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Do I have fibro?
I have a back problem in one spot in the left upper buttock,with tight hamstring down to the back of the knee the first time, which I got by my dog pulling me forward. The MRI was normal, bone scan normal, blood work normal, hip Xrays normal. I have been to quite a number of doctors including a orthopedic surgeon, pain doc, integrative med doc, neurologist , FP, etc.all think I have myofascial pain syndrome except for the physical therpist who said SI joint dysfunction. I got better after 7 months then was out of pain for a year and a half. I had a recurrance of the back pain in the same place with doing yoga followed by a PT doing a manual manipulation on the wrong leg which gave me high pain. This second time I had a lot of pain and dull pain/tight muscle down the back of the leg all the way to the heal. The doctors still say myofascial pain syndrome except my FP doctor who thinks it could be a type of fibro. I now have some pain in spots on my legs when I press on the muscle. The thighs or the rest of my body are not sore to the touch and no pain. Does this sound like fibro because I have sore spots on my legs? I am deconditioned and now walking a lot and trying to stretch etc. and I figure that it is due to the exercise after sitting for months. Any advice is welcome. I am on no pain meds or any meds now and the pain is low one day and moderate the next. Also, the muscles get tight/sore on the same day that my pain goes up.
thank you,
mkh9
thank you,
mkh9
Best Answer
Hi and thanks for your reply. I didn't know you see a rheumatologist for the fibro diagnosis. Do they work with muscle problems and ligment etc. or just joints and autoimmune diseases like RA?
thx,
mkh9
thx,
mkh9
Thank you for all your information. I do think I had a torn ligament as I couldn't lift my foot/leg for about 2 months and still can't cross my left leg right. It felt like a tearing pain across the buttock.Also, I'm leaning towards a sciatic type problem like pyriformis syndrom. But since the GP said he thinks fibro can be different than the criteria they have set up (why I don't know) that I could have some of that. Mainly I was wondering because of the sore legs in spots. I have few of the fibro symptoms. It does seem more like SI joing but what works on the pain are muscle relaxers, and NSAIDS. As I walk more and do more exercises I get better though the pain is there still but I get less nerve tweeks. I getting these nerve tweeks when I turned alittle the wrong way etc. Now that I 'm walking hills and stuff then the tweeks have all but gone away. Last time I got this I didn't have the nerve thing, and also after I got stronger, the pain just went poof gone. This time it is more chronic. Probably because I was reinjured several times in a row. Anyway, thanks for the info.
mkh9
mkh9
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I'm leaning toward your PT's opinion for some of your issues, as the probable causes and contributing factors are :some SJ cartilage deterioration, ligament damage, imbalanced walking pattern, incorrect stance and excess weight.
But that's just part of it.
There's an emotional component, that is responsible for most of your physical suffering. Healing is necessary before any significant physical improvement can be experienced in such cases.
This is very common when there are consistently negative results from various tests, along with catch-all medical label diagnosis.
The MFP syndrome is a catch-all label when muscular pain cannot be explained,so I wouldn't give it much consideration.
A good reference also is Dr. John Sarno's TMS theory. Even if you may not meet all the TMS criteria, it offers very valuable insight. Just do a search.
As far as Fibromyalgia goes, I cannot see how your FP can suspect it.
(On the other hand, (s)he has the advantage of the actual interview and examination, so I may be missing some key facts.)
NEW FMS DX CRITERIA
A patient satisfies the (new as of 2010) diagnostic criteria for fibromyalgia if the following 3 conditions are met according to :
1.Widespread pain index (WPI) 7 and symptom severity (SS) scale score 5 or WPI 3–6 and SS scale score 9.
2.Symptoms have been present at a similar level for at least 3 months.
3.The patient does not have a disorder that would otherwise explain the pain.
Reference:
Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, Russell AS, Russell IJ, Winfield JB, Yunus MB. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken). 2010 May;62(5):600-10
WPI: note the number of areas (below) in which the patient has had pain over the last week. In how many areas has the patient had pain? Score will be between 0 and 19.
Shoulder girdle, left; Hip (buttock, trochanter), left; Jaw, left; Upper back; Shoulder girdle, right; Hip (buttock, trochanter), right; Jaw, right; Lower back; Upper arm, left; Upper leg, left; Chest; Neck; Upper arm, right; Upper leg, right; Abdomen; Lower arm, left; Lower leg, left; Lower arm, right; Lower leg, right.
SS scale score:
Fatigue, Waking unrefreshed, Cognitive symptoms
For the each of the 3 symptoms above, indicate the level of severity over the past week using the following scale:
0 = no problem
1 =slight or mild problems, generally mild or intermittent
2 =moderate, considerable problems, often present and/or at a moderate level
3 = severe: pervasive, continuous, life-disturbing problems
Considering somatic symptoms in general, indicate whether the patient has:*
0 = no symptoms
1 = few symptoms
2 = a moderate number of symptoms
3 = a great deal of symptoms
The SS scale score is the sum of the severity of the 3 symptoms (fatigue, waking unrefreshed, cognitive symptoms) plus the extent (severity) of somatic symptoms in general. The final score is between 0 and 12.
Hope this helps. Let me know if you need more details.
I'm very informed and resourceful regarding Fibro, as I'm putting together a very comprehensive multi-therapy holistic FMS program.
Cheers.
Niko