Fibromyalgia: Is My Pain Really Fibromyalgia?

Questions regarding a diagnosis of fibromyalgia?

Hello, Doctor.
Let me describe my condition: I am deeply troubled by long-term pain in the lower right side of my body and the left shoulder and neck.
Sometimes the condition improves, and I feel no pain, but it comes and goes.

1.
Several years ago, I strained my lower back on the right side, which often feels tight.
Additionally, I sprained my right inner ankle about two years ago.
Since six months ago, I have been experiencing soreness from my right hip down to my foot, sometimes to the point where the pain disrupts my sleep or wakes me up.
After walking for a while, my entire leg feels stiff, and my ankle tends to rotate involuntarily, causing a clicking sound; otherwise, it feels uncomfortable.

2.
On the left side, I have had neck pain since I woke up with a stiff neck about a year ago, which has not improved.
I often feel tightness and a bit of throbbing pain on the left side of my head, and sometimes my left hand goes numb.
After sitting for a while, my left leg also becomes numb.

3.
Additionally, I sprained my left wrist two months ago, and it has not fully healed yet.
Sometimes I have trouble sleeping; when lying on my back, I feel pressure and pain in my neck, lower back, and upper back.
When lying on either side, my neck and shoulder hurt, which sometimes leads me to sleep on my stomach.

------------------
My question is that two days ago, a pain management specialist diagnosed me with fibromyalgia and prescribed three medications: an anticonvulsant, an antidepressant, and a muscle relaxant, to be taken once each night to improve sleep quality.
However, based on my understanding of fibromyalgia, it typically involves widespread pain throughout the body, while my condition does not seem to fit this description.
During my consultation, I mentioned that I feel pain extending from my left neck to the top of my left head and numbness in my left hand, but I do not feel pain in the upper right side of my body, except for shoulder pain when lying on my side.

Could it be possible that the issue lies with my cervical and lumbar spine? I have had a slight scoliosis since childhood, and my bones often feel misaligned.
Occasionally, I visit a chiropractor.
For several years, I slept on a poor-quality mattress, which made my body uncomfortable for a long time.
I wonder if long-term poor posture, combined with not addressing these issues properly, has led to nerve compression rather than fibromyalgia.

I would appreciate your guidance.
Thank you.

Miss Lin, 30~39 year old female. Ask Date: 2021/04/10

Dr. Yin Xinbei reply Rehabilitation

Fibromyalgia is diagnosed by excluding other possible causes.
Your symptoms could certainly be related to issues with the cervical and lumbar spine.
It is recommended that you seek further evaluation, including physical examination and X-rays, to rule out any problems with the cervical and lumbar spine.

Reply Date: 2021/04/10

More Info

Fibromyalgia is a complex and often misunderstood condition characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties. Your symptoms, particularly the localized pain in your right lower body and left shoulder/neck, raise important questions about whether fibromyalgia is the correct diagnosis for you.

1. Understanding Fibromyalgia: Fibromyalgia is typically diagnosed when a patient experiences widespread pain in all four quadrants of the body, along with other symptoms such as fatigue and sleep disturbances. However, it is essential to note that fibromyalgia can present differently in different individuals. Some may experience more localized pain, especially if there are underlying conditions contributing to their symptoms.

2. Localized Pain vs. Widespread Pain: Your description of pain primarily on one side of your body, particularly in the right lower half and left shoulder/neck, suggests that there may be other factors at play. Conditions such as herniated discs, spinal stenosis, or other musculoskeletal issues could lead to localized pain and discomfort. The history of injuries, such as your past back and ankle injuries, could also contribute to chronic pain patterns that mimic fibromyalgia.

3. Potential Spinal Issues: Given your history of scoliosis and the mention of your spine "running out of place," it is plausible that your neck and lower back issues could be causing nerve compression or irritation, leading to the symptoms you are experiencing. Conditions like cervical radiculopathy (nerve pain from the neck) or lumbar radiculopathy (nerve pain from the lower back) could explain the pain radiating to your arms and legs.

4. Role of Posture and Sleep: Poor posture and inadequate sleep can exacerbate musculoskeletal pain. If you have been sleeping on an unsupportive mattress or in positions that strain your neck and back, this could contribute to your discomfort. It is crucial to evaluate your sleeping arrangements and consider ergonomic adjustments to your workspace to alleviate strain on your body.

5. Diagnosis and Treatment: Since you have been diagnosed with fibromyalgia, it is essential to follow up with your healthcare provider regarding your treatment plan. The medications prescribed, including anticonvulsants, antidepressants, and muscle relaxants, are commonly used to manage fibromyalgia symptoms. However, if you suspect that your pain may be related to structural issues in your spine, it may be beneficial to consult a specialist, such as an orthopedic surgeon or a neurologist, for further evaluation.

6. Physical Therapy and Lifestyle Modifications: Engaging in physical therapy can be beneficial for both fibromyalgia and any underlying spinal issues. A physical therapist can help you develop a tailored exercise program that focuses on strengthening and stretching the affected areas, improving posture, and enhancing overall function. Additionally, lifestyle modifications such as stress management techniques, regular low-impact exercise, and proper sleep hygiene can significantly improve your quality of life.

In conclusion, while your symptoms may align with fibromyalgia, it is crucial to consider the possibility of other underlying conditions, particularly given your history of spinal issues and localized pain. A comprehensive evaluation by a specialist may provide further insights and help tailor a treatment plan that addresses all aspects of your health. It is essential to communicate openly with your healthcare providers about your concerns and seek a multidisciplinary approach to your care.

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