纤维肌痛的原因, Symptoms, Diagnosis and Treatment

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纤维肌痛的通用指南:您想知道的一切,直接来自专家。

In This Article:What Is Fibromyalgia?|原因|Symptoms|Diagnosis|治疗|与纤维肌痛生活|来源

Every illness has its own unique set of challenges, but there’s something about an “invisible illness” that has even more hurdles. Even though your particular condition isn’t necessarily visible to the outside world, you still get up each day knowing that you’ll face struggles that seem “easy” for everyone else.

女人躺在床上躺在她的枕头和床上用品下除了广泛的身体疼痛外,有些患有纤维肌痛的人会遇到睡眠困难。照片来源:123rf.com。

And so it goes for fibromyalgia . As a disorder that’s characterized by intense, widespread pain, you might wake up and wonder if you can handle going to the grocery store or if you should just stay in bed. Do you feel good enough to work out? Socialize? Or even take a shower? When you have fibromyalgia, these things might consume your mind.

它变得更加复杂,因为纤维肌痛与大多数形式的背痛不同。这意味着 - 您很失望 - 许多传统形式的背痛治疗形式无效。

Read on to learn more about this often-misunderstood disorder that causes not onlyback pain但是在整个身体的其余部分也疼痛。

What Is Fibromyalgia?

纤维肌痛是一种慢性疼痛障碍,每年影响数百万美国人(主要是女性),并且在身体和情感上都可能令人痛苦。纤维肌痛来自纤维组织(纤维)的拉丁语和肌肉(Myo)和疼痛(ALGIA)的希腊语单词。确实,纤维肌痛患者经历了广泛的慢性肌肉疼痛。

想象一下您的身体作为网络浏览器和纤维肌痛作为一系列开放式标签。一个标签是深肌酸痛。另一个是背痛。有一个标签失眠还有另一个用于抑郁症。然后还有另外五个一般疲劳的选项卡。所有这些选项卡都打开了,您的整个系统可能会开始减速或关闭。

纤维肌痛是一种慢性且经常被误解的状况,如此复杂。为了增加对伤害的侮辱 - 直到最近,医生才经常误诊它,但有些人质疑其作为一种实际疾病的合法性。

But fibromyalgia is very much real. And it’s thought that about 4 million people in the U.S. (that’s 2 to 4% of the adult population), are impacted by it, saysAi Mukai, M.D。这是奥斯汀德克萨斯州骨科的董事会认证的物理医学和康复医生。

她补充说,它在中年成年人中往往更为普遍,并且女性尤其是。Mukai博士阐述说:“女性患有纤维肌痛的可能性是纤维肌痛的3到9倍。”

If you’ve lived with widespread muscle pain for more than 3 months with other symptoms such as sleep disturbance, mood, memory issues, and fatigue, then—congrats, you might be diagnosed with the F word.

纤维肌痛症状纤维肌痛是一种广泛的慢性疼痛障碍,会影响身体的许多不同区域和功能。照片来源:123rf.com。What Are the Possible Causes of Fibromyalgia?

Like so many misunderstood conditions, fibromyalgia can be brought on by a host of causes.

“纤维肌痛是由称为概念驱动的复杂条件中央灵敏度(CS),”迈克·比尔(Mike Bierle),医学博士, an associate professor of medicine with the Division of General Internal Medicine at Mayo Clinic and a core faculty member of the Fibromyalgia and Chronic Fatigue clinic.

Bierle博士继续说:“我认为CS是神经系统用来分析,解释和应对感觉的策略的变化。”“这当然会影响疼痛信号,但也会影响其他感官,从而导致敏感性触摸,气味,光,声音,食物和药物。”

Bierle博士补充说,这些敏感性通常与他所谓的“创伤性侮辱”激活大脑或边缘系统的生存部分。这些侮辱可能是:

  • Physical, emotional, or sexual abuse
  • 创伤tic events such as a motor vehicle accident or loss of a loved one
  • Medical events such as surgery, pregnancy/childbirth, or infections

Although at times Dr. Bierle says he and his colleagues aren’t able to identify an insult, he notes that several changes in the nervous system can contribute to these issues.

