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Fibromyalgia in the Elderly

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Fibromyalgia is a syndrome of widespread chronic body pain, stiffness and tenderness of joints, muscles and bones. The pain is not caused by inflammation and the causes are largely unknown. It is sometimes mistaken for “old age pains” but it is important to note that poor health and pain is not necessarily a part of growing older. Fibromyalgia is more common in women than in men, and middle-aged women are the most commonly affected. It tends to persist throughout life, although there may be periods of easing. Chronic pain and lack of sleep associated with fibromyalgia affects the normal day-to-day functioning of victims and can have an impact on mental health as well.

Symptoms of Fibromyalgia

The symptoms of fibromyalgia are non-specific, so many other diseases need to first be excluded. Many of these other causes that present themselves in a similar manner to fibromyalgia are more commonly seen in seniors.

  • Chronic and widespread pain in muscles, joints and bones. The pain could be mild or severe and may become worse at night.
  • Chronic fatigue affects the majority of those diagnosed with fibromyalgia.
  • Difficulty in sleeping and waking up tired even after long hours of sleep is a common occurrence in patients with fibromyalgia. Deep sleep is affected in these patients.
  • Tension or migraine headaches
  • Depression and anxiety
  • Irritable bowel syndrome (IBS) characterized by abdominal pain, bloating, and constipation or diarrhea might occur along with fibromyalgia in some patients.
  • Mental health problems such as depression, anxiety, problems in focus and memory might occur in these patients. In the elderly, other conditions such as Alzheimer’s disease should also be excluded.
  • Numbness or tingling in hands and feet

No clinical diagnostic tests exist for fibromyalgia and different individuals may show different sets of symptoms. A diagnosis of fibromyalgia requires that the patient has chronic widespread pain for at least 3 months. Other conditions with similar symptoms are ruled out before diagnosing the pain as being caused by fibromyalgia.

Causes of Fibromyalgia

The cause of fibromyalgia is not known. It is thought that the brain perceives pain signals differently in people suffering from fibromyalgia. This makes these individuals more sensitive to pain and causes them to perceive even non-painful stimuli as pain. Levels of certain brain chemicals (like serotonin, substance P, nerve growth factor) have been found to be abnormal in these patients.

Fibromyalgia is more common in women. Therefore, female hormones may have a causative role in fibromyalgia. Fibromyalgia also tends to run in some families, suggesting that the condition might be caused by genetic defects.

Treatment of Fibromyalgia

Fibromyalgia cannot be cured. However, medication and lifestyle changes can help in controlling the symptoms, especially pain and sleep disorders.

Lifestyle Changes

Lifestyle changes are the first line of therapy. These include exercising and indulging in stress-reducing activities. Alcohol and caffeine should be avoided in the evenings to aid proper sleep. Massage and yoga might help by reducing the physical pain and relaxing the muscles. Cognitive behavioral therapy (CBT) might help in reducing psychological stress.

Medication

In case the lifestyle changes are not effective on their own in controlling the symptoms of fibromyalgia, drugs are recommended. Drugs for the treatment of fibromyalgia include muscle relaxants, antidepressants (doxepin, amitriptyline, fluoxetine), pain relievers (acetaminophen, tramadol, non-steroidal anti-inflammatory drugs) and sleep inducers. Duloxetine, pregabalin, and milnacipran are drugs specifically recommended for the treatment of fibromyalgia.


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