What is fibromyalgia (FM)?

Fibromyalgia (fi-bro-mi-l-ja) is a disorder that causes aches and pain all over the body. People with FM also are tender throughout the body, which is most pronounced at certain regions termed "tender points". Tender points are specific places on the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them.

What are the symptoms of fibromyalgia?

People with FM could have:

• Muscle pain
• Fatigue
• Trouble sleeping
• Joint pain, stiffness (sometimes worse in the morning)
• Headaches
• Restless legs
• Tingling or numbness in hands and feet
• Problems with thinking and memory (sometimes called "fibro fog")
• Leg cramps
• Feeling nervous
• Depression
• Feeling dizzy or lightheaded
• Painful cramping during your period
• Jaw pain
• Upset stomach, cramping, bloating, feeling constipated or diarrhea
• Trouble swallowing
• Frequent or painful urination

How common is fibromyalgia? Who is mainly affected?

FM affects as many as 1 in 50 Americans. Most people with FM are women (about 80-90%). However, men and children also can have the disorder. Most people are diagnosed during middle age. FM can occur by itself, but people with certain other diseases, such as rheumatoid arthritis and other types of arthritis, may be more likely to have FM.

Individuals who have a close relative with FM are more likely to develop FM.

What causes fibromyalgia?

The causes of FM are not known. Researchers think a number of factors might be involved. FM has been linked to:

• Having a family history of fibromyalgia (i.e. genetics)
• Being exposed to stressful or traumatic events, such as
  • car accidents
  • injuries to the body caused by performing the same action over and over again
  • infections or illnesses
  • being deployed to war

How is fibromyalgia diagnosed?

People with FM often see many doctors before being diagnosed. One reason for this may be that pain and fatigue, the main symptoms of FM, also are symptoms of many other conditions. Therefore, doctors often must rule out other possible causes of these symptoms before making a diagnosis of FM. FM cannot be detected by a lab test either.

A doctor who knows about FM, however, can make a diagnosis based upon two criteria:

A history of widespread pain lasting more than 3 months. Pain must be present in both the right and left sides of the body as well as above and below the waist.

Presence of tender points. The body has 18 sites that are possible tender points. For FM diagnosis a person must have 11 or more tender points. To be deemed a tender point, pain must be felt when pressure is applied to the site. People who have FM may feel pain at other sites, too, but those 18 sites on the body are used for diagnosis.

The location of the nine paired tender points that comprise the 1990 American College of Rheumatology criteria for fibromyalgia.

The above criteria were developed for use to standardize research studies and are not necessary to diagnose individual patients, but if you feel your doctor doesn't know a lot about FM or has doubts about whether it is a "real" illness, see another doctor for a second opinion. Contact a local university medical school or research center for help finding a doctor who has helped others with FM.

How is fibromyalgia treated?

FM can be hard to treat. It's important to find a doctor who has treated others with FM. Many family doctors, general internists, or rheumatologists can treat FM. Rheumatologists are doctors who treat arthritis and other conditions that affect the joints and soft tissues.

Treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment.

The U.S. Food and Drug Administration has not yet approved any medicines to treat FM. Doctors treat FM with medicines approved for other purposes. Pain medicines and antidepressants are often used in treatment.

What is the difference between fibromyalgia and chronic fatigue syndrome?

Chronic fatigue syndrome (CFS) and FM are alike in many ways. In fact, it is not uncommon for a person to have both FM and CFS. Some experts believe that FM and CFS are in fact the same disorder, but expressed in slightly different ways. Both CFS and FM have pain and fatigue as symptoms.

The main symptom of CFS is extreme tiredness. CFS often begins after having flu-like symptoms. But people with CFS do not have the tender points that people with FM have. To be diagnosed with CFS, a person must have:

• Extreme fatigue for at least 6 months that cannot be explained by medical tests and
• Have 4 or more of the following symptoms:
  • Forgetting things or having a hard time focusing
  • Feeling tired even after sleeping
  • Muscle pain or aches
  • Pain or aches in joints without swelling or redness
  • Feeling discomfort or "out-of-sorts" for more than 24 hours after being active
  • Headaches of a new type, pattern, or strength
  • Tender lymph nodes in the neck or under the arm
  • Sore throat

Is there anything I can do to help me feel better?

Besides taking medicine prescribed by your doctor, there are many things you can do to lessen the impact of FM on your life:

Get enough sleep. Getting enough sleep and the right kind of sleep can help ease the pain and fatigue of FM.

Get moving. Though pain and fatigue may make exercise and daily activities hard, being active as possible is important. People who have a lot of pain or fatigue should begin with walking or other gentle exercises and slowly build up to more demanding workouts.

Make changes at work. Most people with FM continue to work, but they may have to make big changes to do so. For example, some people cut down the number of hours, switch to a less demanding job, or adapt a current job.

Eat right. Try to add more fruits, vegetables, and whole grains to your diet.

What research is being done on fibromyalgia?

The National Institute of Arthritis and Musculoskeletal and Skin Diseases sponsors research to help understand FM and find better ways to diagnose, treat, and prevent it. Researchers are studying:

• Why people with FM are highly sensitive to pain
• The role of stress hormones in the body
• Medicines and behavioral treatments
• Whether there is a gene or genes that make a person more likely to have FM

Tags: Chronic Fatigue Syndrome and Fibromyalgia

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