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Chronic pain of fibromyalgia

👤Dr Arun Ommen 🕔21/10/2014
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Chronic pain of fibromyalgia

Dear Doctor

I’m a 44 year old lady..I have been having recurrent pain over back, neck and shoulder for a long time . There is also tingling sensation over feet, thigh and hands. I don’t feel any weakness but this sensations prevent me from doing my work properly,… I even can’t sleep properly  on many days. I have consulted many doctors. Even an MRI of spine was done which does not show any major problem… What is my problem and how can I get rid of it?

Rajani Suresh , Abudhabi

Dear Rajani ,

Your problem seems to be Fibromyalgia which is a common and disturbing ailment. Fibromyalgia is estimated to affect 2–8% of the population, with a female to male incidence ratio of approximately 9:1. Fibromylgia is basically a functional somatic syndrome ie a physical response to depression and stress.

Exact cause is unknown but is believed to involve psychological, genetic, neurobiological and environmental factors. The same genes causing fibromyalgia  are also associated with other functional somatic syndromes and major depressive disorder. The central symptom of fibromyalgia, namely widespread pain, appears to result from neuro-chemical imbalances including activation of inflammatory pathways in the brain which results in abnormalities in pain processing..

Fibromyalgia patients have a lower threshold for pain because of   increased reactivity of pain-sensitive nerve cells in the spinal cord or brain . Neurochemical abnormalities that occur in fibromyalgia also regulate mood, sleep and energy, thus explaining why mood, sleep and fatigue problems are commonly co-morbid with fibromyalgia

Mode of inheritance is currently unknown, but it is most probably polygenic

Clinical presentation

Fibromyalgia is  characterised by chronic widespread pain and allodynia (a heightened and painful response to pressure. Other symptoms include debilitating fatigue, sleep disturbance, and joint stiffness. Some people also report difficulty with swallowing, bowel and bladder abnormalities, numbness and tingling and cognitive dysfunction. Pain may be localised in areas such as the shoulders, neck, low back, hips, or other areas. Not all people with fibromyalgia experience all associated symptoms.

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