Fibromyalgia

What Is It?

People with fibromyalgia have widespread pain, aches and stiffness in muscles and joints throughout the body along with unusual tiredness. There is no known cause of fibromyalgia. In addition, doctors cannot find a physical reason for the symptoms. Blood tests, X-rays and other tests usually are normal in people with fibromyalgia.

Fibromyalgia syndrome is a controversial illness, as some physicians do not believe that it is a medical illness as much as it may be a reflection of psychological distress or stress. However, there is no proof of a psychological cause, either, and until we have a better understanding of the disorder, it is likely to remain controversial.

It may be that fibromyalgia syndrome has more than one cause. Some researchers have suggested that it is related to abnormalities in a non-dream part of the sleep cycle or to low levels of serotonin, a brain chemical that regulates sleep and pain perception. Other theories have linked fibromyalgia to low levels of somatomedin C, a chemical related to muscle strength and muscle repair, or to high levels of substance P, a chemical that affects the threshold at which a person experiences pain. Still others have cited trauma, blood-flow abnormalities in the muscles, viral infections or other infections as possible triggers of fibromyalgia.

Fibromyalgia afflicts an estimated 3.4 percent of women and 0.5 percent of men in the United States, affecting 3 million to 6 million Americans. It most commonly affects women of childbearing age or older. In fact, some estimates suggest that more than 7 percent of women in their 70s suffer from fibromyalgia.

Many patients with fibromyalgia also suffer from psychiatric problems such as depression, anxiety or eating disorders, although the relationship between them remains unclear.

Symptoms

Fibromyalgia can cause pain and stiffness in the muscles and joints almost anywhere in the body, including the trunk, neck, shoulders, back and hips. Pain often occurs between the shoulder blades and at the bottom of the neck. Pain may be either a general soreness or a gnawing ache, and stiffness is often worst in the morning. Typically, patients also complain of feeling abnormally tired, especially of waking up tired, although they may not recall having trouble sleeping. People with fibromyalgia also have tender points, which are specific spots on the body that are painful to touch. Some patients also report symptoms of irritable bowel syndrome, depression, anxiety and headache. The American College of Rheumatology lists 18 typical tender points in its list of criteria for diagnosing fibromyalgia.

Diagnosis

After asking about your symptoms, your doctor will check for swelling, redness and impaired movement in those parts of your body where you are having pain. Your doctor also will check for tenderness in the 18 specific tender points designated by the American College of Rheumatology. Your doctor also will ask detailed questions about your medical history and examine you to search for other conditions or diseases that could explain your symptoms.