Fibromyalgia

Information to patients.

Up to 5% of the population suffers from fibromyalgia, which is a syndrome characterised by chronic body pain, fatigue, anxiety or depression, sleep disturbances.
Commonly seen in patients between 20 to 50, more in females than males at 9:1 ratio.
primary : not associated with other conditions.
secondary: associated with rheumatoid arthritis or SLE
Common symptoms associated with fibromyalgia with decreasing frequency are:

Condition                                % of FMS Symptoms

Muscular Pain                                         100
Fatigue                                                     96
Insomnia                                                   86
Joint Pains                                                72
Headaches                                               60
Restless Legs                                           56
Numbness and Tingling                            52
Impaired Memory                                    46
Leg Cramps                                             42
Impaired Concentration                            41
Nervousness                                            32
Depression (Major Depression)               20
can also be associated with irritable bowel syndrome, paraesthesia, genitourinary symptoms.

Diagnosis : There is no single test which can establish the diagnosis. It is more a diagnosis by exclusion. Do investigations to rule out all other rheumatological conditions.
Criteria used for diagnosis according to ACR are:

1. Wide spread presence of pain throughout the body present for more than 3 months.
2. Presence of tender spots throughout the body. At least 11 out of 18.

                           
Treatment: Mostly symptomatic treatment, options available are:

1. Medications: Tramadol, pregabalin, ketamine, gabapentin and others.
2. Exercises: Most important part of treatment. Aerobics, stretching and strengthening exercises, etc
3. Relaxation techniques to reduce the effects of stress: meditation, pranayama etc.
4. Antidepressants and muscle relaxants can also used.
5. Psychotherapy.

Back pain and posture.

Nobody is immune to Back pain. It is the most common musculoskeletal condition, like tooth decay and the common cold, this is an affliction that affects a substantial proportion of population, at some point in their lives. This condition does not discriminate by gender, age, race or culture.

There are a number of surveys in many countries that reveal a point-prevalence of 17–30%, a 1-month prevalence of 19–43% and a life-time prevalence of 60–80%.

It has been said that backahe is the price the human race is paying for adopting a erect posture.
There are a number of factors which contribute towards developing backache like: Work environment and ergonomics, posture, psychosocial factors and spine/extraspinal pathologies. Sometimes these factors overlap towards causing this condition.

Common conditions that cause the back ache are: Disc pathologies, Injuries, degenerative changes in the spine, infections etc.

If your have chronic backpain, pain radiating along the thighs or legs, recurrent backpains, tingling or altered sensation in the limbs; please see the orthopaedician as it needs to be investigated.

In this article i will concentrate on backpain related to work and posture.

 Back pain is often a consequence of poor posture and stress on spine. This causes overtaxing of various tissues of the spine.

Stooping either in sitting or standing posture increases the strain on the spine leading to damage to intervetebral disks.