The pain is not all in the head
By Shillpi A Singh | Published: 21st October 2017 10:00 PM |
Last month, when pop megastar Lady Gaga took to Twitter to reveal that she has fibromyalgia (pronounced fy-bro-my-AL-ja), little did the world know about this long-term condition, which can cause pain all over the body. She has also narrated her painful existence in the Netflix documentary, Gaga: Five Foot Two.
For the uninitiated, fibromyalgia is a chronic pain syndrome characterised by tenderness and pain in muscles and deep tissues which lasts for months. The other symptoms include chronic fatigue syndrome, headache, depression, irritable bowel syndrome, sleep disturbances, osteoarthritis and rheumatoid arthritis, stress disorders, restless legs syndrome and mental lethargy. “Each patient with fibromyalgia is unique. Any of the above symptoms can occur intermittently and in different combinations,” says Mumbai-based rheumatologist Dr Nalin Shinde.
According to the National Fibromyalgia Association, it affects 3-6 per cent of the world’s population, but barely 0.5 per cent people are aware of it. Also, because it mimics symptoms of other ailments (vitamin D, B12 deficiency, and thyroid), it is often misdiagnosed. “I first noticed mild aches, which graduated to severe pain all over the body and sleep disturbances. I first consulted a general practitioner, went through the rigmarole of blood tests and scans, followed up with an orthopaedic doctor. Finally, a rheumatologist diagnosed me with fibromyalgia,” rues Mumbai-based Sanjana Sharma (33).
In 1990, the American College of Rheumatology established two criteria for the diagnosis of fibromyalgia—widespread pain lasting at least three months and at least 11 positive tender points. “The diagnosis is made purely on clinical grounds based on the patient’s history,” says Lucknow-based orthopaedic Dr Sanjay Srivastava.
The cause of fibromyalgia is unknown, though those affected tend to feel pain in response to stimuli that are not perceived as painful. But what causes this supersensitivity of the brain? Lady Gaga’s film has made it clear that the pain is not ‘all in the head’. Chennai-based Dr U Gauthamadas says fibromyalgia amplifies painful sensations by affecting the way brain processes pain signals resulting in a heightened sensitivity and a lower pain threshold. But for some, the condition may also be triggered by a physical trauma.
Moreover, there is no cure. In general, treatment for fibromyalgia works on minimising symptoms and improving general health. The medication acts on the chemical neurotransmitters in the brain to help increase pain threshold. The self-care model works on alteration of daily activities and lifestyle modifications, exercises, reducing stress and maintaining a regular sleep/wake cycle.
Dr Gauthamadas offers Osteopathic Manipulative Posture Alignment Treatment at his centre that involves stretching muscles, applying pressure, and moving the parts of the body against resistance but under supervision. The complementary and alternative therapies such as acupuncture, massages, yoga and tai chi also relieve stress and reduce pain. Dr Anupama Singh, an ayurvedic medicine practitioner, says, “Our treatment includes a combination of Panchakarma therapies, exercises, stress management, strict diet and lifestyle modifications.”
• Affects 7-8% of the general population
• Occurs in people of all ages, even children
• More common in women
• Symptoms are chronic but may fluctuate
• Roughly 25% of patients are work-disabled
• Fibromyalgia is manageable with medications, exercise