Common joint and tendon disorders
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FM is seldom alone. One of the most common problems seen as s primary, is arthritis and other joint-tendon disorders. A few words about these common co-commitant problems. I think you will be surprised to find, how many of them are treated in almost the exact same ways as FM is currently treated.
All of the above are independent, treatable conditions, that a great many of FMers have, as what we call, Primary conditions, meaning, it came first. Like me for example, I am Primary Osteoarthritis, with, TMJ, Costochondritis and Carpal tunnel. Now, each of these things, came into being, long before a diagnosis of FM was ever reached. In the case of Osteoarthritis, that was first seen when I was just 17 years old. ( According to studies, such early onset of arthritis in FMers, is a common event )
about me ... since these issues are so common to us with FM, I feel it
to discuss some of the issues and treatments that are common to all of
the above, and how they can interact with FM.
"Osteoarthritis (OA, also known as degenerative arthritis, degenerative joint disease), is a clinical syndrome in which low-grade inflammation results in pain in the joints, caused by abnormal wearing of the cartilage that covers and acts as a cushion inside joints and destruction or decrease of synovial fluid that lubricates those joints. As the bone surfaces become less well protected by cartilage, the patient experiences pain upon weight bearing, including walking and standing. Due to decreased movement because of the pain, regional muscles may atrophy and ligaments may become more lax. OA is the most common form of arthritis.
The main symptom is chronic pain, causing loss of mobility and often stiffness. "Pain" is generally described as a sharp ache, or a burning sensation in the associated muscles and tendons. OA can cause a crackling noise (called "crepitus") when the affected joint is moved or touched, and patients may experience muscle spasm and contractions in the tendons. Occasionally, the joints may also be filled with fluid. Humid weather increases the pain in many patients.
OA commonly affects the hands, feet, spine, and the large weight-bearing joints, such as the hips and knees, although in theory, any joint in the body can be affected. As OA progresses, the affected joints appear larger, are stiff and painful, and usually feel worse, the more they are used throughout the day, thus distinguishing it from rheumatoid arthritis.
In smaller joints, such as at the fingers, hard bony enlargements, called Heberden's nodes (on the distal interphalangeal joints) and/or Bouchard's nodes (on the proximal interphalangeal joints), may form, and though they are not necessarily painful, they do limit the movement of the fingers significantly. OA at the toes leads to the formation of bunions, rendering them red or swollen. OA is the most common cause of water on the knee, an accumulation of excess fluid in or around the knee joint. "Wikipedia
Despite what the name implies, it is not a matter of only time that creates this problem. Given as I was not even out of my teens when it first showed up, would seem to suggest that time is not really a factor here. Further, there are those who are literally born with the disorder.
Now, what this disorder means for your average person, is a life long series of ups and downs, as pain waxes and wanes, according to inflammation and the amount of damage done. Please note, that with this form, excess use, brings on more pain, rather than the reverse.
Approximately, 60% or more, of FMers, have symptomatic Osteoarthritis. I say symptomatic, for the simple reason that a good 80% of the population, will, at some point, ( Normally by age 65 ) show the classic signs of this disease on x-ray. However, only some 60% of those will know about it, due to pain and disability.
Treatment of Osteoarthritis:
is interesting to note, is the
recommended treatments for Osteoarthritis, are almost identical, with
typical recommendations for FM. Mayo
other than, a
few important differences,
re: injections into the joints and various surgeries for joint
They are offered a few other NSAID types and various anti-inflammatory
medication. and more immediate access to stronger pain medications. But
otherwise, the recommendations are nearly identical with FM
and Pain Management on site link. Which means, short of using
of the more typical medications for this condition, most anything you
for your FM, will be of benefit ( or lack thereof ) for your arthritis.
"Rheumatoid arthritis (RA) is a chronic, systemic auto immune disorder that causes the immune system to attack the joints, leading to arthritis (inflammation of the joints), as well as other organs of the body such as the lungs and skin. It can be a disabling and painful condition, which can lead to substantial loss of functioning mobility due to pain and joint destruction."
This is a much more serious form of arthritis, mainly due to the fact it can totally destroy the joints in question, causing much deformity and pain. Further, the joints are not the only things subject to damage. The kidneys, eyes, skin, liver and much more, can be damaged by this disease. This disorder is often found in standard blood work, having what is called an RA factor. This test often misses it however and more specific tests called anti-citrullinated protein antibodies (ACPA) have been developed, which are much more accurate.
Treatment for this disease is much more dependent on medications, a rather long list of them, see. Mayo Clinic
The most common treatments are:
to relieve pain and inflammation
note that modification of pain,
is first in the list. Then you get into the more mundane treatments
as, regimens of heat, rest and exercise; physical therapy; and
application of deep heat to soothe affected joints. As well as, yet
almost identical suggestions are are given those with FM. And like its
lesser cousin, Osteoarthritis, there is a higher access to stronger
medications. As with other forms, most things you do to aid your FM,
aid RA. Only a small percentage of FMers (25%) fit the classic
of having RA.
This is one to make special note of, for the simple reason, it and FM, are often mistaken for each other.
