PAIN MANAGEMENT
Dr. Stan Golovac
Mysterious “disease” affects females twice as often as males.
What is this mysterious “disease” that so many people, mainly women, complain about? Why does fibromyalgia cause muscles to ache without experiencing trauma? Why does it also involve nerves that cause sharp, burning-like pain and the day-to-day weakness that comes with it?
Let’s look at these issues and try to make some sense of fibromyalgia, which literally means “soft tissue-like pain.” It’s a chronic condition characterized by widespread pain, and patients usually hurt all over and feel exhausted. The pain can migrate from one area of the body to another at different times of the day, and change with weather conditions, menstrual cycles, and hormone levels. Other signs and symptoms include sleep disturbances, irritable bowel syndrome, headaches and facial pain, heightened sensitivity, and depression.
Fibromyalgia is more common in women than in men, affecting females twice as often as males. Five percent of the female population in the United Stated suffers from fibromyalgia, and the average age at the time of diagnosis is 40 years old.
Myofascial Pain Syndrome (MPS) is more common than fibromyalgia. The pain associated with MPS is more localized and regional than fibromyalgia’s diffuse pain. MPS also manifests itself with headaches, fatigue, de-conditioned muscles, excess weight, sore muscles, and a poor attention span. It’s important to make the distinction between MPS and fibromyalgia because treatment may vary.
Causes of Fibromyalgia
It’s not known what causes fibromyalgia, but recent literature supports a link with various mixed connective tissue diseases and chronic fatigue syndrome. It’s likely that a number of factors contribute to the development of fibromyalgia. Research and clinical trials are underway to identify a gene or mutation and determine why this condition affects so many people in the U.S.
Treatment
Before fibromyalgia can be treated, it’s important to first rule out other contributing causes. These include mixed connective tissue disease, hypothyroidism, systemic lupus erythromatosis, and chronic fatigue syndrome.
Once these have been ruled out, then it’s time to begin an aquatic therapy program and work on improving sleep. Painful muscles can be treated with stretching and muscle elongation. Medications can also help reduce pain and alleviate other symptoms, and include analgesics, antidepressants, and muscle relaxants.
Especially promising is the first drug approved by the Food and Drug Administration to treat fibromyalgia, called Pregabalin or Lyrica. At first, the patient takes 50 mgs of Lyrica twice a day, increasing it to 75 mgs three times a day. This may be enough to improve muscle pain and nerve discomfort, and allow the patient to sleep through the night, become more active and participate in aquatic therapy.
Physical therapists are turning their fibromyalgia patients on to the idea of exercise — in the water. It has been demonstrated that aerobic exercise is a crucial treatment for the population of fibromyalgia patients since they tend to be physically deconditioned. This deconditioned state promotes a continued cycle of pain, fatigue, and decreased motivation, leading to further inactivity. Fibromyalgia patients who participate in a regular aquatic exercise program can break that pattern of inactivity, and recapture control over their own symptoms.
Self Care of Fibromyalgia
Self-care is critical in the management of fibromyalgia. Here are some things a patient can do to help control the condition—and to live a more normal lifestyle:
- Reduce stress. Avoid or limit overexertion and emotional stress, and take time to relax. Try to stick to your routine and learn stress management techniques, such as deep-breathing exercises or meditation.
- Get enough sleep. Adequate sleep helps fight the fatigue often associated with fibromyalgia. Go to bed and get up at the same time each day, and limit daytime napping.
- Exercise regularly. Work through the increased pain that may be experienced at first with exercise, because regular exercise often decreases symptoms.
- Pace yourself. Keep your activity on an even level—overdoing it on good days may result in more bad days.
- Be health-conscious. That’s right. Eat healthy foods and limit caffeine intake. Do something you enjoy and find fulfilling every day.
- Learn coping skills. Fibromyalgia can be frustrating—in addition to being painful and exhausting—because it’s misunderstood by many. Learn as much as you can, and educate your family and friends. It’s important to know that you’re not alone, and support groups offer a great source of help and advice.
Stanley Golovac, MD is the co-director of Space Coast Pain Institutue. Dr. Golovac completed his education at UTESA University in 1985, where he received his Doctor of Medicine. Upon graduation, Dr. Golovac completed his postgraduate training in Family Practice Residency Program at St. Mary Hospital in New Jersey and in the Department of Anesthesiology at Jackson Memorial Hospital in Miami. Dr. Golovac gained extensive clinical experience in anesthesiology, emergency room medicine, and alternative services. He served as Assistant Clinical Professor of Anesthesia at the University of Miami Jackson Memorial Center for several years, and then as a practicing Pain Consultant in the Miami area. He currently utilizes his expertise at Cape Canaveral Hospital/Health First Pain Management and the Space Coast Surgery Center of Pain Management. For more information log on to YourPainInstitute.com
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