Newspaper: Irish Times [Article 1]
Day & Date: Tuesday 9th November 2021
Section: Health and Family
The Irish times published a very interesting article highlighting Fibromyalgia and its symptoms.
The article states that 1 in 50 people in Ireland suffer from Fibromyalgia. Dr Deborah Galvin, a consultant anaesthetist and pain physician at the Beacon Hospital and Blackrock Clinic in Dublin says' "It's a big broad condition with a mixture of symptoms that can be very daunting for patients." The article goes on to talk about diagnosing patients with Fibromyalgia, that there is no diagnostic test, the condition is based on the patients history and the exclusion of other disorders. Dr Galvin says, "The most common symptom is widespread pain all over the body with muscle aches and flare-ups of pain."
The article has a diagram of a human pointing out other symptoms like
1. Tiredness, sleep disorders, concentration problems, fatigue, headache, depressions,
2. Difficulties swallowing, toothache, Increased noise sensitivity, photosensitivity and sensitivity to cold,
3. Chronic pain, joint pain in arms and legs, morning stiffness, cramps, trembling hands
4. Neck/back pain, chest pain
5. Arrhymia, shortness of breath, Increases susceptibility to infection
6. Irritalbe Stomach, Irritable bowel
7. Swelling in Feet, hands or face
Bold: Main symptoms
Underline: Secondary symptoms
Normal: Possible additional symptoms
Dr Paul Murphy, clinical lead for pain medicine at St. Vincent's University Hospital, Dublin says that our bodies are not designed to have persistent pain so when we do our nervous system is over stimulated. "Pain is [usually] a warning sign, but when someone has persistent pain, it switches on other nervous system pathways which disturb sleep, cause anxiety and disturb moon." he explains.
The International Association for the study of pain defines pain as "an unpleasant sensory and emotional disorder associated with or resembling that associated with actual or potential tissue damage"
Dr Murphy explains that "To be diagnosed with fibromyalgia the patient had to experience tenderness or pain at 11 out of 18 points throughout the body, but now the American College of Rheumatology defines it as a syndrome with cognitive impairments, anxiety/depression, sleep disturbances and impairment of daily living as well as musculoskeletal pain and tenderness."
"Some studies have shown biochemical abnormalities and increased activity in certain neurotransmitter but nothing is conclusive and the exact cause is unknown," says Dr Galvin. "Patients find it very frustrating when they can't link their symptoms to some cause and yet the pain can be overwhelming. The problem is that we don't know what's driving the pain, according to Dr Galvin who also said that pain medication is generally not appropriate in the treatment of fibromyalgia becasue the side effects outweigh the benefits.
The article says that the current best approach to care within the medical model is for the patient to be treated by a multidisciplinary team including a physiotherapist, a dietician and a psychologist. "Regular daily exercise is good for both physical and mental health and depending on what a patient can tolerate, I'd advise 20-30 minutes walk a day and weekly pilates or yoga classes," says Dr Galvin.
St Vincent's University Hospital multidisciplinary approach to treating chronic pain has introducaed Tai Chi classes. "Aerobic exercises greatly benefits Fibromyalgia but some people find it extremely difficult to engage with exercises. They can become fearful of activity that worsens their pain. We have to explain how pain isn't always equal to damage," explains Dr Murphy. One study in the British Medical Journal found Tai Chi to be as good if not bettr than aerobic exercises for people with chronic pain. "The study found participants pain and fatigue decreased. They felt bettr at work and their wellbeing improved from twice weekly Tai Chi classes." he says.