Fibromyalgia or FM is a chronic pain condition characterized by generalized muscular pain and fatigue. The name fibromyalgia is made up from "fibro" for fibrous tissues such as tendons and ligaments: "my" indicating muscles; and "algia", meaning pain.

Fibromyalgia typically involves pain in the muscles, ligaments and tendons and related sleep and quality of life disturbances.

This condition is often referred to as a “syndrome” because it is a set of signs and symptoms that occur together.

Statistics

Although rarely talked about, fibromyalgia is a common disorder that affects about 3.4% of all women and 0.5% of all men in the United States, especially those of early middle age.

It is believed that it is as common as rheumatoid arthritis and can even be more painful.

It has been estimated that on a typical day, about 5% of the people in a doctor’s waiting room are affected by fibromyalgia.

For most rheumatologists, it is the second or third most common condition diagnosed.

Fibromyalgia is a syndrome associated with chronic, widespread disabling pain.

Those who have fibromyalgia have aching muscles and sore necks, shoulders, and backs. They sleep poorly and are often stiff when they wake up or move after sitting for long periods of time.

The intensity and location of the pain and the degree of fatigue may vary from day to day and may become worse with excessive exercise and with stress.

The disease is often misunderstood because its symptoms are quite common; however, medical studies have proven that fibromyalgia does indeed exist.

Many experts believe that fibromyalgia is not a disease but rather a chronic pain condition brought on by a constellation of dysfunctional biologic responses to stress.

The exact cause of fibromyalgia is not known. Some researchers believe fibromyalgia may be the extreme end of a continuous spectrum of chronic pain due to abnormal levels of various hormones.

One theory is that a powerful nerve impulse (particularly a pain impulse) from the body sent over and over again physically changes the central nervous system, especially the nerves and nerve connections in the dorsal horn of the spinal cord.

Risk Factors 

Such individuals are thought to be more susceptible to stress because of traumatic personal histories, genetic factors, or both.

Physical injuries, emotional trauma, or viral infections, such as Epstein-Barr, may act as triggers for the onset of the disorder, but none have proven to be a cause of primary fibromyalgia.

Diagnosis

Diagnosis of fibromyalgia is difficult and it is often misdiagnosed because symptoms can be mistaken for another condition. Coexisting nerve and muscle disorders such as rheumatoid arthritis, spinal arthritis, or Lyme disease may further complicate diagnosis.

Currently, there are no specific tests available to diagnose fibromyalgia, so the doctor may make a diagnosis by ruling out other conditions with similar symptoms.

The doctor may be able to diagnose fibromyalgia if the patient has widespread pain in combination with tenderness in at least 11 of 18 sites known as trigger points. These include areas such as the base of the neck, along the backbone, at the elbow, hip, the back of the knee, and shoulder. Most physicians use a diagnostic technique of palpating tender points, specific spots on the body that are usually very pressure-sensitive in individuals with the disorder. This technique was developed by the American College of Rheumatology as a means of confirming the diagnosis for clinical studies, and required participants to have 11 of 18 identified tender points. 

Treatment

There is no cure for fibromyalgia, but many treatment options are available. Patient usually try many routes of treatment under the guidance of a physician to find relief. Treatments range from prescription medication to herbal medicine to exercise therapy. Most treatments only ease some symptoms. In mild cases, symptoms may go away when stress is decreased or lifestyle changes are implemented. A combination of treatments including medications, education, physical therapy, and counseling are usually recommended.  

The most popular treatment involves conventional analgesics to reduce the effects of fatigue and pain. Low doses of antidepressants are often prescribed as well to adjust nerve response and help to deal with the psychological effects of constant fatigue and pain.  Studies show that antidepressants in low doses can decrease depression, relax craniofacial and skeletal muscles, improve sleep quality, and release pain-killing endorphins. Other medications that are used include anti-inflammatory pain medications and medications that work on pain transmission pathways, such as Gabapentin.Physicians may also prescribe exercise in an attempt to build up muscle bulk and reduce stress on the muscles, but it is often poorly tolerated in the more severe cases.

Lifestyle changes that can help alleviate symptoms include exercising, avoiding caffeine (it can aggravate sleep disorders ), establishing regular sleep routines, and eating a healthy diet . Learning relaxation techniques (e.g., meditation, biofeedback) may help control symptoms. Eating a well-balanced diet , and avoiding caffeine may help with problems sleeping , and may help reduce the severity of the symptoms. Lifestyle measures to improve the quality of sleep can be effective for fibromyalgia. Some reports indicate that fish oil, magnesium/ malic acid combinations, or vitamins may be effective. Reducing stress and improving coping skills may also help reduce painful symptoms.

Improved fitness through exercise is recommended. Studies have shown that fibromyalgia symptoms can be relieved by aerobic exercise . Routine low-impact aerobics and strength may help reduce pain, tender-point counts, depression, and sleep disturbance. During aerobic exercise, endorphins, hormone-like substances, are released. Endorphins help relieve pain and produce a feeling of well-being. The best way to begin a fitness program is to start with low impact exercises, like walking and swimming. Starting slowly helps stretch and mobilize tight, sore muscles. High-impact aerobics and weight lifting could cause increased discomfort. Symptoms may be relieved by gentle stretching and light massage, as well as acupressure, acupuncture, and relaxation techniques.

Many patients find temporary relief by applying heat to painful areas, through physical therapy, lymphatic drainage, or massage. Occupational therapy may assist patients in maintaining employment. Some patients find the Guaifenesin Protocol particularly effective when followed properly. Some have even reported a full reversal of symptoms through the application of this treatment, though it is not a cure.

Prognosis

People with mild to moderate cases of FMS are usually able to live a normal life, given the appropriate treatment. If symptoms are severe, however, people may not be able to hold a paying job or enjoy much of a social life.

Other Tools 

• Take the Fibromyalgia Awareness Quiz and Test your Knowledge About This Disease