  • Hypergerseia:神经系统会放大疼痛,“将'卷从2升至11,” Bierle博士说
  • 异常痛:神经系统将非呼吸信号转换为疼痛信号
  • 疼痛的集中化:大脑和脊髓会产生疼痛信号,而无需等待神经的刺激

某些医疗状况会增加患纤维肌痛的风险,包括:

Mukai博士说:“有一些理论可能与女性生殖激素有关,因为生殖年龄妇女的纤维肌痛发生率似乎更高。”

她继续说:“自身免疫性疾病的症状有很多重叠,在身体多个区域和纤维肌痛中疼痛。”“受影响最大的患者人群(即妇女)是相似的。另外,似乎还有一些遗传成分。患有纤维肌痛的家庭成员的人似乎有更高的发展风险,但尚未建立确切的遗传联系。”

Dr. Mukai also says that post-traumatic stress disorder (PTSD) can be a contributing factor.

Fibromyalgia Flare Triggers

Fibromyalgia Flare Triggers纤维肌痛爆发的最常见触发因素。

While we’re talking about causes, it’s also important to recognize that fibromyalgia is prone to flare-ups, when your symptoms intensify. These flare-ups can be triggered by:

  • Stress
  • Sleep deprivation
  • 感染
  • 手术
  • 用药更改
  • Repetitive movements
  • 姿势不佳
  • 创伤

Fibromyalgia flare trigger stressStress can trigger a fibromyalgia flareup

What Are Common Fibromyalgia Symptoms and How Does It Cause Back Pain?

Bierle博士分享了这些纤维肌痛的标志性症状,这些纤维肌痛相似:男性与男性相似:

  • 全身疼痛
  • 疲劳
  • Memory and concentration difficulties
  • 睡眠不足
  • 头痛
  • 腹痛
  • 腹泻
  • 便秘
  • 情绪问题

Bierle博士说:必威礼包“在纤维肌痛患者中,背部和颈部疼痛非常普遍。”“我从患者那里听到的一个常见故事是,他们的疼痛始于脖子和/或背部,然后在数周,几个月或几年的时间内传播到身体的其他区域。”

Fibromyalgia can also lead to解剖学(肌肉力量的丧失),导致其他颈部和背部疼痛的原因恶化,例如退化性椎间盘疾病,根治性疾病或脊柱狭窄。

“Patients with other causes of back pain, like a椎间盘突出,可能会经历更严重的症状,持续时间更长,并且可能不会像预期的那样对治疗做出反应。” Bierle博士指出。必威betway微博

Fibromyalgia doesn’t limit itself to paraspinal back pain, either. According to Dr. Mukai, “it can cause pain anywhere in the body where there are soft tissues and muscles. Fibromyalgia pain is different than more specific spine-related pain like sciatica or disc pain. It tends to be more diffuse and not in a specific location.”

还有其他条件可以与纤维肌痛共存。这些合并症可以包括:

  • Anxiety
  • 自身免疫性条件
  • 慢性疲劳综合征
  • 沮丧
  • 间质性膀胱炎
  • 肠易激综合症
  • 刺激性膀胱
  • 偏头痛
  • 骨盆底故障
  • Post-traumatic stress disorder (PTSD)
  • Postural orthostatic tachycardia syndrome
  • 雷诺综合症
  • 不安的腿综合征
  • Sleep disturbance
  • TMJ或颞下颌关节障碍
  • Vulvodynia (chronic pain in the vaginal area)

纤维肌痛不是威胁生命的疾病,但确实需要解决。

Bierle博士说:“纤维肌痛通常是蜡和减弱的,如果不像任何慢性病一样有效治疗,可能会变得更糟。”他补充说,纤维肌痛不会变成另一种疾病,例如类风湿关节炎或狼疮。

但这会极大地影响您的生活质量。

“Depression, anxiety, deconditioning, social isolation, and difficulties working are common,” Dr. Bierle observes. It’s expensive, too, costing the U.S. healthcare system somewhere in the neighborhood of $12 to $14 billion every year.

