Fibro Possible with No Trigger Points? | Arthritis Information

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Last visit to my RA, he mentioned the possibility of Fibromyalgia (sp?) as the reason for my odd muscle spasms.  After reading up on it, I've found that there is a "trigger points" test to determine if one has this disease.  I don't have any trigger points.  Now I'm not sure if I have Fibro in addition to my other issues or not.  Do any of you have a firm diagnosis of Fibro but have no trigger points?  What are your symptoms?  I've heard there is a new drug just out to treat it but I don't remember what it's called.  I'd rather not add another drug to my mix and I'm wondering what the ramifications are of not treating it and just dealing with the spasms.  They're not that painful, just weird.  Thank you for your help.  This site is so great for those many weeks between RA appointments.  I'm sure my RA would bill me if I started calling with all these questions.   I am not positive but I believe that you do have to have a certain number of the trigger points to make a firm dx of fibro.  I would be interested in the new drug if you can remember the name of it as there isn't a lot available in the way of treatments for fibro. I'll do a Google search and see if I can find something out.  I know it is something very new, just on the news in the last week or two.Got it.  It's called Lyrica and Pfizer makes it.  It's an approved drug for treating epilepsy, shingles and nerve pain from diabetes.

Here's the article.  Hope it helps someone out there.

 

Oops, never mind, it got all mushed up.  Google will get you there.

 

Fibromyalgia Drug Wins Approval

Tuesday, July 10, 2007; Page HE06

The first drug approved to treat fibromyalgia was given the go-ahead for marketing by the Food and Drug Administration last month. Lyrica, made by Pfizer, was approved several years ago to treat epilepsy, shingles pain and nerve pain related to diabetes. The federal agency okayed the new use after clinical trials showed some fibromyalgia patients had improved as well.

Fibromyalgia, a disorder that can cause pain, fatigue and interrupted sleep, affects an estimated 3 million to 6 million Americans. It can occur on its own, or it can be a problem secondary to autoimmune disorders such as lupus and osteoarthritis, said Philip Mease, chief of rheumatology at the Swedish Medical Center in Seattle. (As a clinical investigator for Lyrica, Mease has accepted fees from Pfizer but has not been compensated to speak with reporters about the drug.)

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Because there is no definitive test for the condition, fibromyalgia is a diagnosis of exclusion: Doctors make the diagnosis by conducting physical examinations, evaluating symptoms and ruling out other conditions.

Other drugs shown effective in treating fibromyalgia include the antidepressant Cymbalta. Doctors often suggest exercise and acupuncture in addition to drugs, Mease said.

Without insurance, the drug could cost or more per day, based on Drugstore.com prices. Side effects include dizziness, sleepiness, blurred vision, weight gain, dry mouth and swelling of the hands and feet. The FDA advises patients to ask their doctor about the safety of driving while taking Lyrica.

-- Francesca Lunzer Kritz

Jesse8839281.492337963Good article.  I know that I use Lyrica to help with the pain of RA.  My doc prescribed it because some of the pain is due to nerves being compressed with swollen joints. Aw yes, tried it!  I also have neuropathy.  I tried the lycria and than gabapentin and neither one helped and they made me really dizzy!  I also tried the cymbalta and had an awful reaction to it, it made me suicidal!  I am taking lexapro as an anti-depressant and that works much better for me but I have heard others do really well with the cymbalta!  Thanks for finding the info though, maybe it well help someone else! So, back to my original question...If I don't have any trigger points does that mean the occasional muscle spasms are not Fibro and are maybe related to the undifferentiated connective disease disease?  I'd appreciate hearing from the fibro voices of experience out there.  Thanks!

I have fibro along with my other problems. I was diagnosed by my rheumatologist about 3 years before I was diagnosed with R/A. And from everything I have read and been told the only definitive test for it is the triggerpoints.

I can't recall the exact numbers, but it is something like 11 out of 18 triggerpoints.

There are so many autoimmune and associated diseases that have very similar symptoms, it's very hard to tell if it is fibro or not. But without the triggerpoints, I'm sure it is something else. Have you actually been checked by a doctor and tested negative for triggerpoints? If your spasms are not painful, that's another indication it is not fibro. Fibro is very painful.

Why don't you write it on your list to ask you Rheumy next time you go in?

Be well,

Nini

 

 Hi Jesse, I have had fibro for over 20 years and it is one of the most complex of conditions you will ever find. Back then not much was known about fibro and many Drs dismissed it as "all in your head" and would prescribe pain pills and nerve pills

  Thankfully my Dr. dx'ed me with it and prescribed, muscle relaxers,Paxil, sleep aids, and pain killers.

 At the time I was dx'ed trigger points weren't an issue. Mostly it was an elimination dx. Everything under the sun was tested for and ruled out before the Fibro was dx'ed.

 Fibro is different and at different levels of pain sources for each individual. Sometimes in a flare I will have multiple trigger points and at other times only one or two. It sometimes depends on over exertion as to the level of pain. The weather is a factor and so is stress in most cases. An infection or virus can determine the severity of a flare.Most of my flares last from 1 to sometimes 2 weeks. Thats the extreme, go to bed, cry and drugged to the max times. Everyday there is pain and muscle aches somewhere in my body. Most of the time i can deal with it with fewer medicines unless it is severe. Then I have to use pain patches with phenegan, physical therapy, and massage.

  Good luck on your search for knowledge about fibro.Through trial and error you will find whats best for you. I also have Osteo and gout  am being tested for ra in a few weeks.Hope you get the help you need and fibro is your only source of pain

my story: i was diagnosed with fibro a few years before my diagnosis of PA(psoriatic arthritis)  i did not have the full amount of trigger points they were looking for. But still gave me the diagnosis. now looking back it was probably related to my PA. They give muscle realxants.antidepressants encourage light exercise. They have recently came out with a medication that help (Lycra) which is used for people with neuropathy. i think down the road they will find it to be a disease of the immune system such as RA etc. i have recently asked my Rheumy if she still believes i had fibro or was it all PA? she said" possibly" so i may never know. Good luck finding your answers. Ps. i cant imagine a doctor diagnosing you with fibro if you do not have the trigger points.

Different things can cause spasms.  Do you have RA?  The swelling can cause this in any portion of your body.  Do you take Ultram?  It also causes horrible problems in me.

On the days it is the worst, look at your meds, foods you eat and write down where you went.  See if anything remains the same.

Thanks for the responses.  I have been busy with my sweet little grand-daughter so I haven't had time to check in. 

There was no exam done for trigger points except he touched my elbow which has felt like "tennis elbow" for several months now (I didn't think that was one of the trigger points but I could be wrong).  That hurts terribly but the spasms are just weird.  I have Undifferentiated Connective Tissue Disease (translation:  It's autoimmune but they don't know which one(s)) and a high ANCA level which I'm told usually indicates vasculitis, and which is the test that is making him "nervous" (his word, not mine).  I thought the vasculitis might be causing the spasms but apparently I wouldn't be able to feel the actual swelling of the blood vessels.  I don't know.  You're all right, it can be so confusing and hard to pin down.  It seems I have my answer, though.  You've confirmed what I've read, that several trigger points are needed to DX FM.  Thank you!

 


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