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Dr. Faye Cohen, St. Luke's Hospital

A few simple steps help women get a grip on fibromyalgia

Ask any woman with fibromyalgia about her disease, and she'll probably tell you this: The disease - and the pain - is real. People who have fibromyalgia may look fine. Their medical test results may be normal. But they are suffering from serious pain.

Fibromyalgia is a chronic pain disorder that affects between three million and six million Americans, and more than eight out of 10 of them are women. The American College of Rheumatology classifies the disease as chronic widespread musculoskeletal pain for three or more months and tenderness at 11 or more of 18 designated "tender points."

Although fibromyalgia's main symptoms are muscle and joint pain, many people with the disease have other symptoms, including fatigue, headaches and problems sleeping.

Many women with fibromyalgia find their symptoms are worse right before menstruation. Pregnant women with fibromyalgia typically experience a worsening of the disease's symptoms, especially during the last trimester, and increased depression and anxiety immediately after childbirth. Postmenopausal women with fibromyalgia often experience more severe pain overall.

Researchers don't fully understand what causes fibromyalgia, but genetic as well as environmental factors such as stress or trauma may trigger it. There is evidence that people with fibromyalgia experience greater pain from painful stimuli than people without the disease. The theory is that pain signals in the brain and central nervous system are amplified. The good news is that we might be able to prevent this by treating intense periods of pain adequately.

On an ongoing basis, management of fibromyalgia can be difficult. Every woman with fibromyalgia should start by educating herself about the disease. This allows her to reassure herself that fibromyalgia is real, empowering her to better deal with it. Lifestyle changes also help. Patients who exercise regularly fare much better. A positive outlook and stress reduction techniques such as yoga or meditation also help.

In addition, physicians can prescribe fibromyalgia-specific medications, such as Cymbalta, Lyrica and Savella, which work by blocking or lessening pain.

It's important to remember that fibromyalgia is real. Just as important is the fact that with education, lifestyle changes and medication, it can be manageable.

Dr. Faye Cohen is a board-certified rheumatologist at St. Luke's Hospital. Visit her Physician Referral page or call 314-205-6444.

This article was published in the St. Louis Post-Dispatch on January 28, 2010.

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