Fibromyalgia and autoimmune disorders

Dear Ask The Doctor: Dr, I've been seeing Doctors who can't figure my symptoms out. They are currently thinking autoimmune disease or fibromyalgia, but I'm not convinced. Here are my symptoms, which are episodic in nature. The episodes can last anywhere from 1 week to 3 weeks, seem to have no regularity, and there seems to be no trigger. Very painful back, mainly lower back, but tonight mid and upper back as well, which radiates into my shoulder. Recurring constipation that seems to be related to the painful lower back and which stops me from eating and moving It feels like there is a mass of something inside of me in my lower abdomen and back. The curvature of my back has changed from banana shaped to almost convex. Distended stomach, even though I only way 108 lbs Painful spots in my stomach, when touched, that the Doctors never find because they never push on the right spot when they ask, Does this hurt? Spots are near my navel and feel like a very hard mass Legs so itchy that they are keeping me awake, associated with and at the same time as the onset of very painful mid and upper back Sore, painful feet, shins and legs even though I haven't been on my feet numb and tingling right arm numb, cold, tingling left index finger Serious fatigue Light headedness, dizzy upon standing and walking up stairs, which is associated with the other symptoms: back pain, constipation, fatigue, itchy legs Brain flashes when I close my eyes at night and resulting inability to fall asleep Painful hips Pain radiating down my legs Light sensitivity and sore eyes. Again, associated always with back pain, constipation, fatigue, light head. Very sore hands, but no swollen joints A few weeks ago I was in the ER after what I describe as 30 minutes of my brain taking a ride on a roller coaster through a dark tunnel. It was like I was fainting. I've fainted before. But I never did faint and it lasted for 30 min. ER Doctor called is vagovasal syncope. While in ambulance, my right arm was blue I will feel heart flutters, which feels like my heart rhythm changes or flutters while sitting and doing no activity. These don't seem to be combined with other symptoms I've had bouts of night sweats, awaking every night for weeks totally soaked I have one spot on the middle of my left foot which has always itched with these symptoms, a very irritating itch that won't go away and there is no rash, bump, skin irritation of any kind. Always the exact same spot. Sometimes, the combined symptoms are so bad that I can barely speak or finish a sentence, partly because the words just don't come to me, and has had a serious impact on my professional life. Doctor thinks fibromyalgia because I have the trigger points associated with the disease

I would agree with your doctor with the diagnosis of Fibromyalgia. The diagnostic criteria of fibromyalgia includes (1) history of widespread pain and (2) pain upon touching on at least 11 of the 18 tender point sites. Widespread pain is decribed as pain on all of the ff: left side AND right side of body, pain above AND below the waist, and axial pain (neck, trunk, upper and lower back, chest). The tender points needs physical exam; if I will discuss them one by one, you might be more confused with the terms (gluteal, supraspinatus, occiput, to name a few). Sometimes, pain in fibromyalgia is so severe it can be debilitating and affect one’s normal functioning. The lightheadedness and dizziness could also be your body’s response to pain. If you honestly believe you have a mass on your abdomen, on your next doctor’s visit, you should point to the doctor where it hurts so it can be reassessed accordingly. Perhaps an ultrasound of the abdomen can be done. Autoimmune diseases present with various manifestations and some symptoms may overlap; it may need a battery of blood tests and other procedures before a specific autoimmune disease can be diagnosed. If your doctor knows all of these symptoms and has done previous investigations, you may ask what conditions have been ruled out. If not, then you should tell him/her all of your symptoms so your doctors can be directed to the right path. I do hope I have appeased your concerns and take care always.