What is fibromyalgia?
Fibromyalgia is a chronic connective tissue disorder characterized by widespread pain, fatigue, and weakness. The disease is characterized by multiple tender points on the body. The tender points are found in specific locations around the neck, back, and upper and lower extremities. Light pressure at these points causes pain. Fibromyalgia is most commonly seen in women ages 30 to 50, however, it can be experienced by anyone. It is associated with anxiety, depression, and sleep disorders. Constipation, diarrhea, and abdominal pain associated with irritable bowel syndrome (IBS) are also typical in people with fibromyalgia.
What causes fibromyalgia?
Doctors don’t know what causes fibromyalgia, but it most likely involves a variety of factors, including:
- Genetics: Fibromyalgia tends to run in families, which means there may be certain genetic mutations that may make you more susceptible to developing the disorder.
- Infections: Some illnesses appear to trigger or aggravate fibromyalgia.
- Physical or emotional trauma: Fibromyalgia can sometimes be triggered by a physical trauma, such as a car accident. Psychological stress may also trigger the condition.
The fibromyalgia specialist is able to make the diagnosis of fibromyalgia in a patient based upon the history of symptoms and by eliciting the specific tender points on physical exam. Patients with a history of multiple areas of aches or pain for at least three months, and patients who have a minimum of 11 of 18 locations on the body that are abnormally tender under relatively mild pressure fall within a typical fibromyalgia diagnosis. If the patient has a history associated with fibromyalgia, but has less than the 11 tender spots, or are tender in non-fibromyalgia locations, then this is considered “myofascial pain syndrome” and is managed and treated similar to fibromyalgia.
Patients with fibromyalgia generally experience pain in specific locations of the body when pressure is applied. These locations are commonly the back of the head (occiput), upper back, neck, elbows, hips, and knees. The pain generally persists for weeks to months and is often accompanied by stiffness. Signs of inflammation are particularly absent.
Another frequently reported complaint of patients with fibromyalgia is headaches with associated facial pain that may be related to the tenderness they are experiencing in their neck and shoulders. Fibromyalgia can also predispose someone to an increased sensitivity to noises, bright lights, odors, and touch, similar to experiences during a severe migraine headache.
Although the intensity and frequency of the symptoms may vary, they probably never disappear completely on their own. It may be encouraging to know, however, that this is not a progressive or life-threatening condition and certain fibromyalgia treatments can significantly improve symptoms. People may experience a remission period, where they are free from symptoms without treatment or have much lower levels of pain.
Treatment goals include the improvement of physical pain, increasing daily activities, and restoration of normal sleep cycles. A combination of treatments including pharmacotherapy with alternative therapies such as acupuncture, physical therapy, and activities increasing physical movement is increasing in popularity.
One of the most difficult aspects for fibromyalgia specialists in treating patients is that they experience both physical discomfort and psychological/emotional hardships. Both the body and the mind need to be addressed for successful treatment.
- Physical therapy
- Cognitive behavioral therapy
Medications to treat Fibromyalgia include: antidepressants, analgesics (NSAIDs), muscle relaxants, acetaminophen, membrane-stabilizing drugs, and sleeping aids.