Dombrowski can offer customized treatments to fibromyalgia patients for whom chronic pain is an issue. They could try to diagnose it themselves and treat the symptoms to see if that helps.
One of the reasons that fibromyalgia can be difficult to diagnose is that doctors spend time and resources searching for diseases that could be causing all of the various symptoms of fibromyalgia, says Dr. Seeing a rheumatologist or doctor who is experienced in treating fibromyalgia patients may accelerate your time to getting diagnosed. While someone with, say, RA can often point to a specific body part like the hand that has swelling, redness, and stiffness in addition to pain, someone with fibromyalgia tends to experience widespread pain and tenderness in larger areas, like specific quadrants of the body.
Some people with fibromyalgia experience tingling or burning sensations, along with pain, in areas of the body, as well as significant fatigue. People can have fibro at the same time as other diseases, such as inflammatory arthritis or osteoarthritis. A scenario is that a patient might have a diagnosis of RA and is taking medication that reduces inflammation but still experiences pain.
In this case, the pain may be due to fibro or something else rather than from the RA. One study published in the journal Annals of Rheumatic Diseases found that 14 percent of the RA patients who participated in the research also fulfilled fibromyalgia criteria. If you have RA or OA and think you might also have fibromyalgia, bring it up to your rheumatologist to see if they can treat those symptoms of fatigue and overall pain as well.
They will likely want to know about specific pain, sensitivity, and tenderness that you feel in certain areas of the body. In addition, your doctor should also ask about other symptoms, since fibromyalgia commonly coexists with other seemingly unrelated health issues, including irritable bowel syndrome IBS , jaw pain from clenching , headaches, frequent urination, and anxiety or depression. However, more recent criteria have downplayed the role of the tender points in clinching a fibromyalgia diagnosis.
Wolfe — suggests using questionnaires that assess pain and related symptoms, called the widespread pain index WPI and symptom severity scale SSS. The SSS assesses how the pain feels in terms of fatigue, cognitive symptoms, and how you feel when you wake up, on a scale of 0 no problems to 3 severe and continuous. They would apply pressure to 18 sometimes 19 specific points on the body where fibromyalgia patients tend to experience more pain and sensitivity.
The tender points, which occur on both sides of the body, include:. Now the tender point counting method is not recognized as a standardized measure for diagnosing fibromyalgia and determining whether the condition is getting better or worse.
You can have fibromyalgia without having pain in these specific tender points. There is no specific blood test to diagnose fibromyalgia. Your rheumatologist will perform initial and follow-up tests and monitor how well treatment is working. Psychologists and psychiatrists both treat mental disorders like anxiety and depression.
A psychiatrist is a medical doctor and can prescribe medications. These doctors may be able to help you manage feelings of despair and pain. Fibromyalgia frequently leads to depression and the depression can worsen your symptoms.
Both psychologists and psychiatrists can provide counseling and other forms of therapy that are useful for fibromyalgia. Cognitive behavioral therapy, for example, helps those with depression by challenging the negative self-talk that can worsen your mood. You may use one-on-one sessions or take part in a support group led by one of these professionals. Physical and occupational therapists help people strengthen muscles and joints. This can help you perform everyday activities better.
They also help find ways to go about daily life with less pain. They can help you be more active and create effective exercise programs. They may assist with stretching and range of motion exercises.
Some of these therapists come to your home for visits while others are available at a clinic. Morning stiffness lasting less than an hour. Constipation or diarrhea related to irritable bowel syndrome. Memory problems and trouble concentrating.
Anxiety or depression. What Happens For most people, fibromyalgia seems to involve a cycle of muscle pain, increased sensitivity to pain, and inactivity that may be made worse by sleep problems and fatigue. Increasing pain causes a person to be less physically active. Muscles that aren't exercised regularly are more likely to be irritated during activity. And it may be that people with fibromyalgia are more sensitive to pain or have muscles that are more easily irritated. The irritated muscles are painful.
Some doctors think that the muscles of people with fibromyalgia stay sore because they don't repair themselves as well as they should.
Muscle pain, sometimes occurring with disrupted sleep and daytime fatigue, leads to less and less activity. What Increases Your Risk Certain things may make you more likely to have fibromyalgia. Things that increase your risk risk factors include: Being female. Having certain health problems, such as rheumatoid arthritis, lupus, mononucleosis , or depression. Having been through a traumatic event such as a car accident.
