Painful muscles and joints: Fibromyalgia?

Patient

Q: I have been extremely tired for some years now, however I also with slow progression, ache all over, if I do even the most menial of tasks (ex, carrying up laundry then my arms feel like lead for days with a dual ache as if I had exercised for hours, the same goes for my legs.) I also have lower back ache with pain in my right hip that at times is excruciating. My hands have a poor gripe and ache frequently with mild swelling. My feet do the same thing. I am currently on blood pressure meds and celobrex, but nothing seems to really help and lately my hands have been having mild tremors, nothing serious. I just would like any ideas on what may be going on. I used to be extremely active and this is so discouraging as I love being outdoors but everything I do feels as if I'm treading through mud. Anyone have any ideas, my doctor is stumped?

Doctor

A:   Fibromyalgia is difficult to diagnose because there are no tests to do so, then you have to pay attention to symptoms like: sore spots in the muscles (tender points), aches and pains for at least three months, fatigue, sleeping problems, anxiety and depression, dizziness, memory problems. I recommend you to get a consultation with a Rheumatologist who will ordered the appropriate lab and imaging tests in order to rule out other possible causes for your symptoms; also a psychologist and a Physical therapist are very useful. The treatment options include: medication (like “Cymbalta”) may be used, Cognitive Behavioral Therapy which helps you to learn what triggers the pain so you can cope with it, also muscle relaxation and stress management techniques like meditation. The exercise may help you too, because the more active you are the less pain and depression you have, to learn an exercise routine you can use a Physical Therapist to teach you. So, in summary try to get enough rest, practice a consistent exercise routine, keep yourself active and learn techniques that relieve your stress.

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