Fibromyalgia is a chronic disorder that causes widespread musculoskeletal pain. The cause of fibromyalgia is unknown, but onset of symptoms usually begins after physical trauma, surgery, infection, or situations that cause extreme psychological stress.

Symptoms of fibromyalgia include fatigue, sleep disturbances, weakness, and memory or mood issues. However, the hallmark symptom of this condition is pain in certain areas called tender points. Not to be confused with trigger points which cause pain in another location of the body, tender points are parts of the body that become painful or sensitive when pressure is applied. Common tender points associated with fibromyalgia are:

• Back of the head
• Tops of shoulders
• Upper chest
• Outer elbows
• Hips
• Knees

Although fibromyalgia is not a life-threatening condition, it may interfere with your ability to perform daily activities. There is currently no cure for fibromyalgia, but certain treatments can be quite successful in managing symptoms and improving quality of life. These treatments include:

• Pain relievers such as acetaminophen, ibuprofen or naproxen sodium to manage body aches and pains. Over-the-counter or prescription strength medications may be used, but narcotics are not recommended due to the risk of dependency
• Antidepressants to relieve anxiety, depression, pain, fatigue, or sleep problems caused by fibromyalgia
• Sleep aids to address sleep disturbances and improve sleep quality
• Exercise to improve flexibility and muscle tone which may help alleviate painful symptoms
• Getting adequate rest to help fight fatigue caused by fibromyalgia
• Massage to relax tense muscles and boost levels of endorphins and serotonin, your body’s natural painkillers and mood regulators

If you regularly experience symptoms associated with fibromyalgia, schedule an appointment with your doctor for further evaluation. There is no test that can diagnose fibromyalgia, so your doctor will need to rely on your symptoms in order to make a diagnosis. Because of this, you may find it helpful to keep a symptom journal in the weeks leading up to your appointment. Keeping track of your symptoms, their severity, when they occur, and for how long will help you provide accurate, detailed information that your doctor can use to make the right diagnosis (Source: Medical News Today).

There are several factors that can contribute to back pain, but one common cause is muscle tension from stress and anxiety.

April is Stress Awareness Month, a 30-day campaign to raise awareness about the causes and cures for stress. While we typically think of stress as a mental and emotional struggle, what many of us don’t realize is that stress can manifest itself through a number of physical symptoms such as fatigue, body aches and muscle pain.

Medication is often our first line of defense for treating back pain, but new guidelines released by the American College of Physicians (ACP) suggest a different approach. These guidelines recommend non-pharmacological therapies such as yoga, tai chi and massage for treating lower back pain, while reserving medications and prescription opioids as a last resort.

These updated guidelines come as a result of analyzing over 150 studies to determine which treatments are successful – and which ones are not – when addressing lower back pain. Evidence from this analysis indicated that acetaminophen and steroid injections, two common treatments for back pain, were not effective in improving pain outcomes.

For patients who want to use medications to control back pain, the guidelines recommend nonsteroidal anti-inflammatory drugs or skeletal muscle relaxants. However, ACP President Dr. Nitin S. Damle stresses the importance of trying non-pharmacological treatments first. For patients with chronic low back pain, the ACP recommends some of the following non-drug therapies:

• Exercise
• Multidisciplinary rehabilitation
• Acupuncture
• Mindfulness-based stress reduction
• Tai chi
• Yoga
• Motor control exercise
• Progressive relaxation
• Spinal manipulation

Patients should discuss alternative therapy options with their doctors to determine which treatment will best meet their needs. However, Damle explains that most back pain resolves itself over time regardless of which therapy is used. “For the treatment of chronic low back pain, physicians should select therapies that have the fewest harms and costs, since there were no clear comparative advantages for most treatments compared to one another,” he said (Source: American College of Physicians).

The complete guidelines are published in the Annals of Internal Medicine.

April is Stress Awareness Month, which serves as a helpful reminder for everyone to evaluate areas of stress in their lives and understand how it affects them physically.

Back pain is one of the most common medical complaints among American adults, and it is sometimes linked to muscle tension from stress. Medication has long been considered a convenient and simple way to address back pain, but new guidelines released by the American College of Physicians (ACP) could change that. Departing from their previous recommendations, the organization now recommends that patients use alternative therapies such as yoga, massage or exercise before turning to medication.

The updated guidelines come as a result of analyzing over 150 studies to determine which treatments are successful in relieving back pain and which ones are not. Evidence showed that acetaminophen and steroid injections – two common treatments for back pain – were not effective in improving pain outcomes.

