Fibromyalgia

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Fibromyalgia is a chronic medical condition characterized by widespread pain throughout the body, accompanied by other symptoms such as fatigue, sleep disturbances, memory problems, and mood issues. The exact cause of fibromyalgia is not fully understood, but it is believed to involve a combination of genetic, environmental, and psychological factors that affect how the brain and spinal cord process pain signals.

Fibromyalgia
Common Symptoms
  • Widespread Pain: A dull ache lasting for at least three months, affecting both sides of the body and above and below the waist.
  • Fatigue: Persistent tiredness even after sleeping for long periods; sleep may be disrupted by pain or other sleep disorders, such as restless legs syndrome or sleep apnea.
  • Cognitive Issues (“Fibro Fog”): Difficulty focusing, remembering, or thinking clearly.
  • Sensitivity to Touch, Light, or Sound: An increased response to stimuli that wouldn’t typically cause pain or discomfort.
  • Other Symptoms: Headaches, irritable bowel syndrome (IBS), depression, and anxiety.

While the exact cause is unknown, several factors may contribute to fibromyalgia:

  • Genetics: A family history of the condition.
  • Infections: Certain illnesses can trigger or exacerbate symptoms.
  • Physical or Emotional Trauma: Stressful events, injuries, or psychological stress can act as triggers.

Fibromyalgia is diagnosed based on symptoms, physical exams, and by ruling out other conditions. Blood tests and imaging studies may be done to exclude other causes of similar symptoms.

1. Trigger Point Injections

  • What It Is: Injections of a local anesthetic (sometimes combined with a corticosteroid) directly into painful muscle knots (trigger points).
  • Purpose: To relieve localized muscle pain and improve mobility.
  • Effectiveness: Provides short-term pain relief for some patients, allowing them to engage in physical therapy or exercise more effectively.

2. Nerve Blocks

  • What It Is: Injection of anesthetics, corticosteroids, or other agents near specific nerves to interrupt pain signals.
  • Types for Fibromyalgia:
    • Sympathetic Nerve Blocks: Target the autonomic nervous system, which may be overactive in fibromyalgia patients.
    • Facet Joint Blocks: For fibromyalgia patients with associated back pain.
  • Purpose: Reduce pain in a targeted area or calm overactive pain responses.

3. Radiofrequency Ablation (RFA)

  • What It Is: A minimally invasive procedure that uses heat generated by radio waves to deactivate specific nerves transmitting pain signals.
  • Purpose: Provides longer-lasting pain relief, particularly for localized pain in the neck or back that might overlap with fibromyalgia symptoms.

4. Spinal Cord Stimulation (SCS)

  • What It Is: An implanted device that delivers electrical impulses to the spinal cord to modulate pain signals.
  • Purpose: Reduces widespread pain in select fibromyalgia patients, though its use is more common for conditions like neuropathic pain.

5. Ketamine Infusions

  • What It Is: Intravenous administration of ketamine, an anesthetic that can modulate pain pathways in the brain and spinal cord.
  • Purpose: May provide relief for severe, treatment-resistant fibromyalgia pain by resetting overactive pain receptors.

6. Botox Injections

  • What It Is: Injections of botulinum toxin into painful areas, particularly muscles in the neck, shoulders, or other commonly affected regions.
  • Purpose: Relieves muscle tension and reduces localized pain.

7. Epidural Steroid Injections (ESI)

  • What It Is: Steroids injected into the epidural space around the spine.
  • Purpose: Primarily used for back or neck pain that might coexist with fibromyalgia, rather than directly treating fibromyalgia pain.

8. Prolotherapy

  • What It Is: Injections of a sugar or saline solution to stimulate healing and strengthen connective tissues.
  • Purpose: Targets areas of ligament or tendon pain to improve stability and reduce pain.

 

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