Fighting Fibro Fog: Strategies for Women with Fibromyalgia

Women may find that their symptoms fluctuate with their menstrual cycle, pregnancy, and menopause. Hormonal changes during these periods can exacerbate fibromyalgia symptoms, making the management of the condition even more challenging.

Additional information on fibromyalgia, diagnosis and treatment can be obtained from these sources:

• Mayo Clinic: Fibromyalgia - Symptoms & Causes
• Cleveland Clinic: Fibromyalgia Symptoms, Diagnosis & Treatment
• Office on Women's Health: Fibromyalgia

Diagnosing Fibromyalgia

Diagnosing fibromyalgia can be particularly challenging due to the overlap of its symptoms with other conditions, such as rheumatoid arthritis and lupus.

There are currently no specific laboratory tests for fibromyalgia, which makes clinical diagnosis based on patient history and symptomatology essential.

Tender Points and Their Role in Diagnosis

One of the primary diagnostic criteria for fibromyalgia is the presence of pain in specific tender points on the body. There are 18 designated tender points located at various sites, including the neck, shoulders, chest, lower back, hips, and knees. For a diagnosis of fibromyalgia, pain must be present in at least 11 of these 18 tender points, coupled with a history of widespread pain lasting for at least three months.

The tender point examination involves applying pressure to these points to assess the level of pain. The pressure applied is just enough to blanch the fingernail bed of the examiner's thumb, ensuring consistency in the diagnosis.

Here are the 18 tender points used to diagnose fibromyalgia:

1. Front of the Neck: Just above the collarbone.
2. Upper Chest: Near the collarbone, just above the top of the chest.
3. Base of the Skull: Where your head meets your neck.
4. Top of the Shoulders: Midway between your neck and your shoulder.
5. Shoulder Blades: On the back, near the top of the shoulders.
6. Upper Buttocks: On the upper outer areas of your buttocks.
7. Hip Bones: Just behind the hip, at the upper side of the thighs.
8. Inner Knees: On the inside of your knees.
9. Outer Elbows: On the outer side of your elbows.
10. Base of the Skull (Back): Where your neck muscles insert into the base of your skull.
11. Sides of the Neck: Near the vertebrae on the sides of your neck.
12. Upper Chest (Just Below the Collarbone): Just below the collarbone in the upper chest.
13. Inner Thighs: Above the knee, on the inside of your thighs.
14. Buttocks (Hip Level): On the upper part of the buttocks at hip level.
15. Bottom of the Buttocks: Where your buttocks meet your thighs.
16. Base of the Neck (Front): Near the base of the neck, above the collarbone.
17. Upper Back (Between Shoulder Blades): At the top of the back, between the shoulder blades.
18. Inner Knees (Just Inside the Knees): Just inside the knees on the inner part of your knee area.

Challenges in Diagnosis

The diagnosis of fibromyalgia is not straightforward. Many patients undergo numerous tests and consultations with various specialists before receiving a definitive diagnosis. This delay can be frustrating and can contribute to the emotional distress often experienced by women with fibromyalgia.

Additionally, because fibromyalgia symptoms can mimic those of other conditions, it is crucial for healthcare providers to conduct a thorough assessment to rule out other possible causes. This often involves a combination of physical examinations, patient history, and exclusion of other medical conditions through laboratory tests and imaging studies.

Impact of Hormonal Changes on Diagnosis

Hormonal fluctuations play a significant role in the severity and management of fibromyalgia symptoms in women.

1. Menstruation: Many women report that their fibromyalgia symptoms worsen during their menstrual periods. The pain, fatigue, and mood swings associated with menstruation can compound the symptoms of fibromyalgia, making these times particularly challenging.
2. Pregnancy: Pregnancy can also affect fibromyalgia symptoms. Some women experience a decrease in symptoms during pregnancy, while others find that their symptoms worsen. Managing fibromyalgia during pregnancy requires a careful balance of treatment options to ensure the safety of both the mother and the developing fetus.
3. Menopause: The transition to menopause can lead to an increase in fibromyalgia symptoms. The decline in estrogen levels during menopause is believed to exacerbate the pain and fatigue associated with fibromyalgia. Hormone replacement therapy (HRT) may be considered for some women, but it must be approached with caution and under the guidance of a healthcare professional.

Treatment and Management of Fibromyalgia

While there is no cure for fibromyalgia, various treatment strategies may help to manage the symptoms and improve quality of life. A comprehensive treatment plan typically includes:

1. Medications: These may include pain relievers, antidepressants, and anti-seizure drugs to help reduce pain and improve sleep.
2. Therapy:
   • Physical Therapy: Helps improve strength, flexibility, and stamina.
   • Occupational Therapy: Assists in making adjustments to the work and home environment to reduce stress on the body.
   • Cognitive-Behavioral Therapy (CBT): Manages the psychological impact of fibromyalgia.
3. Lifestyle Changes: Regular exercise, a healthy diet, and stress management techniques such as yoga, meditation, and mindfulness may significantly improve symptoms.
4. Chiropractic Care: Chiropractic care may offer relief by improving spinal alignment, reducing pain, and enhancing overall function. Chiropractors use various techniques, including spinal manipulation and adjustments, to address musculoskeletal pain, which may be beneficial for fibromyalgia patients. Chiropractic care often focuses on improving the nervous system's function, which may positively impact the body’s ability to manage pain and stress.
5. Massage Therapy: Different types of massage, such as Swedish, deep tissue, and myofascial release, may help alleviate pain, improve circulation, reduce stress, and enhance sleep quality. Working with an experienced therapist who understand fibromyalgia's complexities is crucial.
6. Education and Support: Understanding fibromyalgia and connecting with support groups may provide emotional support and practical advice for managing the condition.

By adopting a multi-faceted approach that includes medical treatment, therapy, lifestyle changes, and alternative therapies like chiropractic care and massage, individuals with fibromyalgia can better manage their symptoms and improve their overall quality of life.

Better Health May Be for You

Dr. Lanoue and his team of dedicated health professionals have helped many patients with chronic conditions such as fibromyalgia over the years.

Please contact us if you have any questions about fibromyalgia, or about how chiropractic care, massage orphysiotherapy may help you to manage your symptoms more effectively and improve your quality of life.

Better Health may be for you: Call Dr. Lanoue