Patients with lower back pain may benefit from a variety of treatments including exercise, acupuncture, tai chi, yoga, progressive relaxation, or spinal manipulation. However, ACP President Dr. Nitin S. Damle says that most acute and subacute low back pain usually resolves on its own regardless of treatment. “Physicians should avoid prescribing unnecessary tests and costly and potentially harmful drugs, especially narcotics, for these patients,” he says.

While Damle stresses that non-pharmacological treatments should be considered first, the guidelines do recommend nonsteroidal anti-inflammatory drugs or skeletal muscle relaxants for patients who desire medications.

The guidelines also recommend opioids only be prescribed as a last resort treatment. Due to the high risk of addiction and accidental overdose, these medications should only be given when all other therapies have failed.

The complete clinical practice guidelines are published in the Annals of Internal Medicine (Source: American College of Physicians).

But it seems these negative opinions may be undeserved. New findings suggest that running actually changes the biochemical environment within the knee to prevent inflammation and benefit the overall joint.

Researchers from Brigham Young University conducted a study on 15 male and 15 female runners with no prior history of knee injury or arthritis. Each participant submitted a blood sample from the arm and a small amount of synovial fluid from the right knee at the beginning of the study. The participants were then transported by wheelchair to the university’s biomechanics lab where they were asked to either sit for 30 minutes or run on a treadmill for 30 minutes. Afterwards, the patients were transported back to a clinic for an additional sample of blood and synovial fluid. Each participant completed one sitting session and one running session on different days.

In examining the samples of blood and synovial fluid, researchers specifically looked for GM-CSF and IL-15, which are molecules associated with inflammation, and a substance known as cartilage oligomeric matric protein (COMP). COMP is a marker of disease activity and is about five times more prevalent in the synovial fluid of arthritis patients compared with healthy individuals.

Due to difficulties with safely extracting full samples of synovial fluid, researchers were only able to complete numbers on six participants. However, their findings were consistent among all testable samples. In nearly every case, researchers noted substantially lower levels of GM-CSF and IL-15 compared to baseline readings. Interestingly, COMP levels increased in the blood and decreased in the synovial fluid, suggesting that running may push these molecules out of the knee joint and into the blood.

Sitting appeared to have the opposite effect. Individuals who sat for 30 minutes showed increased COMP levels in the knee and had high concentrations of one of the inflammatory molecules.

While these findings are encouraging, the researchers acknowledge that the study is quite small. Further research involving more participants and larger samples of synovial fluid is needed to produce more conclusive results. In the meantime, lead study author Robert Hyldahl concludes that moderate running is “not likely to harm healthy knees” and likely offers protection against joint damage (Source: The New York Times).

Hip fractures are often associated with reduced bone mineral density and an increased risk of falls. Antidepressants appear to influence both of these factors.

Researchers analyzed study data from the register-based MEDALZ cohort. This database included all community-dwelling patients diagnosed with Alzheimer’s in Finland between 2005 and 2011. For each patient with Alzheimer’s, the study included two age and sex-matched controls without the disease. The mean age of study participants was 80 years old.

The study showed that antidepressant use was associated with two times the risk of hip fracture among controls. However, more fractures were seen among Alzheimer’s patients overall. This risk was still present even after researchers adjusted results to account for osteoporosis, socioeconomic status, history of psychiatric illness, medications that increase the risk of falls, and chronic diseases that increase the risk of falls or fractures.

This increased risk was seen among all major antidepressant groups, including serotonin reuptake inhibitors (SSRIs), mirtazapine and selective noradrenaline reuptake inhibitors (SNRIs). These medications are often used to treat the psychological and behavioral symptoms of dementia, which include anxiety, agitation, depression, and insomnia. Researchers believe that the increased risk of falls and fractures may be linked to antidepressant side effects, which include confusion, sedation, low blood sodium levels, decreased blood pressure after standing, and arrhythmia.

Researchers recommend that community-dwelling patients who use antidepressants be regularly monitored to determine medication necessity. In addition, caretakers should be increasingly aware of factors which may contribute to falls and subsequent fractures (Source: Medical News Today).

Exercise is crucial for individuals suffering from arthritis pain, but patients may find it difficult to stay physically active when joints feel stiff or sore. The current Physical Activity Guidelines for Americans issued by the Centers for Disease Control and Prevention recommend that adults age 65 and over engage in at least 150 minutes of moderate-intensity physical activity each week. However, only 10 percent of American adults with knee osteoarthritis meet these guidelines.

A new study published in the journal Arthritis Care & Research found that arthritis patients can experience significant relief from their symptoms even if they are not able to exercise for long periods of time. Dorothy Dunlop, professor of rheumatology and preventive medicine at Northwestern University Feinberg School of Medicine in Chicago and colleagues examined data from 1,629 adults with pain, aching or stiffness in the hips, knees or feet. All subjects were age 49 and older and were part of the Osteoarthritis Initiative, a nationwide research study that aims to prevent and treat knee osteoarthritis.

