Fibromyalgia is a label that is ascribed to a large number of patients who describe chronic pain. Some of these patients have distinct tender points around their body, while others don’t have this at all but describe more of a diffuse pain that really isn’t specific to one particular anatomical region.
Fibromyalgia is not caused from a single pain generator. It is a common, yet complicated condition where patients have a heightened pain perception. Presenting complaints may be very broad and include irritable bowel syndrome, generalized aching, headaches, shooting pains in extremities, and other endocrine problems.
The specific cause of fibromyalgia is unknown. Professors, researchers, and clinicians do not understand why patients end up with a diagnosis of fibromyalgia. A significant amount of the time patients present with restless leg syndrome, disturbed sleep patterns, mineral and vitamin deficiencies, but no established cause can be figured out.
Some literature has displayed a relationship between fibromyalgia and pre-adolescent sexual abuse. Pre-adolescent sexual abuse can end up with a patient having problems of chronic migraines, fibromyalgia, hypertension, and potentially autoimmune diseases. During the evaluation of the patient, this should be asked.
Since fibromyalgia’s cause is not known, we can’t say that depression causes it, but it is often seen along with fibromyalgia. Multiple antidepressants have been shown to work well for fibromyalgia so it is known that depression is a common comorbidity. These include tricyclic antidepressants along with some others.
Fibromyalgia is definitely frustrating. The constellation of symptoms it comes with do not come from a known cause. Mental health often co-exists. A number of medications, some of which are FDA approved, work very well. They include tramadol, duloxetine, milnacipran, tricyclic antidepressants, and pregabalin. Interestingly, narcotics used to be commonly prescribed but have fallen out of favor due to their ineffectiveness. They can produce a condition called opioid induced hyperalgesia.
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