Some folks with shoulder pain or knee pain walking around the streets of Carlsbad may be suffering from a very difficult pain syndrome called fibromyalgia. In fact shoulder pain can become so profound to a patient suffering from fibromyalgia that s/he may go on to develop a frozen shoulder (adhesive capsulitis).
Recent research has shown that treatment for fibromyalgia should be on an individualized basis, as opposed to a general, conventional basis. Experts tend to recommend treatment that includes non-pharmacologic approaches, which is often more effective than drugs. However, currently many orthopaedic surgeons and pain management specialists tend to rely on medications such as antidepressants, anticonvulsants, narcolepsy drugs, pain relievers, sleep aids, and the like. These medications alter brain chemistry to help reduce pain, improve sleep, and ease anxiety or depression, which often times seem to coincide with fibromyalgia. Some of the more common medications used include Cymbalta, Savella, Lyrica, Neurontin, Effexor, etc.
Fibromyalgia is a condition which causes muscular or musculoskeletal pain with localized tenderness at specific points on the body. These tender points include specific spots on the neck, shoulders, back, hips, arms and legs, hurt when pressure is applied to them.

What is the musculoskeletal system?
The musculoskeletal system provides support, stability and movement to the body such as the connective tissue between joints, ligaments, muscles, tendons, nerves and bones. Inflammatory conditions such as fibromyalgia impair the normal function of this system, causing pain and negatively impacting on physical activities and joint mobility.
This is especially true of the shoulder joint which has a greater range of movement than any other joint in the body. Because of this very mobility, the inflammation of the connective tissue results in almost constant shoulder pain, seriously limiting movement.

Shoulder pain and shoulder injury.
A shoulder problem may be minor or serious, and besides the pain, could include swelling, numbness, a tingling sensation and weakness. This shoulder pain can make you more susceptible to shoulder injury, especially during sporting activities or work-related tasks. The severity of shoulder pain and the risk of shoulder injury can be reduced if fibromyalgia, being the root cause, is effectively treated.

How is fibromyalgia usually treated?
There is no single magic pill that will cure fibromyalgia. There are, however, medications that can help reduce pain and inflammation. Because of pain when moving about, many people tend to become inactive, which in effect just aggravates the condition, resulting in more pain. Now studies have shown that mild exercise, especially aerobic exercise, is of enormous benefit to fibromyalgia patients in helping them to stay functional.

What is aerobic exercise?
Aerobic exercise is any moderate exercise which maintains an increased heart rate for an extended length of time, oxygenating the blood which in turn feeds more oxygen to the muscles, improving their energy generating process and possibly reducing pain and inflammation.
How to manage your exercise program.
• Before starting a program, discuss it with your doctor.
• Don’t be over-intense, focus on moderate exercise.
• Be aware of your limitations.
• Opt for activities you enjoy doing.
• Start slowly and build up gradually.

Fibromyalgia is a chronic condition causing almost constant muscle and joint pain. The cause of the disorder is not known, and there is no cure. However it is treatable with anti-inflammatory and pain medication, and moderate aerobic exercise. A positive and proactive attitude to the illness will also help keep depression and anxiety at bay when you are feeling low.
If the condition is well-managed, it will give relief to muscle and joint pain including the important shoulder joint, and definitely reduce the risk of what could be a debilitating shoulder injury.

© 2023 Dr. Robert Afra – San Diego Orthopedic Surgery Shoulder – Knee – Elbow