Fibromyalgia - The Basic Facts

A Form of Soft Tissue Rheumatism

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Fibromyalgia is an arthritis-related syndrome characterized by widespread or generalized muscular pain, tenderness, and fatigue. Fibromyalgia literally means pain in the muscles, ligaments, and tendons.

Fibromyalgia is considered a syndrome because it is a set of signs and symptoms occurring together. It is not considered a type of arthritis, but definitely is a form of soft-tissue rheumatism (conditions which cause pain and stiffness around joints, as well as in muscles and bone).

There is no inflammation associated with fibromyalgia.

Cause of Fibromyalgia

The cause of fibromyalgia remains unknown. Researchers have suggested that fibromyalgia patients experience pain amplification caused by abnormal sensory processing in the central nervous system. Other research has determined that some fibromyalgia patients have:

  • Increased level of substance P (a chemical which increases nerve sensitivity to pain) in the spinal cord
  • Decreased blood flow to the thalamus region of the brain
  • Imbalance of hormones in hypothalamic-pituitary-adrenal axis (affecting how the patient copes with stress)
  • Low levels of serotonin and tryptophan
  • Abnormal cytokine function

Symptoms Associated With Fibromyalgia

Other than the primary symptom associated with fibromyalgia -- widespread muscular pain -- there are other symptoms which are linked to the syndrome. The symptoms can come and go and vary in intensity:

  • Severe fatigue
  • Headaches
  • Irritable bowel syndrome
  • Irritable bladder
  • Cognitive and memory problems
  • TMJ or temporomandibular joint disorder
  • Restless leg syndrome
  • Pelvic pain
  • Noise and temperature sensitivity
  • Anxiety or depression
  • Skin color changes

Diagnosis of Fibromyalgia

No single test can diagnose fibromyalgia.

Laboratory tests are ordered to rule out other conditions. X-rays do not reveal evidence of fibromyalgia.

In 1990, the American College of Rheumatology established criteria to be used for diagnosing fibromyalgia:

  • A history of widespread pain in all four quadrants of the body (e.g. above the waist on both sides; below the waist on both sides of the body) for three months or more.
  • Pain at 11 of 18 tender point sites

According to the National Fibromyalgia Association, it has been estimated that it takes five years on average to get an accurate diagnosis of fibromyalgia.

Treatment of Fibromyalgia

Pain management is a primary area of focus for the treatment of fibromyalgia. Pain can be relieved by using pain medications like acetaminophen or NSAIDs (nonsteroidal anti-inflammatory drugs). Tramadol (Ultram) is another pain reliever prescribed by doctors to treat fibromyalgia pain. Certain anti-depressants or benzodiazepines can also be prescribed to help with sleep and pain. Local injections into tender points may also be helpful.

Lifestyle modifications including regular exercise, good sleep habits, emotional support, and complementary treatments help manage fibromyalgia symptoms.

Prevalence of Fibromyalgia

According to the National Fibromyalgia Association, about 5 to 7 percent of Americans are affected by fibromyalgia. Women are the predominantly affected gender, although men and children also can have fibromyalgia. All races are affected by the condition.

Points of Interest About Fibromyalgia

  • Overlapping symptoms with other rheumatic conditions makes diagnosing fibromyalgia difficult.
  • People who already have a rheumatic disease such as lupus, rheumatoid arthritis, or ankylosing spondylitis are at greater risk for developing fibromyalgia.
  • Activity level, time of day, weather patterns, sleep patterns, and stress can all affect fibromyalgia pain and other symptoms. Being aware of certain patterns may help you manage fibromyalgia.
  • Fatigue or sleep disturbance occurs in 90 percent of fibromyalgia patients.
  • More research is ongoing to study the role of genetics, environmental stress, and physical trauma.

Sources

Fibromyalgia. Arthritis Foundation. http://www.arthritis.org/conditions/DiseaseCenter/Fibromyalgia/fibromyalgia.asp

Fibromyalgia. American College of Rheumatology. http://www.rheumatology.org/public/factsheets/fibromya_new.asp?aud=pat

About Fibromyalgia. National Fibromyalgia Association. http://www.fmaware.org/fminfo/brochure.htm

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