Fibromyalgia management

Understanding fibromyalgia

Definition

Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas of the body. While the exact cause is unknown, research suggests several factors may contribute to its development:

Genetic Predisposition: Genetics may play a role, as fibromyalgia tends to run in families. Certain genetic mutations may increase sensitivity to pain.
Abnormal Pain Processing: People with fibromyalgia have a heightened sensitivity to pain. Their central nervous system may amplify pain signals, causing normal sensations to be perceived as painful.
Infections or Illnesses: Certain infections or illnesses have been linked to triggering or exacerbating fibromyalgia symptoms.
Physical or Emotional Trauma: Physical injuries, surgeries, or significant emotional stress may act as a trigger for the onset of fibromyalgia.
Hormonal Imbalances: Fibromyalgia may be related to imbalances in neurotransmitters such as serotonin, norepinephrine, and dopamine, which are involved in pain regulation, sleep, and mood.

Fibromyalgia symptoms

Fibromyalgia presents with a range of symptoms that can vary in intensity. The most common include:

Widespread Pain: The hallmark symptom is pain throughout the body, often described as a dull ache that persists for three months or more. It typically occurs above and below the waist and on both sides of the body.
Fatigue: Despite getting sufficient sleep, individuals with fibromyalgia often feel fatigued. Sleep is frequently disrupted by pain or other sleep disorders, such as restless leg syndrome or sleep apnea.
Cognitive Difficulties: Often referred to as "fibro fog," this includes problems with memory, focus, and concentration.
Sleep Disturbances: Many individuals with fibromyalgia have trouble falling asleep or staying asleep due to pain or other related conditions.
Tender Points: Specific areas of the body, such as the neck, shoulders, back, and hips, may be especially tender to touch.
Other Symptoms: Headaches, irritable bowel syndrome (IBS), anxiety, and depression are commonly associated with fibromyalgia.

Fibromyalgia management recommendations

The European League Against Rheumatism (EULAR) recommends a comprehensive, multidisciplinary approach to fibromyalgia, focusing on patient education, physical activity, and tailored treatments.

Key recommendations include:

Education and Self-Management: Informing patients about the condition to promote autonomy and coping strategies.
Multidisciplinary Care: Collaboration between osteopaths, physiotherapists, rheumatologists, psychologists, and other professionals.
Physical Activity: Regular, adapted exercise to improve pain, mobility, and well-being.
Cognitive Behavioral Therapy (CBT): To address stress, anxiety, and mood disturbances.
Sleep Management: Improving sleep hygiene and addressing sleep disorders when present.
Pharmacological Support: When necessary, medications such as antidepressants or anticonvulsants may be considered.
Complementary Therapies: Mindfulness, acupuncture, yoga, and massage as supportive options.
Regular Follow-Up: Continuous assessment to adapt treatment to the patient’s progress.

Dr Charbel Kortbawi, DO, MSc, integrates these principles into his osteopathic practice.
In addition to his manual care, he provides therapeutic patient education and helps design individualized physical activity programs tailored to each patient’s condition.