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by Staff
January 1, 2001
An Overview of Fibromyalgia
What is Fibromyalgia?
Fibromyalgia (FM) is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas of the neck, spine, shoulders, and hips called “tender points.” According to William Hennen, Ph.D., author of Fibromyalgia: A Nutritional Approach, fibromyalgia has been classified as a syndrome, not a disease. He explains that a disease is a condition with a clearly identifiable cause, while a syndrome is a set of symptoms that define the condition without a single causative agent upon which to place the blame.
What are the Symptoms of Fibromyalgia?
While the symptoms associated with FM fluctuate from person to person, there is one common symptom that all agree on - they ache all over. The pain can feel like a deep bone ache, pains and needles, or a stabbing or burning pain. Muscles may feel like they have been pulled or overworked. There are times this pain is mild, others when it is so severe that it becomes unbearable.
Along with pain, many FM sufferers report headaches, poor sleep, fatigue, depression, and irregular bowel habits. Many others simply describe their symptoms as "flu-like."
What Causes Fibromyalgia?
There are many theories on what causes fibromyalgia, but for the most part, this syndrome remains somewhat of a mystery.
Researchers believe an event occurs that triggers fibromyalgia - this could be an infection, stress or a traumatic injury. It is important to note that researchers do not believe that these events cause fibromyalgia; rather, they may awaken a dormant abnormality or virus that has been present in the body for years.
Current research is exploring the possibility that fibromyalgia could be triggered by the Human Herpes Virus-6 (HHV-6) - a universal virus. Infection usually occurs during childhood, after which it generally turns dormant within the body. Presently, the reactivation of HHV-6 has been shown to play a role in the development of AIDS and several other diseases.
What is known about fibromyalgia is that as many as 3 to 10 million Americans, most of them female, suffer from this mysterious syndrome. The range is wide because many people may not even realize that there is a name for the pain they are suffering from, or because they have been diagnosed with another condition.
Are Fibromyalgia and Chronic Fatigue Syndrome the Same?
An article by Muhammad Yunus, MD, Professor of Medicine at the College of Medicine at Peoria, looks at how fibromyalgia and several other chronic conditions, such as chronic fatigue syndrome, myofascial pain syndrome, headaches, irritable bowel syndrome, Gulf War syndrome, etc., may possibly be similar conditions.
Dr. Yunus cites various studies that have shown how these syndromes are associated and how not just one, but several of these syndromes, can be present in the same patient. In addition, studies have proposed that these syndromes have overlapping features and are linked by common characteristics.
These syndromes share several characteristics - pain, hyperalgesia, poor sleep, and fatigue.
How Fibromyalgia Treated?
Treatment of fibromyalgia requires a comprehensive approach. The first step is a positive diagnosis, which can be difficult because many of the symptoms mimic those of other diseases. The American College of Rheumatology (ACR) has developed criteria for diagnosing fibromyalgia that physicians can use. According to ACR criteria, a person is considered to have fibromyalgia if he or she has widespread pain for at lease 3 months in combination with tenderness in at least 11 to 18 specific tender point sites.
With this criteria, a comprehensive treatment approach can be taken that includes a physician, physical therapist, and others in the medical support system. Patients should also take an active roll in their treatment. Combined, all elements play an active roll in the management of fibromyalgia.
Studies have shown that mild aerobic exercise, such as walking and swimming, improves muscle fitness and reduces muscle pain and tenderness. However, this subject is one of debate. While doctors feel that exercise is important in the treatment of fibromyalgia, many patients claim it is too painful to exercise or if they do, they notice no great improvement in their symptoms. Other patients agree with the doctors and say that exercise has greatly decreased their pain.
Robert Bennett, M.D., noted expert in the diagnosis and treatment of fibromyalgia and on staff at the Department of Medicine at Oregon health Sciences University states “Treatments for fibromyalgia are not long-term. Current philosophy to manage the pain and fatigue that are symptomatic of the ailment involves a multi-model approach.” Dr. Bennett’s approach includes:
Education
Therapeutic treatment of pain
Cognitive behavioral therapy
Exercise and stretching programs
Treatment of accompanying psychological problems that arise as an adjunct to the syndrome
"Optimal treatment of FM should include non-pharmacological interventions, specifically exercise and cognitive behavioral therapy, in addition to appropriate medication management as needed for sleep and pain symptoms," says Lynn A. Rossy, MA, head of a study being conducted at the University of Missouri-Columbia.
In addition, researchers are constantly testing new pain killers to determine their usefulness in treating fibromyalgia pain.
One such drug being tested in Europe is Tropistron, which adjusts serotonin levels and substance P, a peptide found in the brain that plays a role in nervous and immune systems. Others include: the fentanyl patch (sold under the name Duragesic), OxyContin®, an opioid for the treatment of persistent moderate to severe pain, and a variety of herbal remedies.
How Can You Tell if You Have Fibromyalgia?
Your doctor will ask about your pain symptoms and then press on a series of anatomically-defined soft tissue body sites called “tender points.” There are 18 tender points on the body that will usually be highly sensitive to pressure in people with fibromyalgia as specified by the American College of Rheumatology criteria.
People who do not have fibromyalgia are much less tender to pressure applied at these points.
Fibromyalgia Resources
The National Institutes of Health recognizes fibromyalgia as a cause of musculoskeletal pain and has set aside specific funding for research in this area.
With the dawning of the Internet, many sites that deal specifically with fibromyalgia and chronic pain now exist - others offer excellent research and treatment news. In addition, there are numerous support groups.
To begin, click on a topic link below:
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