"Systemic lupus erythematosus (SLE or lupus) is a chronic auto immune disease that can be fatal, though with recent medical advances, fatalities are becoming increasingly rare. As with other auto immune diseases, the immune system attacks the body's cells and tissue, resulting in inflammation and tissue damage. SLE can affect any part of the body, but most often harms the heart, joints, skin, lungs, blood vessels, liver, kidneys and nervous system. The course of the disease is unpredictable, with periods of illness (called flares) alternating with remission." Wikipedia
the overlap of the first set of
signs, and the signs of FM, it is easy to see why it is often confused
with FM, unless other factors are taken into account. And yet again,
the advent of treatment, other than some disorder specific drugs, the
for sun screen and the like, the suggestions for treatment, are nearly
identical to the suggestions given for FM. 90% of those with Lupus, are
women. Those with Lupus primary who have FM, is a small percentage, at
"Reactive arthritis is considered a systemic rheumatic disease. This means it can affect other organs than the joints, causing inflammation in tissues such as the eyes, mouth, skin, kidneys, heart, and lungs. Reactive arthritis shares many features with several other arthritic conditions, such as psoriatic arthritis, ankylosing spondylitis, and arthritis associated with Crohn's disease and ulcerative colitis. Each of these arthritic conditions can cause similar disease and inflammation in the spine and other joints, eyes, skin, mouth, and various organs. In view of their similarities and tendency to inflame the spine, these conditions are collectively referred to as "spondyloarthropathies." Med net
is brought about by an infection,
and is easily identifiable. Treatments are drug specific, with
for the effected areas. There are no current figures, for those with FM
and this condition.
Temporomandibular disorders (TMJ):
"Temporomandibular joint disorder (TMJD, TMJ or TMD), or TMJ syndrome, is an umbrella term covering acute or chronic inflammation of the temporomandibular joint, which connects the lower jaw to the skull. The disorder and resultant dysfunction can result in significant pain and impairment. Because the disorder transcends the boundaries between several health-care disciplines — in particular, dentistry, neurology, physical therapy, and psychology — there are a variety of quite different treatment approaches. The temporomandibular joint is susceptible to many of the conditions that affect other joints in the body, including ankylosis, arthritis, trauma, dislocations, developmental anomalies, and neoplasia." Wikipedia
Some 75% of FMers, present with the signs of TMJ. They are:
Pain or tenderness
of the jaw
Bruxism, or night
time clenching of the jaw, is a major culprit ( see sleep
disorders on site link ), and of course most forms of arthritis.
Other than Occlusal
Splints ( a devise to help keep you from grinding your teeth ) the
of NSAIDS, rest, exercise of the jaw, moist heat, etc., are much the
as for any other arthritis type of problem.
"Costochondritis is an inflammation of the cartilage that connects a rib to the breastbone (sternum). It causes sharp pain in the costosternal joint — where your ribs and breastbone are joined by cartilage. Pain caused by costochondritis may mimic that of a heart attack or other heart conditions." Mayo Clinic
Common signs are:
Pain when taking
trunk movement, deep inspiration, and/or exertion
This is one of the few that is considered an FM sign in and of itself. Given as one of the sets of tender points, is in this area.
NSAIDS for pain
As before, most
treatments are consistent with the treatments suggested for FM.
Carpal tunnel syndrome:
"Many people with carpal tunnel syndrome have gradually increasing symptoms over time. The first symptoms of CTS may appear when sleeping and typically include numbness and paresthesia (a burning and tingling sensation) in the fingers, especially the thumb, index, and middle fingers. These symptoms appear at night because many people sleep with bent wrists which further compresses the carpal tunnel. If the median nerve is already under stress, the increased compression of the bent wrist results in numbness and tingling. Difficulty gripping and making a fist, dropping objects, and weakness are symptoms of progression. In chronic cases, there may be wasting of the thenar muscles (the body of muscles which are connected to the thumb)." Wikipedia
Hypothyroidism, on site link, Osteoarthritis ( see above ) and diabetes were most often associated with carpal tunnel syndrome. Also common are repetitive stress injuries, brought on by; Power tools Typing, Construction work; Percussion instruments, in short, anything that causes repeated trauma to the wrist.
to rest the joint
Depending on the
severity, rest and therapy, as well changes in whatever movements or
that are contributing to it, might help. Surgery is a last resort, as
it does have a decent success rate, its failure rate is also high. Some
55% of FMers, present with the signs of Carpal tunnel disorder.
Is an interesting problem, in that I personally feel is somewhat under researched. It is, in effect, where the joints can move too far, in any direction, but has much further effects than that. For example, during stretching exercise, it is common for those of us with FM, to over extend and therefore injure the joint, this is possibly due to this hyper flexibility. This factor is yet another disorder that is commonly classed as a sign of FM, and in fact is considered to be a problem of misdiagnoses in some cases. Study on Joint hypermobility and FM
"Hypermobility can cause joint pain and results in a higher incidence of dislocations, sprains and secondary Osteoarthritis" Mayo Clinic
Other over laps:
Reflux Disease (GERD) *
As you can see,
again, we have a large overlap here, of signs and symptoms, common to
( see *) Medical treatment is nearly identical to FM to the point
of also including antidepressants, and the anticonvulsants, like
These are used, along with NSAIDS and steroid injections. Of note, is
difficulty in doing stretching exercise, a fact we with FM are told to
do, repeatedly. If however, Hypermobility is more of an issue, that is
currently believed, this could be a problem unless, the exercises are
done very carefully to avoid doing damage. Some 81% of persons with FM,
fit the definition of Hypermobility.
When you look at all of these, at once, and the typical suggested treatments for each, you find that they are almost identical with the suggestions for FM. This is not really a surprise, disappointing perhaps, but not really a surprise, as we with FM, present a great deal of the above. So, I guess we are in the same boat as those who have these disorders, without FM.