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What is fibromyalgia? Chronic pain forces Lady Gaga to pull out of concert

by Shamard Charles M.D. / / Source: TODAY

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The "severe pain" that made Lady Gaga cancel a performance at the Rock in Rio music festival in Brazil Friday is caused by a difficult to diagnose and treat condition that affects mostly women and, until recent years, was often dismissed by doctors.

The singer has been very open about her struggle with fibromyalgia, but had yet to cancel a show because of it, until now.

What is fibromyalgia?

Fibromyalgia is a condition that causes pain all over the body, sleep problems, fatigue, and often emotional and mental distress, according to the Centers for Disease Control and Prevention. The painful condition is often hard to diagnose and its causes are unclear. Because there's no laboratory test that can definitively show that someone has fibromyalgia, doctors have to diagnose it based on symptoms, which can vary from person to person.

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“It takes a while to diagnose and it can mimic many conditions like thyroid conditions, lupus, and other kinds of arthritis," says NBC News medical contributor Dr. Natalie Azar, a rheumatologist with NYU Langone Medical Center.

Often, fibromyalgia is diagnosed only after other possible causes have been ruled out.

It affects 4 million people, or about 2 percent of the population, and about 80 to 90 percent of those diagnosed with the condition are women.

How do I get it?

Doctors don't know the exact cause, but there are likely several factors that play a role:

  • Genetics: Research has shown fibromyalgia runs in families, so scientists believe there may be certain genetic mutations that put you at greater risk for developing or triggering the disease.
  • Infections: Some illnesses appear to trigger or aggravate fibromyalgia.
  • Physical or emotional trauma: Psychological or physical trauma like car accidents have been reported to trigger fibromyalgia.

Why does it hurt?

The leading theory by researchers is that repeated nerve stimulation causes the brains of people with fibromyalgia to change, a phenomenon associated with an overreaction to pain signals called abnormal pain perception processing.

Am I at risk?

Women and people with certain autoimmune diseases such as rheumatoid arthritis, lupus and ankylosing spondylitis or spinal arthritis are at higher risk of disease, according to the National Institutes of Health.

Fibromyalgia often co-exists with other painful conditions, such as:

  • Irritable bowel syndrome
  • Migraine and other types of headaches
  • Interstitial cystitis or painful bladder syndrome
  • Temporomandibular joint disorders (TMJ)

Why is this so hard to treat?

Because a diagnosis make take time, an effective treatment can be delayed. But the situation has improved for many fibromyalgia sufferers.

“With the influx of research, it is much more treatable now than it was 10 years ago,” says Azar. “With the right specialist treating her condition, there’s a good chance that Lady Gaga could be effectively treated.”

There are common and effective double-duty treatments — including medications that treat pain and other illnesses, such as antidepressants and anticonvulsants, as well as muscle relaxers.

Physical therapy, acupuncture, and tai chi can also be used as adjunctive therapy, but narcotics are not considered appropriate therapy for treatment of fibromyalgia.

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