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*It generally occurs in females. Patients have typically seen many physicians, who have given a variety of diagnosis like chronic fatigue syndrome, “Its in your head”, psychogenic rheumatism, some pain syndrome like Tietze’s syndrome, or just labeled them as plain “hypochondriac”.
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*Usually the sleep is disturbed and there are multiple symmetric tender points like tennis elbow site, back of head, back, buttocks and knees etc. This tenderness is different from usual tenderness, such that it is associated with an excessive emotional response, and worsening of pain after palpation. * Exact cause of Fibromyalgia is unknown. It may be a multi-factorial disorder, predominantly affecting the functioning of nervous system, especially in response to stress. Stress worsens sleep pattern, which in turn lowers the pain threshold, causing more pain and worsening the pain. Thus, a vicious cycle is established. *Fibromyalgia patients may have other related syndromes in other parts of body, like irritable bowel syndrome, and non-cardiac chest pain (see article on angina-like chest pain). |
*Fibromyalgia may be associated with other conditions like lupus, rheumatoid arthritis, osteoarthritis, Lyme’s disease, excess or diminished thyroid disorders, alcohol or narcotic withdrawal.
*Treatment: Low doses of tricyclic antidepressants like imipramine and amitriptyline raise the pain threshold and help Fibromyalgia patient sleep better. Aerobic exercises, swimming, aerobic dancing and lots of TLC and support are helpful. Assurance and stress management programs are beneficial.
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