Fibromyalgia

American College of Rheumatology, jo America mein gathiya aur joron ki bimariyon ke mahireen (rheumatologists) ki tanzeem hai, fibromyalgia ko, jise fibromyalgia syndrome (FMS) bhi kehte hain, aik lambi muddat ki takleef batata hai jis se saare jism mein dard hota hai. Woh kehta hai ke yeh 2 se 4 feesad logon ko hota hai, zyada tar auraton ko. Yeh soozish wali ya autoimmune (jab jism ka difai nizam apne hi jism par hamla kare) bimari nahin.

NICE ki daimi dard wali hidayat, NG193, ise chronic primary pain maanti hain: aisa dard jo teen mahine se zyada rahe ya baar baar laute, aur jis ki wajah koi aur bimari na ho.

American College of Rheumatology kehta hai ke is ki sab se aam alamat mukhtalif joron mein phaila hua dard hai. Bohat zyada thakawat aur kharab neend bhi aam hain, aur ho sakta hai ke poori raat sone ke baad bhi aap taaza dam na uthein. Phir baaqi:

• Yaad rakhne ya saaf sochne mein mushkil, jise fibro fog kehte hain.
• Depression ya bechaini.
• Migraine ya tanao wala sar dard.
• Haazme ki takleef, jaise irritable bowel syndrome (IBS) ya seene ki jalan.
• Masane ki takleef, masana hassas ya zaroorat se zyada mutaharrik hone se, aur pairu mein dard.

Ab NHS ki menopause ki alamaat ki fehrist parhein: hot flush (achanak garmi lagna) jin mein bohat garmi ya sardi lag sakti hai, neend ki kami, dimaghi dhund, udaasi, sar dard, patthon ka dukhna aur joron ka dard. Bohat se wahi alfaaz. Koi hairat nahin ke aik ko doosre ke khate mein daal diya jata hai.

Menopause par, Climacteric mein 2024 ke aik jaize ne paya ke fibromyalgia ki alamaat menopause ke baad umooman zyada hoti hain, aur bachedani nikalne ke operation ke baad, ande daniyan nikali jayen ya nahin, barh sakti hain. Woh kehta hai ke kuch tehqeeq jinsi hormones ke khatam hone se is ka taalluq batati hai. Batati hai, saabit nahin karti.

Maturitas mein 2026 ki aik tehqeeq ne, jis mein Yunan ki 169 auratein shamil thin, tasveer ko aur wasee kiya: 51 feesad mein fibromyalgia menopause se pehle aaya, taqreeban 22 feesad mein is ke saath, aur 27 feesad mein is ke baad. Yani fibromyalgia menopause se pehle, is ke aas paas ya is ke baad, kabhi bhi shuru ho sakta hai.

• American College of Rheumatology ke 2016 ke mayaar, jin se doctor is ki tashkhees karte hain, jism ke paanch mein se kam az kam chaar hisson mein dard maangte hain, jo aam taur par kam az kam teen mahine se ho, aur saath baaqi alamaat ka aik score. Tashkhees apni jagah qaim rehti hai chahe aap ko koi aur bimari bhi ho, aur yeh doosri bimariyon ko radd nahin karti. Yani perimenopause aur fibromyalgia donon aik saath ho sakte hain.
• American College of Rheumatology kehta hai ke fibromyalgia x-ray ya khoon ke test mein nazar nahin aata, magar yeh test doosri wajuhaat jaanchne mein madad kar sakte hain, jaise thyroid ke masail ya soozish wali bimariyan.
• Pakistan Menopause Society doctors se kehti hai ke menopause ki mulaqat mein joron aur patthon ke dard, thakawat aur kam chalne phirne ke baare mein poochein (Table 2).

NICE NG193 nigrani mein group ki shakal mein warzish ka programme tajweez karti hai, aur doctors se kehti hai ke acceptance and commitment therapy (ACT) ya CBT par ghaur karein. Baalighon ke liye woh doctors se kehti hai ke faidon aur nuqsanaat par poori baat karne ke baad depression ki chhe dawaon mein se kisi aik par ghaur karein (amitriptyline, citalopram, duloxetine, fluoxetine, paroxetine ya sertraline), aur samjhayen ke yeh depression na hone par bhi dard, neend, pareshani aur zindagi ke mayaar mein madad kar sakti hain.

Yahi hidayat kuch dawaein ginwati hain jo woh is qisam ke dard ke liye shuru na karne ka kehti hain, kyunke un ke faide ke shawahid nahin. In mein pregabalin aur gabapentin jaisi gabapentinoids, opioids, soozish kam karne wali dard ki goliyan aur paracetamol shamil hain. Agar aap pehle se in mein se koi le rahi hain, to NICE doctors se kehti hai ke aap ke saath mil kar is par nazar daalein aur mil kar mansooba tay karein. Yeh aap ke doctor ke saath baat cheet hai, akele badalne ki cheez nahin.

Jo dard teen mahine ya is se zyada se chal raha ho, woh theek se dekhe jane ka haq rakhta hai, kandhe uchkane ka nahin. Agar saath mein dil bhi udaas raha ho, to yeh bhi batayen.

Aik Bartanvi tehqeeq ne paya ke jin auraton ko 44 saal ki umar mein lamba dard tha, un mein 50 ki umar mein menopause ki bohat si alamaat ka bojh hone ke imkanaat taqreeban teen guna the. Is ke likhne wale khabardar karte hain ke aisi auraton mein menopause ki alamaat ko kabhi kabhi dard samajh kar un ka ilaaj kiya ja sakta hai.

Likh kar jayen: kahan dard hota hai, neend kaisi hai, mahwari kaise badli hai. Alamaat ka record rakhna is ka aik tareeqa dikhata hai.

Jo dard kisi ko nazar na aaye, us par doosron ko shak karna aasan hai. Ghar mein ise nakhre, susti ya bas umar keh diya jata hai. Ise naam dene se sab ise sanjeedgi se lete hain, aap khud bhi.

Lambe dard wali auratein poochti hain ke jab uthna baithna dard de to namaz kaise sambhalein, aur roz ki dawa ke saath roze ka kya matlab hai. Namaz aur roze ke sawal kisi mustanad aalim ke hain. Ramzan mein dawa kab li jaye, yeh us se poochein jis ne dawa likhi hai.