FIBROMYALGIA

What is fibromyalgia?

Fibromyalgia is a disorder that causes aches and pain all over the body. People with fibromyalgia also are tender throughout the body, which is most pronounced at certain regions termed "tender points". Tender points are specific places on the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them.

People with fibromyalgia could have:

• Muscle pain
• Fatigue
• Trouble sleeping
• Joint pain, stiffness (sometimes worse in the morning)
• Headaches
• Restless legs
• Tingling or numbness in hands and feet
• Problems with thinking and memory (sometimes called "fibro fog")
• Leg cramps
• Feeling nervous
• Depression
• Feeling dizzy or lightheaded
• Painful cramping during your period
• Jaw pain
• Upset stomach, cramping, bloating, feeling constipated or diarrhoea
• Trouble swallowing
• Frequent or painful urination

• fibromyalgia affects as many as 1 in 50 Americans. Most people with fibromyalgia are women (about 80-90%). However, men and children also can have the disorder. Most people are diagnosed during middle age. fibromyalgia can occur by itself, but people with certain other diseases, such as rheumatoid arthritis and other types of arthritis, may be more likely to have fibromyalgia.
• Individuals who have a close relative with fibromyalgia are more likely to develop fibromyalgia.

The causes of fibromyalgia are not known. Researchers think a number of factors might be involved. Fibromyalgia has been linked to:

• Having a family history of fibromyalgia (i.e. genetics)
• Being exposed to stressful or traumatic events, such as
  • car accidents
  • injuries to the body caused by performing the same action over and over again
  • infections or illnesses
  • being deployed to war

People with fibromyalgia often see many doctors before being diagnosed. One reason for this may be that pain and fatigue, the main symptoms of fibromyalgia, also are symptoms of many other conditions. Therefore, doctors often must rule out other possible causes of these symptoms before making a diagnosis of fibromyalgia. fibromyalgia cannot be detected by a lab test either.

A doctor who knows about fibromyalgia, however, can make a diagnosis based upon two criteria:

• A history of widespread pain lasting more than 3 months. Pain must be present in both the right and left sides of the body as well as above and below the waist.
• Presence of tender points. The body has 18 sites that are possible tender points. For fibromyalgia diagnosis a person must have 11 or more tender points. To be deemed a tender point, pain must be felt when pressure is applied to the site. People who have fibromyalgia may feel pain at other sites, too, but those 18 sites on the body are used for diagnosis.

The above criteria were developed for use to standardize research studies and are not necessary to diagnose individual patients, but if you feel your doctor doesn't know a lot about fibromyalgia or has doubts about whether it is a "real" illness, see another doctor for a second opinion. Contact a local university medical school or research center for help finding a doctor who has helped others with fibromyalgia. 

fibromyalgia can be hard to treat. It's important to find a doctor who has treated others with fibromyalgia. Many family doctors, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who treat arthritis and other conditions that affect the joints and soft tissues.

Treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment.

The US. Food and Drug Administration has not yet approved any medicines to treat fibromyalgia. Doctors treat fibromyalgia with medicines approved for other purposes. Pain medicines and antidepressants are often used in treatment.

Chronic fatigue syndrome (CFS) and fibromyalgia are alike in many ways. In fact, it is not uncommon for a person to have both fibromyalgia and CFS. Some experts believe that fibromyalgia and CFS are in fact the same disorder, but expressed in slightly different ways. Both CFS and fibromyalgia have pain and fatigue as symptoms.

The main symptom of CFS is extreme tiredness. CFS often begins after having flu-like symptoms. But people with CFS do not have the tender points that people with fibromyalgia have. To be diagnosed with CFS, a person must have:

• Extreme fatigue for at least 6 months that cannot be explained by medical tests and
• Have 4 or more of the following symptoms:
  • Forgetting things or having a hard time focusing
  • Feeling tired even after sleeping
  • Muscle pain or aches
  • Pain or aches in joints without swelling or redness
  • Feeling discomfort or "out-of-sorts" for more than 24 hours after being active
  • Headaches of a new type, pattern, or strength
  • Tender lymph nodes in the neck or under the arm
  • Sore throat

Besides taking medicine prescribed by your doctor, there are many things you can do to lessen the impact of fibromyalgia on your life:

• Get enough sleep. Getting enough sleep and the right kind of sleep can help ease the pain and fatigue of fibromyalgia.
• Get moving. Though pain and fatigue may make exercise and daily activities hard, being active as possible is important. People who have a lot of pain or fatigue should begin with walking or other gentle exercises and slowly build up to more demanding workouts.
• Make changes at work. Most people with fibromyalgia continue to work, but they may have to make big changes to do so. For example, some people cut down the number of hours, switch to a less demanding job, or adapt a current job.
• Eat right. Try to add more fruits, vegetables, and whole grains to your diet.