Tender Points and Fibromyalgia
One of the key determinants of a fibromyalgia diagnosis is the presence of tender points, or tender, painful areas of the skin, tendons, or places where the bone can be felt through the skin. In the human body, there are 18, or 9 contralateral groups, sections that may be more sensitive or painful to the touch upon medical examination, for patients with fibromyalgia. Patients will be diagnosed with fibromyalgia if the express a heightened sensitivity to the doctors pressing on 11 or more of these tender points. A positive diagnosis for Fibromyalgia will include a positive expression by the patient for pain or heightened sensitivity in 11 of 18 tender points, plus widespread pain.
Fibromyalgia is a somewhat strange and complex medical disorder to diagnose and treat. Though the most common symptoms of this condition related to the musculoskeletal system, such as muscle pain and aches, but other symptoms include depression, anxiety, cognitive dysfunction, fatigue, and sleep disturbance. Some doctors are of the belief that all the symptoms fall under the umbrella of psychological disturbance, while other doctors think that all of the symptoms are caused by some other systemic disease that is still largely unknown.
Symptoms of Fibromyalgia: The fibromyalgia syndromes are a group of disorders characterized by achy pain and stiffness in the ligaments, tendons, muscles, and joints, as well as negative emotional states such as depression and anxiety. This condition is more common in women, but men have it also. Men are more likely to have a physical cause of their pain that can be traced back to and documented, such as recreational or occupational muscle strain. Fibromyalgia is not usually debilitating to the point of causing disability, but it is a disorder that can cause a lot of chronic pain, and it does carry with it a lot of co-morbid symptoms such as bowel and bladder abnormalities, and it can seriously impair the quality of life for those people who suffer from this condition.
Pain and stiffness are usually the first symptoms of fibromyalgia, and they usually develop gradually. The pain may remain isolated to one area, such as the shoulders, or it may be spread out to cause aches and pain all over. The symptoms are usually aches; in fibromyalgia confined to a specific area, the pain may be more sudden and sharp. The severity of these symptoms may remain the same throughout the day, or may increase in severity with overuse, straining, or fatigue. Specific areas may be tender when pressed on (tender points). Certain areas of muscle ache may tighten or spasm spontaneously. Though this muscle and soft tissue pain may be experienced anywhere, those to be most painful include the thighs, lower back, rib and chest cage, shoulders and neck. Symptoms other than muscle and soft tissue pain (pain of the joints, ligaments, and tendons) include irritable bowel syndrome, fatigue, depression, anxiety, and non-restorative sleep.
Treatments: Treatments for Fibromyalgia may include exercises, muscle relaxants, pain medications, and therapy to treat the anxiety related symptoms of the condition. Tramadol may be prescribed to treat nonrestorative sleep. Antidepressants may be prescribed to treat the anxiety and depression. Treatment of the muscle and soft tissue pain may be difficult because the pain doesn't appear to correlate to a measurable musculoskeletal problem. Sometimes, the muscle pain may be successfully treated with muscle relaxants and opiods.