Condition
Fibromyalgia
Fibromyalgia is a real condition in which the nervous system amplifies pain signals, so ordinary sensation is registered as pain and the pain spreads beyond any one injured struct…
- Seen at
- All three offices
- Typical wait
- Within the same week
- Treated with
- 3 procedures
In short
What fibromyalgia actually is.
Fibromyalgia
Fibromyalgia is a real condition in which the nervous system amplifies pain signals, so ordinary sensation is registered as pain and the pain spreads beyond any one injured structure. It is not a diagnosis of exclusion and it is not another way of saying nothing is wrong. It causes widespread pain, unrefreshing sleep, fatigue and difficulty with concentration and memory, and those features carry as much diagnostic weight as the pain itself. It can also sit alongside a genuine spine or joint problem rather than instead of one, which is worth sorting out because that part is treatable.
Symptoms
How it shows up.
If several of these sound like your week, it is worth having the source looked at properly.
- Pain on both sides of the body, above and below the waist, that moves around from week to week
- Waking up feeling as though you never slept, no matter how long you were in bed
- A fatigue that rest does not fix and that is out of proportion to what you did
- Losing your words mid sentence, or forgetting why you walked into a room
- Skin that hurts to touch, or a waistband, bra strap or bedsheet that feels unbearable
- Hands that feel swollen and stiff in the morning without anything visible to show for it
- Being knocked out for two days by an activity you used to do without thinking about it
What causes it
- Changes in how the spinal cord and brain process pain signals, which turns up the volume on ordinary input
- Disrupted deep sleep, which both worsens pain and is made worse by it
- A triggering event such as an infection, a car accident, surgery or a prolonged period of severe stress
- A long standing untreated pain source, such as arthritis or a spine problem, that sensitized the system over time
- Family history, which is present often enough to point at an inherited component
- Coexisting conditions such as irritable bowel syndrome, migraine, anxiety and depression, which share the same processing mechanism
When to act
Stop waiting when this happens.
Do not sit on these
Any one of the following is a reason to be seen rather than to wait it out.
- Widespread pain has lasted more than three months and nobody has given you an explanation or a plan
- You have been told your tests are normal and sent away, which is not the same as being told nothing is wrong
- Sleep is broken every night, since sleep is usually the first thing worth treating and the one that changes the most
- One area hurts far more than everything else, which suggests a specific pain generator sitting on top of the fibromyalgia and is often treatable on its own
- New symptoms that do not fit the pattern, such as joint swelling, fever, rash or unexplained weight loss, which need evaluation for an inflammatory or autoimmune condition
Diagnosis
Finding the actual source.
A diagnosis is not a guess from an image. It comes from the exam, the history and, where nerves are involved, electrodiagnostic testing.
- A history that maps where the pain is, how long it has been there and how it behaves, since widespread pain lasting more than three months is the core of the diagnosis
- Asking directly about sleep quality, fatigue and cognitive symptoms, because those are part of the diagnosis rather than side issues
- Examination for tenderness in the characteristic areas, alongside a full joint and neurological exam to see what else is present
- Blood work to identify conditions that mimic it, including thyroid disease, anemia, vitamin D deficiency, inflammatory arthritis and lupus
- Identifying any specific coexisting pain generator such as facet arthritis, a disc problem or a nerve entrapment, since those can be treated directly even though the fibromyalgia cannot
- EMG and nerve conduction studies when numbness, tingling or weakness suggests a nerve problem rather than the widespread pain itself
Nerve testing happens here, not elsewhere
EMG and nerve conduction studies are done in the office and read by Dr. Sheikh the same day, rather than sent out and waited on.
Treatment
How fibromyalgia is treated.
Ordered from the most common first step to the options reserved for pain that has not responded.
Trigger Point InjectionA trigger point injection treats a knot in a muscle, a tight band that will not release and that often refers…Read more →
15–45 minNerve BlockA nerve block is an injection of local anesthetic, often with a steroid, placed next to a specific nerve or c…Read more →
45 minJoint InjectionsA joint injection places medication directly into a painful joint, either a corticosteroid to reduce inflamma…Read more →Questions
Fibromyalgia, answered.
Is fibromyalgia real?
Yes. It is a recognized condition with a defined mechanism in how the central nervous system processes pain, and it is not a label applied when nothing else fits. Many patients arrive having been disbelieved by people who should have known better, and that experience is part of what makes the condition harder to live with. You do not need to argue your way into being taken seriously here.
Can injections treat fibromyalgia?
Not the condition itself, and it would be dishonest to suggest otherwise. Injections treat specific painful areas, such as a trigger point in the shoulder or an arthritic facet joint, and they can genuinely help when one region is far worse than the rest. What they do not do is change the central pain processing that drives the widespread pain. An interventional practice is one part of your care here, not the whole of it.
What actually helps?
The best results come from a combination rather than any single treatment. Graded exercise, started at a level that does not flare you and increased slowly, has the most consistent evidence behind it. Treating the sleep disruption, appropriate medication chosen for central pain rather than ordinary painkillers, and treating any coexisting pain generator all add to it. Each piece is modest on its own and the combination is what moves people.
Why did my blood tests come back normal?
Because there is no blood test for fibromyalgia. The testing is done to rule out thyroid disease, inflammatory arthritis, lupus, anemia and vitamin deficiency, all of which can look similar and are treated differently. Normal results narrow the field rather than dismiss your symptoms. The diagnosis is made on the pattern of what you describe and what the examination shows.
Can I have fibromyalgia and a back problem at the same time?
Yes, and it is common. Fibromyalgia does not protect you from a herniated disc, facet arthritis or a pinched nerve, and a long standing untreated pain source can contribute to the sensitization in the first place. This is why one area hurting far more than everything else is worth investigating rather than attributing to the fibromyalgia. Treating that specific generator often lowers the overall pain level.
Get a real diagnosis for fibromyalgia.
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