FIBROMYALGIA - What should I know?

If you find yourself confused about fibromyalgia, you are not alone. Patients, physicians, and researchers alike have been perplexed by this complex condition. Even as few as ten years ago, there was little discussion about this syndrome within the medical community. With the wide array of symptoms associated with it, fibromyalgia was often confused with the symptoms which accompanied it, and consequently was misdiagnosed or thought to be "in the mind." Today science has recognized fibromyalgia as a rheumatic autoimmune disorder affecting between 3 and 6 million Americans each year. What was once thought of a psychosomatic complaint has turned out to be a complex disorder which is only now beginning to be understood.

Your health care professional may use other names for this condition including fibromyositis, fibrositis, periarticular fibrositis, muscular rheumatism, chronic muscle pain syndrome, musculoskeletal pain syndrome, and tension myalgia. However, fibromyalgia, which means pain of the muscles and other fibrous tissue, is now the acknowledged term. It is now accepted that the following two criteria must be met for a diagnosis of fibromyalgia: widespread musculoskeletal pain in all four quadrants of the body for at least three months duration, in combination with tenderness at 11 or more of the 18 specific "tender point" sites.(1)

What causes this disorder? We simply do not know yet. However, the medical community has begun to develop theories about how certain life events can act as triggers which somehow relate to its onset. While these triggers do not necessarily cause fibromyalgia, it is thought that they might somehow awaken some underlying abnormality which then leads to the onset of the disorder. Some of these triggers include such things as infections and physical traumas like an automobile accident. Illnesses such as lupus, "leaky gut" syndrome, and rheumatoid arthritis are being looked at as possible triggers as well.

Part of the confusion over fibromyalgia is that it mimics, or looks like, many other diseases or conditions. That is why, in the past, it was so often misdiagnosed. For years, the diagnosis of fibromyalgia was difficult because objective signs, such as inflammation and joint deformity, are not associated with the condition. In fact, many clinicians initially thought that fibromyalgia was a psychiatric illness. Today, several well-designed studies have disproved this theory.(2, 3) Fibromyalgia is now accepted as a physical illness.

Other conditions that may commonly mimic, or look like, fibromyalgia include hypothyroidism, lupus, Lyme disease, rheumatoid arthritis, and infections. We now know that there is a very close relationship between fibromyalgia and chronic fatigue syndrome.(4) Still again, some patients have absolutely no underlying or related disorder. No wonder this condition is so difficult to diagnose with absolute certainty!

The good news is that medical science is taking this disorder seriously now. That means that there will be more studies conducted which will give us some of the answers to the complexity of this condition. Studies published in medical journals offer information to the healthcare professional which assist them in making diagnostic and treatment decisions. In the meantime, there are lifestyle and nutritional changes that patients with fibromyalgia may make which may help with the many symptoms associated with FM. Listed below is information which covers what has been reported in these journals about how to treat FM. This information is useful for the patient and healthcare professional alike and covers both conventional and alternative treatments.

1 Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. Feb1990;33(2):160-72.
2 Kirmayer LJ, et al. Somatization and depression in fibromyalgia syndrome. Am J Psychiatry. Aug1988;145(8):950-4.
3 Yunus MB, et al. Relationship of clinical features with psychological status in primary fibromyalgia. Arthritis Rheum. Jan1991;34(1):15-21.
4 Goldenberg DL. Fibromyalgia and chronic fatigue syndrome: are they the same? J Musculoskel Med. 1990;7:19.
5 Chang L. The association of functional gastrointestinal disorders and fibromyalgia. Eur J Surg Suppl. 1998;(583):32-6.

STATISTICS

American College of Rheumatology, 2000. National Institute of Arthritis and Musculoskeletal and Skin Diseases, 1999. Fibromyalgia Network, 1999.  

SIGNS and SYMPTOMS

Several symptoms must be present in order to confirm a fibromyalgia diagnosis. The first is widespread muscle and skeletal pain. Widespread is defined as pain occurring on the right and left sides of the body, above and below the waist, and along the spine. Localized pain also must occur in a majority of identified "tender points" all over the surface of the body.

Other general, common symptoms include aching, disturbed sleep patterns, fatigue, morning stiffness, depression, recurrent headaches, tender lymph nodes, bowel or bladder disturbances, sensitivity to heat or cold, anxiety, gastrointestinal disturbances, dizziness, occasional racing heart beats, decreased coordination, and environmental allergies. The presence of certain diseases is also common with a fibromyalgia diagnosis. Three of the most common diseases are irritable bowel syndrome (IBS), Raynaudís disease, and temporal mandibular joint dysfunction (TMJ).

 

This information is educational in context and is not to be used to diagnose, treat or cure any disease. Please consult your licensed health care practitioner before using this or any medical information.