Upper back pain and numbness: Fibromyalgia?

Patient

Q: I keep getting sicker. I'm tired all of the time. A few days ago I slept almost all day. I have pain in my upper back right between my shoulders that burns or feels like cold water. I get tingling in my face and in my hands. I have limbs fall asleep almost every night, that wakes me up. I've gone to 6 months of physical therapy and they told me every time it was like I hadn't even been in. They said I may have fibromialgia or maybe AS...But I ahve had x-rays and MRIs and they don't see anything. this has been since about two thousand six. In the last two years I have started having major neck pain, stiffness and lower back pains that are much like menstral cramps except in the back. I've also noticed that if I have my arms over my head for any period of time they get tingly. At this point I can't walk around for more then a half hour without a lot of pain and feeling extremely tired. I can't sit for a long period or stand for a long period. Any ideas? thanks you.

Doctor

A:    Fibromyalgia is a widespread or global pain, it can start in one site, as in your case in the back, but becomes generalized pain for more than 3 months of duration, it can affect individuals of any age, and more women than men, but just the 2% of the general population in US meet the criteria to be diagnosed of Fibromyalgia. Fibromyalgia is an illness that causes chronic pain in muscles and ligaments. Although this disorder affects about 4 million Americans, the vast majority of them are women in their mid-30s to late-50s.In addition to muscular pain and stiffness, this ailment can also cause fatigue, sleep problems, depression and an inability to think clearly. While there is no known cause for fibromyalgia, recent research has revealed some new facts about the disease. One of the new discoveries is that people with fibromyalgia process pain differently. The level of chemical in the cerebrospinal fluid (CSF) called substance P, which transmits pain impulses to the brain, is three times higher in people with the disease than in those who do not have the condition. This likely causes someone with fibromyalgia to experience pain more intensely. Although there is no cure for fibromyalgia, home treatment can relieve some of the symptoms. The most important therapy for muscle pain is regular, low-impact exercise. Keeping muscles conditioned and healthy by exercising three times a week decreases the amount of discomfort. It is important to try low-stress exercises such as walking, swimming, water aerobics, and biking rather than muscle-straining exercises such as weight training. Besides helping with tenderness, regular exercises can also boost energy levels and help with sleep. No single treatment will take away all the symptoms associated with fibromyalgia. But most people do get some relief by trying a combination of therapies.’Lyrica’, ‘Cymbalta’ and Savella, These are the only three drugs approved by the U.S. FDA for the treatment of fibromyalgia. Lyrica is an antiseizure medication, while Cymbalta and Savella are antidepressants. All three have been shown to reduce the pain of fibromyalgia. Flexeril: This muscle relaxant not only decreases muscle pain but also improves sleep. Mirapex: This drug is used in the treatment of Parkinson's disease. When used to treat fibromyalgia, it reduced pain in 80% of patients. Low doses of antidepressant medication: These medicines improve sleep and decrease pain as well as eliminate depression. Biofeedback and relaxation techniques: Besides lessening pain, these therapies also decrease the number of tender points. Acupuncture: Multiple studies have shown that acupuncture can decrease tender point pain. Tender point injections: Steroid or lidocaine injections into a painful area may provide temporary relief. Massage therapy: This can help relax and soothe painful muscles.

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