如何获得纤维肌痛诊断?

希望我们可以说您可以接受X射线检查或实验室测试,但是,“通常,风湿病学家将看到患者的广泛疼痛,并会进行测试以排除自身免疫性和流变学条件。” Mukai博士说。“有时,在自身免疫性条件的基础上可以具有纤维肌痛。这通常是“排除诊断”,这意味着需要排除导致疼痛的其他疾病。没有具有纤维肌痛的经典X射线发现或实验室发现。”

排除纤维肌痛诊断没有一个测试纤维肌痛;您的治疗团队将不得不一一排除其他条件,这被称为诊断排除。

患者可以期待血液检查观察以下情况:

  • 血统
  • 肾功能
  • Thyroid function
  • Electrolytes
  • Muscle enzymes
  • Liver enzymes
  • Blood sugar

可能模仿纤维肌痛症状的疾病包括:

  • Inflammatory conditions
  • Anemia
  • 甲状腺功能障碍
  • 类风湿关节炎
  • Muscle disorders
  • 神经损伤
  • 沮丧and other mood disorders
  • 胃肠道条件
  • Some cancers

What Are Some Fibromyalgia Treatment Options?

Fibromyalgia treatment is heavily weighted toward medication. Over-the-counter options include:

  • 非处方非甾体类抗炎药(NSAID)等非甾体类药物(NSAIDS)
  • 对乙酰氨基酚(例如泰诺)
  • Topical ointments such as those containing menthol or capsaicin

如果你疼得厉害,医生将出来the big guns: prescriptions. These may include:

  • Fibromyalgia nerve pain medications like Lyrica or Neurontin
  • Muscle relaxers
  • 抗抑郁药

…or some combination of the above. “In general, opioid prescriptions and spinal injections are not going to be helpful for fibromyalgia pain,” says Dr. Mukai.

Bierle博士补充说:“由于其神经系统的变化,纤维肌痛的患者更为常见,因此建议以低剂量开始并逐渐增加。”

手术通常是解决无数健康问题的常见解决方案,但纤维肌痛不是其中之一。Mukai博士解释说,目前,对于纤维肌痛患者而言,手术不是一种选择,因为尚未确定其结构原因。

Although the baseline of diagnostic criteria for fibromyalgia was set by The American College of Rheumatology back in 1990, there have been many new findings on the disorder since then. For example, experts have been studying new types of remedies for fibromyalgia, such as diet changes and ozone therapy—both were found to be effective.

A Mayo Clinic study suggests that fibromyalgia patients commonly use complimentary and integrative treatments; another determined that an animal-assisted activity session may improve physical and mental health parameters in the short term (up to two weeks) in patients with fibromyalgia.

纤维肌痛生活有哪些策略?

在药物外,还有许多应对机制和生活方式调整可以帮助纤维肌痛。

“主要是治疗症状,” Mukai博士说。

这些治疗方法(必威betway微博可能需要6到12个月才能有效)涵盖了纤维肌痛的身体和心理方面。

“Fibromyalgia patients are best treated in a comprehensive pain management program or practice, with psychologists and psychiatrists, pain management doctors, physical therapists, and nutritionists,” Dr. Mukai shares.

纤维肌痛团队纤维肌痛最好由多学科治疗团队管理。

Dr. Bierle stresses the importance of adding treatments gradually over time rather than all at once. You have a serious condition and you don’t want to overload your body and take on additional mental stress, both of which can make your fibromyalgia worse.

As you tackle the physical characteristics of fibromyalgia, you have several options available to you.

