Faqs on Fibromyalgia

What Is Fibromyalgia?

Fibromyalgia syndrome is a common and chronic disorder characterized by widespread muscle pain, fatigue, and multiple tender points. The word fibromyalgia comes from the Latin term for fibrous tissue (fibro) and the Greek ones for muscle (myo) and pain (algia). Tender points are specific places on the body—on the neck, shoulders, back, hips, and upper and lower extremities—where people with fibromyalgia feel pain in response to slight pressure.

Although fibromyalgia is often considered an arthritis-related condition, it is not truly a form of arthritis (a disease of the joints) because it does not cause inflammation or damage to the joints, muscles, or other tissues. Like arthritis, however, fibromyalgia can cause significant pain and fatigue, and it can interfere with a person's ability to carry on daily activities. Also like arthritis, fibromyalgia is considered a rheumatic condition.

You may wonder what exactly rheumatic means. Even physicians do not always agree on whether a disease is considered rheumatic. If you look up the word in the dictionary, you'll find it comes from the Greek word rheum, which means flux—not an explanation that gives you a better understanding. In medicine, however, the term rheumatic means a medical condition that impairs the joints and/or soft tissues and causes chronic pain.

In addition to pain and fatigue, people who have fibromyalgia may experience

• sleep disturbances,
• morning stiffness,
• headaches,
• irritable bowel syndrome,
• painful menstrual periods,
• numbness or tingling of the extremities,
• restless legs syndrome,
• temperature sensitivity,
• cognitive and memory problems (sometimes referred to as "fibro fog"), or
• a variety of other symptoms.

Fibromyalgia is a syndrome rather than a disease. Unlike a disease, which is a medical condition with a specific cause or causes and recognizable signs and symptoms, a syndrome is a collection of signs, symptoms, and medical problems that tend to occur together but are not related to a specific, identifiable cause.

Who Gets Fibromyalgia?

According to a paper published by the American College of Rheumatology (ACR), fibromyalgia affects 3 to 6 million - or as many as one in 50 - Americans. For unknown reasons, between 80 and 90 percent of those diagnosed with fibromyalgia are women; however, men and children also can be affected. Most people are diagnosed during middle age, although the symptoms often become present earlier in life.

People with certain rheumatic diseases, such as rheumatoid arthritis, systemic lupus erythematosus (commonly called lupus), or ankylosing spondylitis (spinal arthritis) may be more likely to have fibromyalgia, too.

Several studies indicate that women who have a family member with fibromyalgia are more likely to have fibromyalgia themselves, but the exact reason for this—whether it be hereditary or caused by environmental factors or both—is unknown. One study supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) is trying to identify if certain genes predispose some people to fibromyalgia. (See What Are Researchers Learning About Fibromyalgia?)

What Causes Fibromyalgia?

The causes of fibromyalgia are unknown, but there are probably a number of factors involved. Many people associate the development of fibromyalgia with a physically or emotionally stressful or traumatic event, such as an automobile accident. Some connect it to repetitive injuries. Others link it to an illness. People with rheumatoid arthritis and other autoimmune diseases, such as lupus, are particularly likely to develop fibromyalgia. For others, fibromyalgia seems to occur spontaneously.

Many researchers are examining other causes, including problems with how the central nervous system (the brain and spinal cord) processes pain. Some scientists speculate that a person's genes may regulate the way his or her body processes painful stimuli. According to this theory, people with fibromyalgia may have a gene or genes that cause them to react strongly to stimuli that most people would not perceive as painful. However, those genes—if they, in fact, exist—have not been identified.

How Is Fibromyalgia Diagnosed?

People with fibromyalgia often go through a detailed process of diagnosis, typically consulting with multiple doctors before obtaining a conclusive result. The main symptoms of fibromyalgia, which include pain and fatigue, are common in other conditions, necessitating the ruling out of alternative causes.

While there are no definitive lab tests for fibromyalgia, the American College of Rheumatology (ACR) provides criteria, which includes a history of widespread pain lasting over 3 months and the presence of tender points, for its diagnosis.

