How Does a Rheumatologist Diagnose & Treat Fibromyalgia?
Affecting nearly 4 million adults annually, fibromyalgia is a medical condition that causes severe musculoskeletal pain throughout the body and may also result in extreme fatigue, trouble sleeping, headaches, and memory or mood changes. In some cases, individuals may also experience irritable bowel syndrome (IBS) or interstitial cystitis.
Although the specific cause of this condition remains unknown, researchers believe that in fibromyalgia there is a disconnect between how the brain and spinal cord process pain in other parts of the body leading to heightened/amplified pain. The symptoms may be triggered by physical trauma, or significant amounts of mental or physical stress. Genetics may also play a role in the development of fibromyalgia. Fibromyalgia affects women more often than men, and patients with certain inflammatory rheumatic diseases such as rheumatoid arthritis may be disproportionately affected.
While fibromyalgia’s root cause remains a mystery, rheumatologists can help patients better manage their symptoms and help understand if there are any other underlying medical conditions that may be contributing.
Diagnosing Fibromyalgia
Fibromyalgia is a diagnosis of exclusion. There are no lab tests or imaging studies that can “rule in” fibromyalgia. Furthermore, many of the symptoms of fibromyalgia may be common with other medical conditions. After taking a detailed history, and performing a physical examination focusing on painful areas of the body, a rheumatologist may order certain blood tests and/or imaging studies to exclude other contributing factors (such as vitamin deficiencies, thyroid disorders, underlying autoimmune condition) and which may help establish the diagnosis. If a patient has significant fatigue, a sleep study to evaluate for sleep apnea may be recommended.
Treating Fibromyalgia
Once fibromyalgia is diagnosed by a rheumatologist, the next step is an individualized approach to treat the patient based on the specificity and severity of symptoms.
In many fibromyalgia cases, a pharmacological approach may only be one piece of the patient’s overall treatment plan. Since fibromyalgia symptoms include pain, sleep disturbances, mood disorders and/or fatigue, rheumatologists will work with the patients to promote self-care to help manage and minimize their symptoms. These self-management strategies include daily structured exercises, a plan to develop better sleeping habits and more restful sleep, and relaxation techniques such as yoga or meditation which may help to reduce stress.
In cases where a patient is experiencing cognitive difficulties, rheumatologists may recommend Cognitive Behavior Therapy to help modify any negative behaviors and emotions they are experiencing. Support groups may also help patients manage their symptoms by discussing and sharing their feelings and experiences with other fibromyalgia patients.
Even though there are many things we do not completely understand about this condition, rheumatologists do know how to diagnose and how to help manage fibromyalgia symptoms through medical knowledge, pharmacologic/supplements, and self-management strategies. If you or someone you care about may be dealing with fibromyalgia, please contact us today to schedule a rheumatology appointment in Scarsdale, NY.