  • Acupuncture, gentle chiropractic sessions, and massage—Dr. Mukai warns that deep pressure massage “can be painful.”
  • 抗炎饮食,含有许多水果,蔬菜和瘦肉(如鱼),例如地中海饮食,您将在那里达到90%
  • 欧米茄3,维生素D和镁等补充剂
  • 温柔的瑜伽
  • 水生疗法
  • Reiki, an alternative form of energy healing delivered through the palms of a practitioner
  • 戒烟(“吸烟与纤维肌痛和慢性背痛的疼痛较差有关,” Bierle博士说)

纤维肌痛的人每天都必须跳过的精神障碍似乎是无法克服的。Mukai博士指出:“许多纤维肌痛的患者从外部看起来健康',并与让人们了解其症状对生活的影响的程度。”

“Non-medication treatments are preferred as they can help ‘re-train the brain’,” Dr. Bierle says.

Here are some ways to help yourself mentally if you’ve been diagnosed with fibromyalgia.

  • 生物反馈,一种使用视觉和听觉反馈来帮助您获得意识和控制非自愿身体功能的思维体技术,例如纤维肌痛的疼痛
  • 认知行为疗法(CBT),which can achieve a similar outcome to biofeedback. “Both biofeedback and cognitive behavioral therapy help with three of the main components of fibromyalgia—mood, sleep, and pain,” Dr. Mukai says. “Biofeedback and CBT can give some control back to the patient on how their body responds to stress.”
  • 冥想,瑜伽和太极. Dr. Bierle adds, “We believe these mindfulness interventions help turn down the activity of the survival part of the brain by activating the frontal lobe, which is the part of the brain that is usually in control.”
  • 优质的睡眠,由于缺乏睡眠会导致难以康复和肌肉放松,进而导致更多的疼痛和更低的情绪。“这是一个恶性循环,” Mukai博士反映。

“Energy conservation and moderation techniques are critical to preventing ‘push and crash’ cycles,” Dr. Bierle says.

为了度过您的日常生活,Mukai博士说,这一切都是关于应对,压力管理,自我护理以及优化营养,睡眠和运动的全部内容。

她说:“能够理解您的触发因素并学习压力和活动的容忍度。睡眠卫生 - 避免在睡前避免T.V.和其他明亮的屏幕,有一个凉爽,黑暗,舒缓的睡眠环境,并设置定期的睡眠效果周期 - 这一切都有帮助。”

Although this condition involves head-to-toe pain, the associated fibromyalgia back pain and fibromyalgia neck pain can be quite bothersome—luckily, this is where these treatments can be a big help. As Dr. Bierle says, “Most people with back pain don’t have fibromyalgia, but many people with fibromyalgia report back pain.”

背痛只是每天遇到纤维肌痛的人的众多不适之一。如果您或您关心的嫌疑人纤维肌痛或想要更好地控制症状,那么只要专门从事疼痛管理的医生就可以更好地控制症状。那些痛苦的早晨在躺在床上和进入世界之间的选择面临选择,而正确的护理团队似乎更加明亮。

来源

有趣的纤维肌痛数据:Arthritis & Rhematology.(February 1990) “The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee”https://pubmed.ncbi.nlm.nih.gov/2306288/

有趣的纤维肌痛数据:Annals of Medicine.(May 2019) “Dietary interventions in fibromyalgia: a systematic review”https://www.tandfonline.com/doi/abs/10.1080/07853890.2018.1564360

有趣的纤维肌痛数据:欧洲医学和药理学评论。(2019)“ 65例纤维肌痛患者的臭氧治疗:一种有效的疗法”https://pdfs.semanticscholar.org/9a5a/b7f0efc8afc73529b51099a0967827d60247.pdf

有趣的纤维肌痛数据:梅奥诊所。(2019年10月)“纤维肌痛患者使用互补和综合疗法:一项14年的随访研究”https://mcpiqojournal.org/article/S2542-4548(19)30084-0/fulltext