Having a family history of fibromyalgia. When should you call your doctor? If not diagnosed Call your doctor if you have had the following symptoms for more than 6 weeks without an obvious cause. Widespread muscle tenderness and pain, particularly on both sides of the body and both above and below the waist Disturbed sleep tossing, turning, waking up frequently during the night and waking up feeling tired and unrested Muscle and joint stiffness that doesn't get better when you move around If diagnosed If you have fibromyalgia, call your doctor if you have: Symptoms of depression, such as a loss of interest in things you usually enjoy or changes in eating and sleeping habits.
These can often be treated if you tell your doctor about them. New symptoms or existing symptoms get worse. Your doctor may need to reassess your treatment, such as adjust your medicines or prescribe different ones. Who to see Health professionals who may be able to help you with fibromyalgia include: Family medicine physicians.
Nurse practitioners. Physician assistants. You may need to see a specialist who has experience with fibromyalgia.
These include: Rheumatologists , who have the most experience with diagnosing fibromyalgia. Pain management specialists , who have experience with treatment. Exams and Tests There are no specific tests that can confirm a diagnosis of fibromyalgia.
Doctors use a set of criteria to diagnose fibromyalgia. These include: Widespread pain. Pain is considered to be widespread if it is above and below your waist and on the right and left sides of your body. Other symptoms such as fatigue, trouble sleeping or feeling unrefreshed in the morning, and trouble thinking.
If these symptoms are severe, widespread pain may not be as important in the diagnosis. Symptoms that have lasted for at least 3 months.
No other medical explanation for why you feel this way for example, another health condition or disease. Treatment Overview There are many steps you can take to manage your symptoms. The treatment you need or want may be based on: How bad your symptoms are. Whether the condition is disrupting your daily life.
What kinds of changes in your life you are willing and able to make. Exercise Getting consistent exercise, especially cardiovascular exercise, is one of the best ways to manage fibromyalgia. Prevention Fibromyalgia can't be prevented or cured. Home Treatment Home treatment is the most important part of treating fibromyalgia. There are many things you can do over time to treat your symptoms: Exercise regularly. Of all the treatments for fibromyalgia, cardiovascular aerobic exercise may have the most benefit in reducing pain and other symptoms and in improving your overall condition.
Work with a physical therapist or other professional who has expertise with fibromyalgia to build an exercise program that works for you.
And then stay with it. Try to avoid or limit your exposure to "triggers" or "stressors" that make your symptoms worse. Common triggers include cold or damp weather, poor sleep, fatigue, physical or emotional stress, and being too active. Improve sleep. Sleep disturbances seem to both cause and result from some of the other symptoms of fibromyalgia, such as pain. Learn good sleep habits. And try to get enough sleep each night. Relieve pain. Heat therapy, massage, gentle exercise, and short-term use of nonprescription pain relievers may be helpful.
Reduce stress. Finding healthy ways to cope with stress may help reduce your pain. Learn about fibromyalgia. The more you know about fibromyalgia, the more control you will have over your symptoms. People who feel more in control also tend to be more active and report less pain and other symptoms. Learn ways to manage your memory problems. Feeling as though you are not thinking clearly—sometimes called "fibro fog"—increases stress and can make memory problems worse.
Simple things like writing yourself notes can help you feel more in control. Have a good-health attitude , along with these other healthy habits. It's hard to stay positive when you don't feel well. But a good attitude helps you focus less on your challenges and feel more healthy. These clinics offer the advantage of multiple specialists under one roof. With multiple potential symptoms and no single widely effective treatment method, fibromyalgia can be challenging for both doctor and patient.
There is typically some trial-and-error involved in finding the most effective medication, diet, type of exercise and therapy. See Multi-Specialty Fibromyalgia Treatment. The need to work closely together to ease pain and improve functioning should be taken into account when choosing a doctor.
Getting answers to these questions may help in selecting the best doctor for an individual:. See Other Specialists for Arthritis Treatment. Once a doctor has been selected, the individual may benefit from planning ahead to make the most out of each office visit.
It is often helpful to write down a brief description of symptoms in order of importance and bring the list to the next appointment. This list helps the individual think through the symptoms in a low-stress environment and ensures that nothing is overlooked during the office visit. See Fibromyalgia or Not?
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