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Fibromyalgia by Ihor Magun, M.D.,F.A.C.P. A complex constellation of symptoms constitute the diagnosis of fibromyalgia, which is a debilitating syndrome that affects women almost ten times more than men. The age of onset is typically 20 to 50, with the highest incidence between the ages of 60 and 79. There appears to be a genetic susceptibility to this ailment. One of the challenges faced both by the physician and the patient is that despite clear diagnostic criteria, the diagnosis has at times re mained controversial. There is no definitive labora tory test nor are there any anatomical abnormalities. Frequently, laboratory tests are performed not to rule in fibromyalgia, but to rule out other diseases that may mimic this syndrome. The hallmark of the disease is tender points with widespread pain present for at least three months' duration and at least 11 of 18 so-called tender points throughout the body. The tender points must be described as painful upon applying pressure with the fingers (amount of pressure to cause whiteness in the examiner’s nail bed). The pain must appear on both sides of the body, along the length of the spine, and be above and below the waist. The tender points can be found • At the hairline on either side of the neck • Above the collar bone on either side of the neck • Below the collar bone on either side of the neck • Between the shoulder blades on either side of the upper back • On the upper back, left or right • On the inside of either arm, where it bends at the elbow • On either side of the lower back, just below the waist • On either side of the buttocks, just below the hips • On either knee • On the bottom of the feet It is important to note that fibromyalgia is not a progressive disease. It is chronic, but the symptoms can fluctuate. Besides pain at these tender points, other conditions associated with this disease include sleep disorders, fatigue, irritable bowel symptoms, depression, and headaches. Treatment options currently include phar macological and nonpharmacological approaches. Aerobic exercises are helpful; cognitive-behavior therapy can also be beneficial. Treatment regimens incorporate addressing sleep problems and using mood elevators. At this point, Pregabalin (Lyrica) is the only FDA approved treatment for fibromyalgia and has shown significant improvement addressing fatigue, pain, and sleep issues. This medication has just recently been introduced to the market and has been a life saver for many. Twenty percent of patients can go into remission after about two years. It is always important to have open dis cussions about your physical ailments with your physician. With a multisymptom disease like fi bromyalgia, the information you provide can clinch the diagnosis and significantly improve the quality of your life. We gratefully acknowledge Christina Holowata Schleshinger for her generous contribution of $100 to Our Life Press Fund in honor of her mother, Iwanna Holowata, who celebrated her birthday on March 4. Видання C оюзу Українок A мерики - перевидано в електронному форматі в 2012 році . A рхів C У A - Ню Йорк , Н . Й . C Ш A.
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