Fibromyalgia Studies and Back Pain:梅奥诊所。(August 2020) “The Impact of a 20-Minute Animal-Assisted Activity Session on the Physiological and Emotional States in Patients With Fibromyalgia”https://www.mayoclinicproceedings.org/article/s0025-6196(20)30519-x/fulltext

Fibromyalgia Studies and Back Pain:关节炎和风湿病。(2013年12月)“脊柱疼痛患者纤维肌痛表型的患病率呈现向三级护理疼痛诊所和潜在的治疗含义””https://pubmed.ncbi.nlm.nih.gov/24022710/

Fibromyalgia Studies and Back Pain:痛苦杂志。(2016年9月)“重叠的慢性疼痛状况:对诊断和分类的影响”https://pubmed.ncbi.nlm.nih.gov/27586833/

纤维肌痛的可能原因:临床风湿病学。(November 2006) “Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome”https://link.springer.com/content/pdf/10.1007/s10067-006-0433-9.pdf

纤维肌痛的可能原因:痛苦杂志。(November 2006) “Sex Hormones and Pain in Regularly Menstruating Women With Fibromyalgia Syndrome”https://www.sciencedirect.com/science/article/abs/pii/S1526590006007693

纤维肌痛的可能原因:Seminars in Arthritis and Rheumatism.(August 2002) “Prevalence of post-traumatic stress disorder in fibromyalgia patients: Overlapping syndromes or post-traumatic fibromyalgia syndrome?”https://www.sciendirect.com/science/article/abs/pii/s0049017202000136

什么是常见的纤维肌痛症状,如何引起背部疼痛?Clinical Biomechanics.(2012年7月)“纤维肌痛女性的功能能力,肌肉力量和下降”https://www.sciendirect.com/science/article/abs/pii/s0268003311003226

什么是常见的纤维肌痛症状,如何引起背部疼痛?疼痛研究和治疗。(2012) “Fibromyalgia and Depression”http://downloads.hindawi.com/archive/2012/486590.pdf

与纤维肌痛生活:梅奥诊所程序。(2006年6月)“针灸的纤维肌痛症状改善:随机对照试验的结果”https://www.sciendirect.com/science/article/abs/pii/s0025619611617291

与纤维肌痛生活:斯堪的纳维亚风湿病学杂志。(2000)“素食饮食减轻纤维肌痛症状”https://www.tandfonline.com/doi/abs/10.1080/030097400447697

与纤维肌痛生活:APUNTS运动医学。(2018年1月3日)“治疗性体育锻炼和补充剂以治疗纤维肌痛”https://www.sciendirect.com/science/article/abs/pii/s1886658117300294

与纤维肌痛生活:PAIN.(2010年11月)“一项在纤维肌痛管理中的瑜伽瑜伽计划的飞行员随机对照试验”https://www.sciencedirect.com/science/article/abs/pii/S0304395910004884

与纤维肌痛生活:风湿病国际。(February 2008) “Effectiveness of aquatic therapy in the treatment of fibromyalgia syndrome: a randomized controlled open study”https://link.springer.com/article/10.1007%2Fs00296-008-0538-3

与纤维肌痛生活:国家纤维肌痛协会。(June 2007) “Reiki Therapy and Fibromyalgia”https://www.fmaware.org/articles/reiki-therapy-and-fibromyalgia/

与纤维肌痛生活:斯堪的纳维亚风湿病学杂志。(2002)“纤维肌痛特征与吸烟之间的关系”https://www.tandfonline.com/doi/abs/10.1080/030097402760375214

继续阅读:原因of Fibromyalgia

Updated on: 03/30/21
Steven Richeimer, MD
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纤维肌痛的原因

Researchers have not yet determined the exact cause of fibromyalgia, but this article summarizes current research on fibromyalgia causes.
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