The researchers assessed the physical function of each study participant at baseline and again after two years through self-reported outcomes. Approximately one third of participants managed to improve or maintain physical function at the two year follow-up.

Subjects who exercised regularly had the best outcomes, even if they did not meet the recommended 150 minutes of exercise per week. Surprisingly, researchers found that study subjects who exercised as little as 45 minutes per week were 80 percent more likely to improve their physical function than subjects who exercised less than 45 minutes per week.

While subjects who exercised more than 45 minutes per week saw greater results, Dunlop hopes these findings will encourage arthritis patients to make any amount of physical activity a priority, even if it’s only for a few minutes each day.

“We found the most effective type of activity to maintain or improve your function 2 years later was moderate activity, and it did not need to be done in sessions lasting 10 minutes or more, as recommended by federal guidelines,” Dunlop explained. “Even a little activity is better than none. For those older people suffering from arthritis who are minimally active, a 45-minute minimum might feel more realistic,” (Source: Medical News Today).

Osteoarthritis patients can work their way towards reduced pain interference and fatigue, and best of all, they can do it while sitting comfortably in a chair! A recent study found that older adults with osteoarthritis in the lower extremities can experience significant improvement in their arthritis symptoms through chair yoga.

Researchers from Florida Atlantic University randomly assigned 131 older adults with osteoarthritis in at least one lower extremity joint to participate in yoga classes or health education classes. Participants attended 45-minute classes twice a week for a period of eight weeks. Researchers measured pain, pain interference, balance, gait speed, fatigue and functional ability of participants before, during and after classes.

Subjects who participated in chair yoga – a gentle form of yoga that is practiced while sitting in a chair or using a chair for support – saw greater improvements in pain and pain interference during the 8-week program and three months post-intervention than participants in the health education group. Researchers also noted that the chair yoga group had a significantly greater decrease in WOMAC pain and fatigue and experienced improved gait speed.

Study co-author Ruth McCaffrey, emeritus professor in FAU’s College of Nursing, explained that these findings could lead to improved non-pharmacologic treatments for management of osteoarthritis.

“Currently, the only treatment for osteoarthritis, which has no cure, includes lifestyle changes and pharmacologic treatments that are not without adverse events,” she said. “The long-term goal of this research is to address the non-pharmacologic management of lower extremity osteoarthritis pain and physical function in older adults, and our study provides evidence that chair yoga may be an effective approach for achieving this goal,” (Source: Newsmax).

We use our knees in nearly all of our daily activities, so it should come as no surprise that they develop some wear and tear over time. Years of standing, bending, climbing, walking, and squatting can place a great deal of pressure on the knees, leaving them prone to aches, stiffness and swelling.

Knee pain can occur in people of all ages, but it is most common in older individuals. An estimated 25 percent of American women and 16.5 percent of American men over the age of 70 report having knee pain (Source: Everyday Health). Regardless of your age, there are two important steps that can help you prevent and control knee pain: exercise and maintain a healthy weight.

According to Harvard Medical researchers, when you walk, the force placed on your knees is about 1.5 times your total body weight. That force increases to two to three times your body weight when climbing stairs and a shocking four to five times your body weight when squatting. If you are currently overweight, your knees are enduring a great deal of stress on a daily basis. Losing even just a few pounds can take a great deal of pressure off your knees and may help alleviate your symptoms (Source: Bicycling).

Low-impact exercises are also important for strengthening knees and keeping the joints lubricated. Try adding these exercises to your routine to keep knee pain under control:

• Walking – Walking is a simple and effective way to stay mobile and relieve joint stiffness. And because it places the least amount of stress on your knees, it is a safe option for those dealing with knee pain.
• Wall sits – Wall sits strengthen the muscle groups that support the knee joint, which can help to keep the knees healthy and strong. Stand with your back against the wall and feet about hip distance apart. Gradually lower your body into a seated position and hold for 30 seconds.
• Leg lifts – Leg lifts are another great way to strengthen the muscles that surround the knee. Lie flat on the floor with legs fully extended. Raise one leg about 12 inches off the floor, then lower and repeat for 10 to 12 reps. Repeat with the other leg.
• Calf raises – Standing behind a chair with feet about hip-width apart, raise your heels a few inches off the floor until you come up onto your toes. Hold for a few seconds, and then slowly lower your heels back to the floor.
• Stretching – Muscles that are limber and pliable allow for proper joint movement and decrease the risk of injury. To maintain healthy knees, remember to regularly stretch all leg muscles including the calves, hamstrings, quads, hip flexors, and IT band.