the soft tissues of the body (muscles, muscle coverings and ligaments) over a widespread area from the neck to the knees. In the past it has been called fibrositis and soft tissue rheumatism. A feature of this rather puzzling condition is that it is chronic, meaning that it lasts for at least three months and usually on and off for years. What i s t he cause? The cause of fibromyalgia is unknown. However, it is thought that certain chemical substances produced in the central nervous system circulate to the soft tissues and make them very sensitive to pain. There is no hidden serious disease, injury or other damage causing the problem. Who get s fi bromyal gi a? It occurs in all types of people. It usually appears in adults between the ages of 30 and 60, particularly in people in their 30s and 40s. It is six times more common in females compared with males. What are t he usual sympt oms? Aches and pains in the areas shown, espe- cially of the neck, shoulders and back Stiffness in these areas Tenderness over spots in these areas called trigger points Fatigue Sleeping difficulties Emotional reactions to the problem Some people may get an irritable bowel condition Note: the degree of pain varies from person to person and for an individual can vary from day to day. What are t he aggravat i ng fac- t ors? Stress Fatigue and overwork Exposure to dampness and cold Excessive activity What i s t he out l ook? Despite the severity or length of the dis- comfort, the problem always has the poten- tial to settle down and spontaneous recovery sometimes occurs. Others tend to have the condition flare up, with periods of feeling well on and off for a long time, even years. Although uncomfortable, fibromyalgia is not life-threatening. A good way to cope with it is to consider it rather like tinnitus (constant ringing in the ears), which is pre- sent in the background, but not so notice- able when one keeps busily occupied and distracted with interesting things. What i s t he t reat ment ? There are many treatments available, but no particular one is magic. The goal of treat- ment is self-management. It is advisable to avoid multiple treatments, especially physical treatments that do not give significant relief. Sel f-hel p Try to understand what aggravates the prob- lem (such as stress, emotion, heavy activity, tiredness) and avoid these factors. Try other strategies that may suit you, for example: Heat, such as hot baths and showers, heat packs or compresses Relaxation techniques Pleasant distractions An exercise program exercise is very important A postural-related program (eg, yoga, tai chi) Hydrotherapy There is no proven special diet, but avoid substances that interfere with sleep, such as caffeine and alcohol. Suppor t programs Most people are helped by a relaxation pro- gram and also a supervised rehabilitation exercise program, including walking, swim- ming and cycling. There are experienced therapists who can help. Medi cat i on There is no single drug for fibromyalgia, but there are a variety of drugs that can help some people on an individual basis. Your doctor may give you a trial of one of these. PATIENT INFORMATION Fibromyalgia AUTHOR: PROFESSOR JOHN MURTAGH Copyright of Professor John Murtagh and Australian Doctor. This patient handout may be photocopied or printed out by a doctor free of charge for patient information purposes. Typi cal t ender poi nt s of fi bromyal gi a
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