Fibromyalgia Syndrome

Diffuse Musculoskeletal Pain May Require Medical Evaluation

Fibromyalgia is a disorder characterized by widespread musculoskeletal pain and fatigue, as well as sleep, memory, and mood disturbances. Researchers believe that fibromyalgia magnifies painful sensations by affecting the way your brain processes pain signals. Symptoms sometimes begin with a physical or emotional trauma. Dr. Cynthia Crawford is Board Certified in Physical Medicine and Rehabilitation. We consulted her for her expertise on the subject matter. She has been in practice in Vero Beach since 1985. She received her medical degree from Virginia Commonwealth University in Richmond, Virginia. She specializes in fibromyalgia, post polio, back care, orthotics, prosthetics, and amputee rehabilitation. Dr. Crawford explains that while we are not sure what causes Fibromyalgia Syndrome (FMS), certain risk factors such as accidents, falls, viruses such as the flu, have been linked with an increased incidence of the disorder. For example, physical stressors such as accidents, surgery and infections, aswell as psychological stress may trigger FMS. However, for some, there may not be any traceable cause for the onset of fibromyalgia.

Women are much more likely to develop this disorder, more so than men. Female reproductive hormones may play a part in how women experience pain. Pre-menstrual and menopausal states may explain the increased incidence in women. Many people who have FMS, also have co-existing conditions such as: tension headaches, Temporomandibular Joint Dysfunction Syndrome (TMJ), Irritable Bowel Syndrome (IBS), anxiety and depression. Approximately seventy five percent of patients have some degree of jaw discomfort, which may be from TMJ. The fatigue can vary in degree from mild to incapacitating. Fatigue has been described as not only physical, but also as “brain fatigue” . Patients report having difficulty with concentration. The pain associated with FMS is described as a constant dull ache, typically arising from muscles. Intense burning may also be present. In order for the pain to be considered diffuse or widespread, the pain must occur on both sides of your body, and above and below the waist. The disorder is characterized by pain in specific areas of the body when pressure is applied. These tender points include: back of the head, between shoulder blades, top of shoulders, front and side of the neck, upper chest outer elbows, inner knees, and the side of the hips. Besides being female, other risk factors are a family history of FMS, rheumatic disease, such as rheumatoid arthritis or Lupus. Other aggravating factors may be changes in weather, cold or hot environments, and over-exertion. Other common symptoms associated with fibromyalgia include: chest pain, morning stiffness, cognitive or memory impairment, numbness and tingling sensations, muscle twitching, and increased sensitivity to odors, bright lights, and loud noises.

The pain and lack of sleep associated with fibromyalgia can interfere with functioning at home or on the job. The frustration of dealing with an often misunderstood condition can result in depression and health related anxiety. In 1990, the American College of Rheumatology established two basic criteria for the diagnosis of fibromyalgia. Widespread pain lasting for at least three months and in at least eleven tender points. Since then guidelines have been modified and are less stringent because for many patients the symptoms come and go. Currently pain must last for at least three months and other causes of the symptoms must be ruled out prior to making the diagnosis. For example, due to the vagueness of patient complaints, FMS symptoms can mimic those of Chronic Fatigue Syndrome CFS . Dr. Crawford points out that with the major differentiation, from a lab standpoint, is that with CFS the lab will be positive for Epstein Barr Virus (EBV). There is no diagnostic lab for fibromyalgia. Blood tests areordered to rule out any other causes for symptoms experienced by the patient. Therefore, a complete blood count, erythrocyte sedimentation rate, and thyroid function tests may be among those ordered to exclude other possible causes.

Dr. Cynthia Crawford reports that FMS can be controlled and that symptoms subside with proper treatment. Both pharmacological and non-pharmacological methods may be utilized. Non- pharmacological methods may include: getting enough sleep, reducing stress, exercising regularly, acupuncture, and massage. The aim is to reduce stress and anxiety to eliminate symptoms. Sometimes, therapy with a counselor may help with regaining belief in one’s abilities. However, if these methods do not alleviate symptoms satisfactorily, medications may be prescribed. Medications can help with reducing pain and improving sleep. Antidepressants and analgesics are sometimes used to reduce fibromyalgia symptoms. If sleep or medications do not alleviate sleep deprivation, a sleep study test may be recommended. Fibromyalgia has alpha intrusion waves. If you have any additional questions for Dr. Cynthia Crawford, she may be contacted at (772) 778-2107.

Dr. Cynthia Crawford
1985 35th Avenue ( Off Rt. 60)
Vero Beach, Florida, 32960