Fibromyalgia (pronounced fy-bro-my-AL-ja) is a complex chronic pain disorder that affects an estimated 5 million Americans. While it occurs most often in women, it strikes men and children, and all ethnic backgrounds. For those with severe symptoms, fibromyalgia (FM) can be extremely debilitating and interfere with basic daily activities.
The FM diagnostic criteria, established by the American College of Rheumatology (ACR) in 1990, includes a history of widespread pain in all four quadrants of the body for a minimum duration of three months, and pain in at least 11 of the 18 designated tender points when a specified amount of pressure is applied.
New diagnostic criteria were developed by the ACR in 2010, which do not use tender points, but focus upon pain being widespread and accompanied by allied symptoms, such as sleep problems, problems with thinking clearly, and fatigue. Since people with FM tend to look healthy and conventional tests are typically normal, a physician knowledgeable about the disorder is necessary to make a diagnosis. Physicians should rule out other causes of the symptoms before making a diagnosis of fibromyalgia.
Since people with FM tend to look healthy and conventional tests are typically normal, a physician knowledgeable about the disorder is necessary to make a diagnosis.
Physicians should rule out other causes of the symptoms before making a diagnosis of fibromyalgia.
Although chronic, widespread body pain is the primary symptom of fibromyalgia, a variety of other symptoms are common in FM patients. Symptoms include: moderate to severe fatigue, sleep disorders, problems with cognitive functioning, irritable bowel syndrome, headaches and migraines, anxiety and depression, and environmental sensitivities.
Research has documented neuroendocrine physiological abnormalities that may contribute to the symptoms.
Recent research has suggested a genetic component. The disorder is often seen in families, among siblings or mothers and their children.
Fibromyalgia often occurs following a physical trauma, such as an acute illness or injury, which may act as a âtriggerâ in the development of the disorder.
Increasing attention is being devoted to the central nervous system as the underlying mechanism of FM. Recent studies have suggested that FM patients have generalized disturbance in pain processing and an amplified response to stimuli that would not ordinarily be painful in healthy individuals.
Since there is no known cure for FM, treatment focuses on relieving symptoms and improving function.
A variety of prescription medications are often used to reduce pain levels and improve sleep. On June 21, 2007, the U.S. Food and Drug Administration approved Lyrica (pregabalin) as the first drug to treat fibromyalgia. Cymbalta (duloxetine HCl) was approved in June 2008; and Savella (milnacipran HCl) was approved in January 2009.
Alternative therapies, such as massage, myofascial release, acupuncture, chiropractic, herbal supplements and yoga, can be effective tools in managing FM symptoms.
Increasing rest, pacing activities, reducing stress, practicing relaxation and improving nutrition can help minimize symptoms and improve quality of life.