Brief Answer:
Fibromyalgia

Detailed Answer:
Hi thanks for you questions.

The symptoms you describe are consistent with fibromyalgia.

Fibromyalgia is characterised by chronic widespread pain and allodynia (a heightened and painful response to pressure). Fibromyalgia symptoms are not restricted to pain, leading to the use of the alternative term fibromyalgia syndrome for the condition. Other symptoms include debilitating fatigue, sleep disturbance, and joint stiffness. Some people also report difficulty with swallowing, bowel and bladder abnormalities, numbness and tingling, and cognitive dysfunction. Fibromyalgia is frequently associated with psychiatric conditions such as depression and anxiety and stress-related disorders such as posttraumatic stress disorder. Not all people with fibromyalgia experience all associated symptoms.

Its exact cause is unknown but is believed to involve psychological, genetic, neurobiological and environmental factors. There is evidence that environmental factors and certain genes increase the risk of developing fibromyalgia – these same genes are also associated with other functional somatic syndromes and major depressive disorder. The central symptom of fibromyalgia, namely widespread pain, appears to result from neuro-chemical imbalances including activation of inflammatory pathways in the brain which results in abnormalities in pain processing. The brains of fibromyalgia patients show functional and structural differences from those of healthy individuals, but it is unclear whether the brain anomalies cause fibromyalgia symptoms or are the product of an unknown underlying common cause. Some research suggests that these brain anomalies may be the result of childhood stress, or prolonged or severe stress.

Psychological therapies, medication and exercise have all been shown to be beneficial in patients with fibromyalgia.

I hope this gives you a new diagnosis to explore and treatment for your symptoms.

Best wishes

---

Brief Answer:
See Dr Initially

Detailed Answer:
hi,

thanks for your follow up question. it would be good for you to meet with your doctor to discuss this possible diagnosis.

As with many other medically unexplained syndromes, there is no universally accepted treatment or cure for fibromyalgia, and treatment typically consists of symptom management. Developments in the understanding of the pathophysiology of the disorder have led to improvements in treatment, which include prescription medication, behavioural intervention and exercise. Indeed, integrated treatment plans that incorporate medication, patient education, aerobic exercise and cognitive-behavioural therapy have been shown to be effective in alleviating pain and other fibromyalgia-related syndromes.

Psychological therapies
Cognitive behavioural therapy (CBT) and related psychological and behavioural therapies have a small to moderate effect in reducing symptoms of fibromyalgia. The greatest benefit occurs when CBT is used along with excercise.

Antidepressants
Antidepressants are "associated with improvements in pain, depression, fatigue, sleep disturbances, and health-related quality of life in patients with FMS. The goal of antidepressants should be symptom reduction and if used long term, their effects should be evaluated against side effects. A small number of people benefit significantly from the SNRIs duloxetine and milnacipran and the tricyclic antidepressants (such as amitriptyline) however many people experience more adverse effects than benefits. While amitriptyline has been used as a first line treatment, the quality of evidence to support this use is poor.

Anti-seizure medication
The anti-convulsant drugs gabapentin and pregabalin may be used. Gabapentin is of a significant benefit in about 30% of people who take it however is commonly associated with adverse effects.

Exercise
Exercise improves fitness and sleep and may reduce pain and fatigue in some people with fibromyalgia. In particular, there is strong evidence that cardiovascular exercise is effective for some patients. Long-term aquatic-based exercise has been proven beneficial as it combines cardiovascular exercise with resistance training. However, due to the cold sensitivities of people with fibromyalgia syndrome, aquatic therapy must take place in a warm pool. Not only that, but the air outside of the pool must also be heated to prevent fibromyalgia patients from getting chills and aches when out of the water. This involves a specialised pool facility, which makes this therapy more expensive and less accessible than regular swimming exercise.

I hope this answers your question.

best wishes

---