnosis guidelines to:
WPI ≥ 7 and SS ≥ 5 OR WPI 3–6 and SS ≥ 9
Symptoms have been persistent for at least three months
There is no other disorder that could explain the pain
Physicians must rely on a patient’s communicated symptoms to make a fibromyalgia diagnosis. Therefore, the first thing a doctor will do is conduct a thorough physical examination of the muscles and joints. After doing this, she or he will then discuss any symptoms a patient is currently having.
Pain: Constant full body pain with pain at the fibromyalgia tender points
Unrefreshing sleep: Even after an uninterrupted eight hours
Fatigue: Chronic fatigue or exhaustion after strenuous activity
Memory loss: Short-term memory problems coupled with bouts of confusion and inability to concentrate
Increased pain sensitivity: Hyperalgesia or allodynia
Depression
Fibromyalgia often is present with other health issues, so a doctor will likely ask about other conditions such as irritable bowel syndrome, headaches, restless leg syndrome, frequent urination, and anxiety.
Since fibro can occur with other illnesses, the next step is to start eliminating more serious medical conditions that could be causing your symptoms. The doctor will run tests on your blood, thyroid, and vitamin D levels. Other tests that could be required are X-rays, computed tomography (CT), and magnetic resonance imaging (MRI). Finally, a biopsy and a physiological exam could be necessary to rule out any suspected mental health issues.
Since fibromyalgia is mainly based off the symptoms that patients share, there are some smart things you can do if you believe you are suffering from fibromyalgia. These tips could save you time, money, and lots of frustration. And, they can help get you back on the path to being healthy and happy faster.
Make sure to communicate any mental or physical trauma that has occurred to you. A major event like this is sometimes associated with the development of fibro symptoms.
Keep a pain diary that includes the location of your pain, how it feels, severity, and the length of time it lasts. This can be a perfect tool to parse out fibro from other health issues.
Choose the right doctor. The stigma around fibromyalgia is fading as more research comes out, but some physicians will be reluctant to diagnose it. Make sure you go to a doctor who is specialized in pain management and has the experience to help you find the right diagnosis.
Treatment of fibromyalgia is best approached as a team, with doctors, physical therapists, and other alternative practitioners working together to treat the physical and mental symptoms.
Dietary changes to eliminate anything that causes inflammation or triggers a pain response (e.g., sugar and red meat)
Changes to exercise plans, including exercises for days when pain is present, and exercise that includes meditation
Prescription medicines as needed
Sleep counseling to develop proper sleep habits to combat fatigue
Changes to work schedules to accommodate good and bad days
Families also play an important role in the treatment of fibromyalgia. Suffering from an “invisible” but chronic illness such as fibromyalgia can be socially isolating. It is important that the family members are supportive of treatment and are understanding when their loved one needs to rest.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) is sponsoring more research on fibromyalgia to better understand this disease, specifically in relation to diagnosis, causes, and better treatments.
To get a fibromyalgia diagnosis, click here to find a certified pain specialist in your area. They have dedicated experience working with fibromyalgia patients and will use the latest diagnostic guidelines to help you diagnose your condition.
