Fibromyalgia

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    The 2012 Institute of Medicine Report about Pain in America revealed that more than 100 million Americans are in pain with a annual price tag of more than $65 billion. The cost of fibromyalgia to both the individual and to society is extensive. A 2007 study found that 34% of people with fibromyalgia spend between $100-$1,000 per month above their insurance to see a healthcare professional. Prominent fibromyalgia researchers and specialists estimate the costs in the U.S. between $12-14 billion each year and accounts for a loss of 1-2% of the nation’s overall productivity.

    According to a 2003 published study in the Journal of Rheumatology:
    • The total annual costs for fibromyalgia claimants were more than twice as high as the costs for the typical insurance beneficiary.
    • The prevalence of disability among employees with fibromyalgia was twice as high as among all employees.
    • For every dollar spent on fibromyalgia specific claims, employers spent approximately $50 -$100 on additional direct and indirect costs.
    Additional studies show:
    • Work and disability status of 1,668 people with fibromyalgia reported that 25% had received disability payments.
    • Failure to diagnose a true case of fibromyalgia has its own costs, largely in excess general practitioner visits, investigations and prescriptions.
    • Use of complementary and alternative medicine is two and a half times higher in people with fibromyalgia.
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    AJennifer Caudle, DO, Family Medicine, answered
    What type of doctor(s) should I see if I think I have fibromyalgia?

    There are many types of physicians who can diagnose and treat fibromyalgia, including family physicians, internists and rheumatologists. Watch family medicine physician Jennifer Caudle, DO, discuss who to see if you think you may have fibromyalgia.


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    ANatalie E. Azar, MD, Rheumatology, answered
    Can the change of seasons or the weather impact my fibromyalgia symptoms?

    Research suggests that changes in seasons and the weather do not have an impact on fibromyalgia symptoms; but patients often claim that weather makes a difference. Watch rheumatologist Natalie Azar, MD, explain how weather can impact symptoms.


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    AJennifer Caudle, DO, Family Medicine, answered
    What is the difference between fibromyalgia and Lyme disease?

    Fibromyalgia and Lyme disease share some symptoms, but they are very different diseases. In this video, family medicine specialist Dr. Jennifer Caudle explains how that affects the way these problems are diagnosed and treated.


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    ARealAge answered

    Napscan't make up for a chronic lack of nighttime sleep -- a common problem for people with fibromyalgia -- but a quick nap or midday rest can go a long way in minimizing fibromyalgia fatigue. Even just a 10-minute power nap may help in dealing with fibromyalgia. Patients should talk with their fibromyalgia doctor about steps they can take to sleep more soundly.

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    ARealAge answered

    Somepeople are allergic or sensitive to certain foods and food ingredients, including gluten (found in wheat) and lactose (found in dairy products). Side effects can include an upset stomach, fatigue or depression. Although no evidence exists about whether these foods help or hurt fibromyalgia symptoms, it's important for patients to know whether they have allergies or sensitivities because they could be making their fibro symptoms worse.

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    ARealAge answered

    There is little to no evidence that artificial sweeteners used in sugar-free beverages and packaged foods actually worsen people's fibromyalgia. But in a handful of individual case studies, nixing aspartame actually improved, and in some cases eliminated, the fibromyalgia pain and fatigue. And some experts suggest that certain food additives, like the flavor-enhancer monosodium glutamate (MSG) or the nitrates in processed meat, might make living with fibromyalgia more difficult if it triggers any unpleasant symptoms or side effects. More research is needed in all cases, but you can try an elimination diet if you'd like to investigate the impact that food additives might be having on your fibro symptoms.

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    ACeleste Cooper, Rheumatology, answered

    There has been a great deal of discussion regarding caffeine in general.  For instance, sources of caffeine, coffee and chocolate in particular, have had varying discussions and the end result is “to have or not to have.”

    The bottom line for fibromyalgia and the overlapping conditions, such as interstitial cystitis (a painful bladder disorder), irritable bowel syndrome, migraine, etc., is to use an elimination diet process. Start by eliminating various caffeine sources from your diet. Do it one at a time and try it for at least a week. If you start to feel better….BINGO! To determine if one source in particular might be the culprit, add each one back into your diet. If you feel worse, then you know to avoid it.

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    ADawn Marcus, Neurology, answered
    In 2010 and 2011, the American College of Rheumatology and the Association of the Medical Scientific Societies in Germany each proposed modifying the criteria for diagnosing fibromyalgia. They argued that many physicians don't complete the tender point examination (to determine areas on the body that are tender when pressed), which means that their patients can't be given a diagnosis of fibromyalgia. In addition, which tender points are positive -- and how tender they are -- may change on any given day. It is therefore possible that on some days you might have more positive tender points than on others, and on other days you might not have the 11 required tender points. As a result, some people with fibromyalgia may not be diagnosed properly.

    The two new sets of criteria have added other common symptoms besides pain to help make a diagnosis. Therefore, you might be diagnosed with fibromyalgia even if your doctor doesn't test your tender points, or you don't have the needed 11 tender points on a given day. Regardless of which criteria are used, your doctor needs to complete a thorough examination before the fibromyalgia diagnosis is made to make certain your symptoms are not caused by other health conditions.
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    ADawn Marcus, Neurology, answered
    In fibromyalgia, tender points are seemingly unrelated areas on the body that are painful when pressed. Researchers have identified 18 areas that are typically tender when pressed.

    People with fibromyalgia often find the tender point examination a little silly, and may ask their doctors, "But doesn't everyone find these spots tender when you press them?" The answer to this is a resounding "no!" At the University of Pittsburgh, we helped develop the tender point examination and studied these areas in people with fibromyalgia and other severe chronic pain conditions. We found that experiencing tenderness when these point areas were pressed was specific for fibromyalgia. Having many sensitive tender points occurs in fibromyalgia, but not in people with pain caused by other conditions -- such as muscle pain, pinched nerves, slipped discs, or arthritis.

    People with other conditions may have several painful tender points, but they usually don't have as many, and they may also have other issues that help distinguish their symptoms from fibromyalgia. The most important message is that people with fibromyalgia have a different pattern of pain than do people with other chronic pain conditions.