Fibromyalgia

What Is Fibromyalgia?

Fibromyalgia is a chronic condition that causes widespread pain, fatigue, and a range of other symptoms, significantly affecting the quality of life. It is often misunderstood and difficult to diagnose due to its complex nature. In Singapore, increasing awareness about fibromyalgia is crucial to helping individuals seek timely diagnosis and treatment.

Fibromyalgia is a long-term condition that primarily affects the muscles and soft tissues, leading to widespread pain and tenderness. The exact cause of fibromyalgia is not fully understood, but it is believed to involve abnormal processing of pain signals by the nervous system.

Symptoms can vary in severity and may affect different parts of the body. Some people may experience mild discomfort, while others suffer from severe, debilitating pain. Fibromyalgia can also fluctuate, with periods of flare-ups where symptoms become worse, followed by times of remission.

What Causes Fibromyalgia?

The exact cause of fibromyalgia remains unknown, but several factors are believed to contribute to its development:

1. Genetics: There may be a genetic predisposition to developing fibromyalgia, as it tends to run in families.
2. Infections or illnesses: Certain infections or illnesses may trigger or worsen fibromyalgia symptoms.
3. Physical or emotional trauma: Traumatic events, such as accidents, surgeries, or psychological stress, are thought to play a role in triggering fibromyalgia.
4. Abnormal pain processing: People with fibromyalgia may have heightened sensitivity to pain due to abnormal pain signalling in the brain and spinal cord.
5. Hormonal imbalances: Imbalances in certain neurotransmitters and hormones that regulate mood, sleep, and pain perception could contribute to fibromyalgia.

What Are the Symptoms of Fibromyalgia?

The primary symptom of fibromyalgia is widespread musculoskeletal pain that affects both sides of the body and persists for at least three months. However, fibromyalgia involves more than just pain. Other common symptoms include:

• Fatigue: Despite resting or sleeping, people with fibromyalgia often feel exhausted and lack energy.
• Cognitive difficulties ("fibro fog"): This includes problems with concentration, memory, and thinking clearly.
• Sleep disturbances: Many individuals experience disrupted sleep, often waking up feeling unrefreshed.
• Headaches or migraines: Chronic headaches are commonly reported in people with fibromyalgia.
• Digestive issues: Symptoms such as irritable bowel syndrome (IBS) are also frequently associated with fibromyalgia.
• Sensitivity to temperature or noise: Individuals may find themselves unusually sensitive to heat, cold, or loud noises.

Is Fibromyalgia Painful?

Fibromyalgia is typically painful, with widespread muscle pain and tenderness being hallmark symptoms of the condition. The pain can vary from dull aches to sharp, stabbing sensations and is often described as burning or throbbing. The severity of pain can fluctuate throughout the day and may worsen with physical activity, stress, or lack of sleep. It is also common for fibromyalgia pain to intensify during flare-ups, making it difficult for patients to engage in daily activities.

Who Is at Risk of Getting Fibromyalgia in Singapore?

While fibromyalgia can affect anyone, certain groups are at higher risk of developing the condition. These include:

1. Gender: Women are more likely to be diagnosed with fibromyalgia than men, possibly due to hormonal differences or genetic factors.
2. Age: Although fibromyalgia can occur at any age, it is most commonly diagnosed in middle-aged adults, typically between the ages of 30 and 50.
3. Family history: Having a close family member with fibromyalgia increases the risk of developing the condition.
4. Existing medical conditions: People with other conditions, such as rheumatoid arthritis, lupus, or osteoarthritis, have a higher likelihood of experiencing fibromyalgia.
5. Stress or trauma: Physical trauma, surgery, or emotional stress can increase the risk of triggering fibromyalgia.

How Is Fibromyalgia Diagnosed?

Diagnosing fibromyalgia can be challenging as there is no specific test for the condition. Instead, diagnosis is usually based on a combination of clinical evaluation and exclusion of other conditions. The following steps are typically involved in diagnosing fibromyalgia:

1. Medical history and symptom review: The doctor will take a detailed history of your symptoms, focusing on the nature, duration, and location of pain.
2. Physical examination: A physical exam may be conducted to assess tenderness in specific areas known as "tender points" or to rule out other conditions.
3. Exclusion of other conditions: Blood tests or imaging may be performed to exclude other conditions, such as rheumatoid arthritis, thyroid disorders, or neurological diseases.

In many cases, a diagnosis of fibromyalgia is made when other potential causes of the symptoms have been ruled out, and the individual has experienced widespread pain for more than three months.

What Are the Treatment Options for Fibromyalgia in Singapore?

While there is no cure for fibromyalgia, managing symptoms and improving quality of life are the primary goals of treatment. In Singapore, treatment options include:

1. Medications:
   • Pain relievers: Over-the-counter medications like paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) may help relieve pain.
   • Antidepressants: Certain antidepressants, such as amitriptyline or duloxetine, can help alleviate pain, improve mood, and enhance sleep quality.
   • Anti-seizure medications: Drugs like pregabalin and gabapentin are often prescribed to reduce nerve pain associated with fibromyalgia.
2. Physical therapy: Gentle exercises and stretching can help reduce pain, improve mobility, and strengthen muscles.
3. Cognitive behavioural therapy (CBT): CBT is a form of talk therapy that helps individuals develop coping strategies to manage chronic pain and stress.
4. Lifestyle changes: Regular exercise, a balanced diet, stress management, and adequate sleep are critical components in managing fibromyalgia.
5. Alternative therapies: Acupuncture, massage therapy, and yoga may provide relief from pain and help reduce stress.