Fibromyalgia - a chronic condition

Fibromyalgia

Fibromyalgia is a chronic disease characterized by musculoskeletal pain, exhaustion, and sleep loss. According to (Hughes et al., 2016), the illness primarily affects women of childbearing age and affects approximately 2% of the American population. Stress and overexertion aggravate it. The cause of this illness is largely unknown because it is idiopathic. EP fits this criteria, hence diagnosing her with fibromyalgia would be correct. The pathologic characteristics observed in fibromyalgia patients are not specific to the disorder, and thorough tests should be performed to make a proper diagnosis.

Diagnosis of Fibromyalgia

A physical exam and a thorough history are essential in the diagnosis of fibromyalgia. It has no confirmatory test but blood work ups and imaging procedures such as x rays might be of help in ruling out of other possible differential diagnosis.

Treatment of Fibromyalgia

Hydrocodone is an opioid type of pain medication. Research has shown that opioid type of medications have not been effective in the treatment of fibromyalgia (Hughes et al., 2016). Therefore, opioid analgesics should not be used in the treatment of this condition due to its hyper analgesia that curtails the effectiveness of this type of medication. Non-steroidal anti-inflammatory agents like ibuprofen usually act on the prostaglandin associated inflammatory pathways. However, fibromyalgia’s main symptom is central pain and NSAID’s have no much effect over this kind of pain.

The appropriate course of treatment would be to use pain relievers such as Pregabalin 25 mg at bed time for the main treatment of the central pain associated with the condition. NSAIDs such as ibuprofen should also be administered to manage co-existing pain generators that cause muscle aches. Tricyclic antidepressants such as Amitriptyline 5-10 mg to be taken 2 hours before bedtime or Desipramine 5-10 mg 2 hours before bed as a starting dose with a maximum of 50 mg. are useful in maintain or restoring a normal sleep pattern (Hughes et al., 2016).

Additional Therapies

Additional Therapies - An exercise program should be used to improve muscle strength while decreasing discomfort for a general improvement in the treatment of these symptoms. Alternative non-traditional therapies that are recommended include acupuncture and osteopathic manipulative procedures, which are administered to reduce the intensity of the symptoms. (Hawkins, 2013)

References

Hawkins, R. A. (2013). Fibromyalgia: a clinical update. The Journal of the American Osteopathic Association, 113(9), 680-689.

Hughes, L., Adair, J., Feng, F., Maciejewski, S., & Sharma, H. (2016). Nurse Practitioners’ Education, Awareness, and Therapeutic Approaches for the Management of Fibromyalgia. Orthopaedic Nursing, 35(5), 317-322.