Criteria for Diagnosis

• Pain should be widespread, affecting all four quadrants of the body.
• ACR has specified 18 potential tender points on the body. For a conclusive diagnosis, a patient should have 11 or more of these tender points.

Note: An illustration detailing the location of these tender points can be found on page 5.

How Is Fibromyalgia Treated?

Treatment for fibromyalgia can be multifaceted and may require a team approach. Finding the right medical professionals is paramount. Various specialists, like rheumatologists, general internists, and family doctors, can offer treatments for this condition.

Treatment Team

• Primary care doctor
• Physical therapist
• Other health professionals
• The patient

Some clinics specialize in pain management or rheumatic diseases and can be an excellent place for treatment.

Although the U.S. Food and Drug Administration (FDA) hasn't approved specific drugs for fibromyalgia, some medications are utilized for their off-label benefits.

Medication Categories

• Analgesics: These are painkillers which can range from over-the-counter solutions to prescription options.
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These drugs like aspirin and ibuprofen (Advil, Motrin) can ease the muscle pain associated with fibromyalgia.
• Antidepressants: These are useful for managing pain and fatigue. They help in elevating the levels of certain chemicals in the brain that can alleviate symptoms.
  • Tricyclic antidepressants like amitriptyline and cyclobenzaprine have shown effectiveness.
  • Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft) are sometimes used.
  • Mixed reuptake inhibitors like venlafaxine (Effexor) and nefazadone (Serzone) are under study for their efficacy.
• Benzodiazepines: These drugs like clonazepam (Klonopin) and diazepam (Valium) can relax muscles and aid in better sleep.

Additional symptom-specific medications and complementary and alternative therapies are also considered for treatment.

Eating well

Although some people with fibromyalgia report feeling better when they eat or avoid certain foods, no specific diet has been proven to influence fibromyalgia. Of course, it is important to have a healthy, balanced diet. Not only will proper nutrition give you more energy and make you generally feel better, it will also help you avoid other health problems.

Tips for Good Sleep

• Keep regular sleep habits. Try to get to bed at the same time and get up at the same time every day—even on weekends and vacations.
• Avoid caffeine and alcohol in the late afternoon and evening. If consumed too close to bedtime, the caffeine in coffee, soft drinks, chocolate, and some medications can keep you from sleeping or sleeping soundly. Even though it can make you feel sleepy, drinking alcohol around bedtime also can disturb sleep.
• Time your exercise. Regular daytime exercise can improve nighttime sleep. But avoid exercising within 3 hours of bedtime, which actually can be stimulating, keeping you awake.
• Avoid daytime naps. Sleeping in the afternoon can interfere with nighttime sleep. If you feel you can't get by without a nap, set an alarm for 1 hour. When it goes off, get up and start moving.
• Reserve your bed for sleeping. Watching the late news, reading a suspense novel, or working on your laptop in bed can stimulate you, making it hard to sleep.
• Keep your bedroom dark, quiet, and cool.
• Avoid liquids and spicy meals before bed. Heartburn and latenight trips to the bathroom are not conducive to good sleep.
• Wind down before bed. Avoid working right up to bedtime. Do relaxing activities, such as listening to soft music or taking a warm bath, that get you ready to sleep. (An added benefit of the warm bath: It may soothe aching muscles.) ==See Also==

Will Fibromyalgia Get Better With Time?

Fibromyalgia is a chronic condition. It doesn't progress or cause additional harm to joints or internal organs. Over time, some people may observe improvement in their symptoms.

What Can I Do To Try To Feel Better?

Patients can take various steps to manage their symptoms better:

• Getting enough sleep
• Exercising
• Making changes at work

External links

• NIAMS/NIH
• The National Fibromyalgia Association U.S
• ARC booklet
• ncf.ca
• Fibromyalgia Fact page
• ArthritisMD
• FM-CFS Canada - to find Canadian support groups
• Fibromyalgia caused by hypothyroidism? (discussion article)
• Fibromyalgia Alternative Network magazine (MyFANnews.com)
• Long Term Disability Claims - FAQ's

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