What is fibromyalgia?
Fibromyalgia is a chronic condition that causes pain, stiffness, and tenderness of the muscles, tendons, and joints. Fibromyalgia is also characterized by restless sleep, awakening feeling tired, chronic fatigue, anxiety, depression, and disturbances in bowel function. Fibromyalgia is sometimes referred to as fibromyalgia syndrome and abbreviated FMS. Fibromyalgia was formerly known as fibrositis.
While fibromyalgia is one of the most common diseases affecting the muscles, its cause is currently unknown. The painful tissues involved are not accompanied by tissue inflammation. Therefore, despite potentially disabling body pain, patients with fibromyalgia do not develop body damage or deformity. Fibromyalgia also does not cause damage to internal body organs. In this sense, fibromyalgia is different from many other rheumatic conditions (such as rheumatoid arthritis, systemic lupus, and polymyositis). In those diseases, tissue inflammation is the major cause of pain, stiffness, and tenderness of the joints, tendons and muscles, and it can lead to joint deformity and damage to the internal organs or muscles.
Sign & Symptoms
Most people with fibromyalgia say they have several, if not all, of the following symptoms. They are specific tender points that are painful.
- Pain and flu-like overall body aches that change intensity (sometimes severe, other times moderate). One aspect of fibromyalgia is that the worst pain can be in your lower back one day and in your neck the next day, and maybe your upper back the following day. Frequently what happens is you suffer a combination of medical problems. You never know when or where the pain will be next.
- Morning muscle stiffness that is common for people with fibromyalgia. Many people with fibromyalgia say that the severe muscle stiffness and achiness is at its worst in the morning. Movements when you get up in the morning or after sitting for a long period look torturous and stiff to onlookers. The stiffness may diminish as you move about but it usually doesn't go away completely.
- Extreme fatigue or constant exhaustion that occur day after day, even when you haven't done anything. Few people find themselves able to get a satisfactory night's sleep. Many people suffer from bone-numbing exhaustion that goes well beyond simple tiredness. Fibromyalgia pain often serves as the cause for insomnia. It becomes a vicious cycle - lack of sleep makes you feel worse.
- Frequent or constant trouble sleeping.
- Family members diagnosed with fibromyalgia (especially a parent or a sibling).
- Recent physical trauma (for example a car crash or a hard fall).
- Mental malaise and confusion, often referred to as fibro fog. Included also would be difficulty concentrating, forgetfulness, and or attention difficulties.
Causes
Doctors don't know what causes fibromyalgia, but it most likely involves a variety of factors working together. These may include:- Genetics. Because fibromyalgia tends to run in families, 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. Post-traumatic stress disorder has been linked to fibromyalgia.
Current thinking centers around a theory called central sensitization. This theory states that people with fibromyalgia have a lower threshold for pain because of increased sensitivity in the brain to pain signals.
Researchers believe repeated nerve stimulation causes the brains of people with fibromyalgia to change. This change involves an abnormal increase in levels of certain chemicals in the brain that signal pain (neurotransmitters). In addition, the brain's pain receptors seem to develop a sort of memory of the pain and become more sensitive, meaning they can overreact to pain signals.
Tests and Investigation
The American College of Rheumatology has established two criteria for the diagnosis of fibromyalgia:- Widespread pain lasting at least three months
- At least 11 positive tender points — out of a total possible of 18
During your physical exam, your doctor may check specific places on your body for tenderness. The amount of pressure used during this exam is usually just enough to whiten the doctor's fingernail bed. These 18 tender points are a hallmark for fibromyalgia.
Blood tests
While there is no lab test to confirm a diagnosis of fibromyalgia, your doctor may want to rule out other conditions that may have similar symptoms. Blood tests may include:
- Complete blood count
- Erythrocyte sedimentation rate
- Thyroid function tests
Treatment & Pharmacology
