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Spine and Pain
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Fibromyalgia

Fibromyalgia (FM) is a chronic condition where there is widespread / whole body pain that is often difficult to diagnose. Some patients may spend years of going to different doctors, undergoing many tests (of which most, if not all, are negative), and they may be diagnosed with different conditions such as rheumatoid arthritis, hypothyroidism, or mononucleosis before a diagnosis of FM is finally given. Needless to say, this process can be very frustrating.

The reason for this dilemma is that there is no single diagnostic test (blood test, x-ray/image finding, etc.) that verifies the diagnosis of FM, leaving doctors in a position to rule out all other possible diagnose-able conditions first, before considering FM as the diagnosis. Another challenge is the fact that FM symptoms vary widely from one person to the next and even vary within the same person at different times of the year. There are a few guidelines doctors can use to help secure the diagnosis of FM.

One such guideline is from The American College of Rheumatology (ACR) which requires that widespread pain be present throughout the body for at least 3 months (widespread is defined as pain on both sides of the body, above and below the waist). The ACR also has identified 18 points on the body of which at least 11 of the 18 tender points must be present to secure the diagnosis of FM. There is debate as to the accuracy of this rather stringent criteria as FM symptoms can come and go and vary, making the 11 of 18 tender point findings sometimes change between visits. Hence, widespread pain above/below the waist on both left/right sides of the body for at 3 months has become a more accepted indicator for diagnosing FM.

Yet another challenge in pinning down the diagnosis is that the FM sufferer may experience signs and symptoms seemingly unrelated to FM, such as stomach ache/digestive problems or headaches. This can lead the doctor down other paths before considering FM as a diagnosis.

 

Video: Fibromyalgia Causes and Treatments

 

Fibromyalgia: Causes and Treatments

Fibromyalgia can be primary (no other condition caused it) or secondary (other condition(s) lead to the development of FM). Hence, the diagnosis process focuses on identifying conditions which can be identified through standard diagnostic tests, often overshadowing the diagnosis of FM. Testing for conditions such as lupus, multiple sclerosis, sleep apnea, diabetes, Crohn’s Disease, and/or others, often makes sense to both you and your doctor, but adds to the delay in diagnosing FM.

Here are some suggestions to help your doctor through this diagnostic maze:

Ask questions: Ask about what each test is for and what the next plan is if the tests are negative. By increasing your understanding, this will reduce your frustration in this process.

Keep records: Obtain a copy of EVERY test you have and share the information with any new doctor or specialist. This can save time and money!

Find the right doctor: Find a doctor you can trust and talk to. Not all doctors believe FM exists and some are close minded to considering it. Try to locate a doctor with a lot of experience with FM cases and is willing to work with you.

Build a good relationship: Be open, honest and avoid anger, skepticism and don’t beconfrontational. Be upfront about what is frustrating you about your symptoms.

Take care of yourself: Ultimately, success of treating FM demands a team effort between you and your doctor. Managing stress (eg., deep breathing exercises), obtain care that works (eg., chiropractic, massage), eat a healthy diet (eg., gluten-free), exercise regularly but don’t overdo it, and get plenty of sleep and rest.

Treating Acute and Chronic Pain

Medical Conditions

Medical Services

  1. Back and Neck Pain
  2. Herniated Disc
  3. Sciatica
  4. Nerve Related Pain
  5. Arthritis
  6. Myofascial Pain Syndrome
  7. Fibromyalgia
  8. Carpal Tunnel Syndrome
  9. Sport Related Injuries
  10. Work Related Injuries or
    Motor Vehicle Accidents
  11. Whiplash (CAD Syndrome)
  12. Migraine Headaches
  13. Degenerative Joint Disease
  1. Comprehensive Medical Evaluation
  2. Physical Therapy
  3. Chiropractic Treatment
  4. Acupuncture
  5. Massage Therapy
  6. DRX 9000 treatment
  7. Electrodiagnostic Studies
  8. Trigger Point Injections
  9. Joint Injections
  10. Epidural Steroid Injections
  11. Facet Joint Injections
  12. SI Joint Injections
  13. Medial Branch Blocks
  14. RadioFrequency Neurolysis
  15. Discography
  16. Lumbar Endoscopic Discectomy
  17. Spinal Cord Stimulation

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The content on NJCSPM is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please call 732-719-8148 for an immediate consultation or 911 if it is an emergency.
 
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