Fibromyalgia
Introduction
Fibromyalgia is a chronic condition that causes widespread pain and tender points on muscles. Although the exact cause of fibromyalgia is unknown, there appear to be several factors that may contribute to it. In addition to lifestyle changes and physical therapy, recently FDA approved medications appear to ease the symptoms of fibromyalgia for some people.
Anatomy
Fibromyalgia is distinguished by pain and tender points on both sides and the upper and lower portions of the body. There are 18 tender point locations including areas at the back of the head, upper back and shoulders, neck and upper chest, elbows, hips, and knees. When pressure is applied to the muscles and tissues at these locations, pain is felt.
Causes
The exact cause of fibromyalgia is unknown. Researchers have many theories including hereditary factors, physical and emotional stress, sleep quality, nervous system sensitivity, brain functioning, infection, and a combination of factors. Although weather changes and physical activity appear to influence fibromyalgia, there are no known triggering causes.
Symptoms
Fibromyalgia causes widespread pain that seems to originate from muscles. The pain may be deep, dull, shooting, or burning. The degree of pain may range from minor to severe. For some people, the pain is more bothersome in the evening than it is during the day. Stress, physical activity, and weather changes may cause an increase in fibromyalgia symptoms.
Diagnosis
There is no specific test for fibromyalgia. It is considered a “diagnosis of exclusion,” meaning all other causes of the symptoms should be ruled out. A doctor can diagnose fibromyalgia by reviewing your medical history, examining you, and considering your list of symptoms. It is helpful to bring a written list of symptoms to your appointment.
Your doctor may conduct blood tests to rule out other conditions with similar symptoms. A diagnosis of fibromyalgia requires pain or tenderness reported at a minimum of 11 tender point locations with symptoms that have lasted for 3 months or longer.
Treatment
Relaxation and lifestyles changes can make symptoms of mild fibromyalgia better. Your doctor may recommend physical therapy, patient education, support groups, and counseling. Regular exercise, pacing activities throughout the day, eating a balanced diet, and good sleep habits can help as well.
In recent years, researchers have made several breakthroughs with prescription medications to ease symptoms of fibromyalgia. Low doses of certain antidepressant medications and anti-inflammatory medications appear to help certain people. Since 2007, the Federal Drug Administration (FDA) has approved the prescription medications Lyrica, Cymbalta, and Savella for the treatment of fibromyalgia, and more studies are underway.
Am I at Risk
Fibromyalgia develops most frequently in people between the ages of 20 and 50, although it can occur at any age, including during childhood. The risk of developing fibromyalgia appears to increase with age. Fibromyalgia occurs more often in women than in men. People with fibromyalgia have a tendency to have other conditions as well, such as chronic fatigue syndrome, depression, endometriosis, headaches, irritable bowel syndrome (IBS), lupus, osteoarthritis, post-traumatic stress disorder (PTSD), restless leg syndrome, sleep apnea, and rheumatoid arthritis.
