Fibromyalgia: A Chronic Pain IllnessBy: Joel Hirschberg, MD Medical Director, Eisenhower Medical Center Arthritis Education Program
For months, 32-year-old Joan Brett (not her real name) had felt extremely tired day after day. At first, this mother of two toddlers attributed her severe fatigue and lack of energy to overwork and restlessness throughout the night, or possibly to flu with persistent, mild pain, mainly in her muscles.
When Joan finally went to see her family physician, he found nothing abnormal in her condition and referred her to a rheumatologist. Joan’s rheumatologist was able to identify several important “tender points” in Joan’s neck, spine, shoulders and hips. These points, along with Joan’s persistent fatigue over a period of several months, helped identify her condition as fibromyalgia.
What Is Fibromyalgia? Fibromyalgia syndrome is usually characterized by generalized muscular pain and fatigue. The condition is often difficult to diagnose because the symptoms – pain, numbness, tingling and burning sensations, extreme fatigue, exhaustion and sleep disorders – are also common in other conditions.
Although similar to arthritis, fibromyalgia is different in a number of ways. Arthritis, for example, affects joints and bones and can cause deformities of the bones. Fibromylagia affects muscles and their attachments to the bones and does not cause any deformities of the joints. In addition, arthritis affects both men and women of all ages as well as children, whereas fibromyalgia more often affects women.
What Causes Fibromyalgia? Although the exact cause of fibromyalgia is unknown, researchers have several theories about what causes or triggers the disorder. Some scientists believe that the syndrome may be caused by an injury or trauma, which affects the central nervous system or may be associated with changes in muscle metabolism. Still other researchers believe the syndrome may be triggered by an infectious agent, such as a virus.
How Is Fibromyalgia Diagnosed? Because the symptoms of fibromyalgia mimic those of many other diseases, family physicians often have a difficult time diagnosing the disease. The American College of Rheumatology, however, says that a person is considered to have fibromyalgia if he or she has widespread pain in all four quadrants of the body for a minimum of three months, along with tenderness in at least 11 of 18 specific tender points on the body when pressured is applied.
Typically, patients with fibromyalgia talk about pain in the neck, back, shoulders, pelvic region and hands.
How Is Fibromyalgia Treated? Treatment of fibromyalgia may involve a combination of aerobic exercise, relaxation techniques and medication, including antidepressant medications to help relax the muscles and improve the quality of sleep. Many patients find that they can cope with fibromyalgia better through support groups or general self-education programs about the disease. Even though fibromyalgia is not lifethreatening, the pain and fatigue can cause both fear and frustration with the disease being so difficult to identify.
Fibromyalgia At-a-Glance What It Is: A chronic pain disorder characterized by persistent fatigue and multiple tender points. Who Has It: Three to six million Americans, mainly women of childbearing age. What Causes It: Unknown, though several theories exist. How It Is Diagnosed: Persistent pain and fatigue over several months in combination with tenderness in at least 11 of 18 specific tender point sites. How It Is Treated: Aerobic exercise, heat and massage therapy, antidepressant medications (to improve sleep and relax muscles).