|By Rick Meyer, MD
Midwest Community Health Associates
Fibromyalgia is a chronic pain disorder that affects muscles, ligaments, and tendons, causing widespread muscle pain, or “myalgias,” and excess tenderness in certain areas of the body.
Many people also experience fatigue, sleep disturbances, headaches, and mood disturbances, such as depression and anxiety. Despite ongoing research, the cause, diagnosis, and optimal treatment of fibromyalgia are not clear.
Fibromyalgia was first reported in France and England in the 19th century and was previously known as “fibrositis”. As there is no tissue inflammation, the condition is now more commonly referred to as “fibromyalgia.” It is thought to be the most common case of generalized musculoskeletal pain in women between the ages of 20 to 75, although it does occur in men, children, adolescents, and older persons.
Fibromyalgia is more common in relatives of patients with fibromyalgia, suggesting the contribution of both genetic and environmental factors.
The cause of fibromyalgia is unknown. Research suggests that various physical or emotional factors may play a role in triggering symptoms. Although the pain is felt in muscles and soft-tissues, there are no permanent pathologic changes seen at these sites.
The primary symptom of fibromyalgia is widespread, chronic, and persistent pain that may be described as a deep muscular aching, soreness, stiffness, burning, or throbbing. Patients may also feel numbness, tingling, or unusual “crawling” sensations in the arms and legs.
Although some degree of muscle pain is always present, it may vary in intensity and may be aggravated by exertion, exposure to cold or dampness, poor sleep, anxiety or stress.
Determining whether a person’s signs and symptoms are related to fibromyalgia or another condition can be a complex and lengthy process. Many illnesses mimic the generalized muscle aches, fatigue, and other common symptoms of fibromyalgia.
Individuals are often affected by fibromyalgia for several years before receiving a diagnosis. During the diagnostic process, people may have undergone multiple testing procedures, consulted with numerous physicians, and been advised that “nothing appears to be wrong”.
The difficulty in diagnosis arises from the fact that there are no specific laboratory or imaging tests that definitively confirm the diagnosis. The diagnosis is typically based upon a complete physical examination, a thorough patient history, and routine tests that assist in excluding conditions with similar symptoms.
In 1990, the American College of Rheumatology, a professional organization of rheumatologists and associated healthcare professionals, developed specific diagnostic criteria for fibromyalgia.
Treatment of fibromyalgia requires a comprehensive, multidisciplinary approach in which patients, physicians, physical therapists, mental health professionals, and other healthcare professionals actively participate in the management of this poorly understood diagnosis.
While fibromyalgia does not result in life-threatening complications, treatment of chronic pain and fatigue are challenging and there are no “quick cures”. Exercise, stretching programs, and other activities are important in helping to manage symptoms.
Medications may be helpful in reducing pain, improving the quality of sleep, and elevating mood. Antidepressants, anticonvulsants and analgesics (such as Tylenol and others) have been found to be helpful in clinical research trials.
In June, 2007, Lyrica (pregabalin) was approved by the FDA as the first medication specifically for fibromyalgia management. Not all people find benefit with this drug and it is quite expensive. About 28 percent of people get a 50 percent reduction in pain but this effect may wane over weeks or months. Side effects include dizziness, drowsiness, and impaired concentration.
Fibromyalgia symptoms may wax and wane over time, yet some degree of muscle pain and fatigue generally persist. Nevertheless, most people with fibromyalgia have improvement of their condition and lead full, active lives.
If you have more questions about fibromyalgia talk to your primary care doctor. For more information you may also contact:
Rick Meyer, M.D. is a doctor of Family Medicine at MCHA, serving the Bryan office.
- National Fibromyalgia Association (www.fmaware.org), 714-921-0150
- Fibromyalgia Network (www.fmnetnews.org), 800-853-2929
- Arthritis Foundtion (www.arthritis,org), 800-283-7800
- National Fibromyalgia Partnership Inc. (www..fmpartnership.org), 866-725-4404