Hip Pain, Shoulder Pain and Fibromyalgia
Fibromyalgia is a disorder that causes aches and pain all over the body. People with fibromyalgia also have “tender points” throughout their bodies. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs that hurt when pressure is put on them.
Fibromyalgia affects as many as five million Americans ages 18 and older. Most people with fibromyalgia are women (about 80 – 90 percent). However, men and children also can have the disorder. Most people are diagnosed during middle age. Fibromyalgia can occur by itself, but people with certain other diseases, such as rheumatoid arthritis, lupus, and other types of arthritis, may be more likely to have it. Individuals who have a close relative with fibromyalgia are also more likely to develop it themselves.
What Causes Fibromyalgia?
- The causes of fibromyalgia are not yet known. Researchers think a number of factors might be involved. Fibromyalgia can occur on its own, but has also been linked to:
- Having a family history of fibromyalgia
- Being exposed to stressful or traumatic events, such as:
- Car accidents
- Injuries to the body caused by performing the same action over and over again (called “repetitive” injuries)
- Infections or illnesses
How is fibromyalgia diagnosed?
People with fibromyalgia often see many doctors before being diagnosed. One reason for this may be that pain and fatigue, the main symptoms of fibromyalgia, also are symptoms of many other conditions. Therefore, doctors often must rule out other possible causes of these symptoms before diagnosing fibromyalgia. Fibromyalgia cannot be found by a lab test. A doctor who knows about fibromyalgia, however, can make a diagnosis based upon two criteria:
- A history of widespread pain lasting more than 3 months. Pain must be present in both the right and left sides of the body as well as above and below the waist.
- Presence of tender points. The body has 18 sites that are possible tender points. For fibromyalgia diagnosis, a person must have 11 or more tender points. For a point to be “tender,” the patient must feel pain when pressure is put on the site. People who have fibromyalgia may feel pain at other sites, too, but those 18 sites on the body are used for diagnosis.
How is Fibromyalgia Treated?
Fibromyalgia can be hard to treat. It’s important to find a doctor who has treated others with fibromyalgia. Many family doctors, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who treat arthritis and other conditions that affect the joints and soft tissues.
Treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment. Treatment for fibromyalgia may include the following:
Getting enough sleep: Getting enough sleep and the right kind of sleep can help ease the pain and fatigue of fibromyalgia. Most adults need seven to eight hours of “restorative” sleep per night. Restorative sleep leaves you feeling well-rested and ready for your day to start when you wake up. It is hard for people with fibromyalgia to get a good night’s sleep. It is important to discuss any sleep problems with your doctor, who can then recommend proper treatment.
Exercising: Although pain and fatigue may make exercise and daily activities difficult, it is crucial to be as physically active as possible. Research has repeatedly shown that regular exercise is one of the most effective treatments for fibromyalgia. People who have too much pain or fatigue to do hard exercise should just begin to move more and become more active in routine daily activities. They can begin with walking (or other gentle exercise) and build their endurance and intensity slowly.
Eating well: Although some people with fibromyalgia report feeling better when they eat or avoid certain foods, no specific diet has been proven to influence fibromyalgia. Of course, it is important to have a healthy, balanced diet. Not only will proper nutrition give you more energy and make you generally feel better, it will also help you avoid other health problems.
Pain management: Three medicines have been approved by the U.S. Food and Drug Administration (FDA) to treat fibromyalgia. These are pregabalin (Lyrica), duloxetine (Cymbalta), and milnacipran (Savella). Other medications are being developed and may also receive FDA approval in the future. Your doctor may also suggest non-narcotic pain relievers, low-dose antidepressants, or other classes of medications that might help improve certain symptoms.
Other treatments: Complementary therapies may help you. Talk to your physician before trying any alternative treatments. These include:
- Physical therapy
- Massage
- Myofascial release therapy
- Water therapy
- Light aerobics
- Acupressure
- Applying heat or cold
- Acupuncture
- Yoga
- Relaxation exercises
- Breathing techniques
- Aromatherapy
- Cognitive therapy
- Nutritional supplements
To learn more information about fibromyalgia, and if you may have it, call Colorado Center of Orthopaedic Excellence at (719) 623-1050, or request an appointment online.
