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People with fibromyalgia (fI-bro-my-AL-gee-ah) syndrome, or FMS, live with constant pain in their muscles and soft tissues. Because the pain is spread throughout the body and because a variety of other symptoms can accompany the disease, fibromyalgia syndrome is often difficult to diagnose.
According to the 2003 National Ambulatory Medical Care Survey from the Centers for Disease Control and Prevention, approximately 4.9 million people in the United States have fibromyalgia syndrome. Women between 20 and 60 years of age are most at risk. The cause of fibromyalgia syndrome is unknown, but factors that may contribute to its development include sleep disturbances, psychological stress, changes in muscle metabolism, and abnormalities in a person's immune, endocrine, or nervous systems. The symptoms of fibromyalgia are slightly different in every person.
Pain is the most compelling symptom of fibromyalgia syndrome. The pain may be aching, burning, throbbing, shooting, or a stabbing pain. It often hurts worse in the morning. The pain may be constant and chronic. The pain may be focused in " trigger points " on the body.
Fatigue and sleep disturbances are common.
Short-term memory loss, mood changes, depression, anxiety, and difficulty in concentrating often accompany the pain.
Migraine and tension headaches, chest pain, numbness in the hands and feet, abdominal pain, bloating, diarrhea, and constipation often develop.
It can be difficult to diagnose fibromyalgia syndrome because no test can prove its presence. Neither X-rays nor lab tests show any abnormalities. These tests can be used to rule out other conditions with similar symptoms. The patient's medical history and description of the symptoms are useful in the diagnosis. The following criteria have been established for a diagnosis of fibromyalgia syndrome:
- Pain on both right and left sides of the body
- Pain both above and below the waist
- Pain in the skeletal spine and/or chest
Pain and tenderness at 11 or more of 18 trigger points, when pressed with a finger with an approximate force of 8.8 pounds.
- There are nine paired sets of trigger points, located at the same spot on both the left and right sides of the body.
- Trigger points are located at the base of the skull, in the neck, shoulders, chest and lower spine, buttocks, hips, elbows, and knees.
Treating fibromyalgia syndrome is a team approach that involves the physician, the patient, and possibly several other health care professionals.
There is no definitive treatment that will cure fibromyalgia syndrome. Treatment is an ongoing process that can involve several different modalities to help control pain and improve function. Fibromyalgia syndrome is not a life-threatening or progressive disease, but a chronic condition that can be managed successfully in many cases. Treatment plans must be individualized to respond to the patient's needs and lifestyle.
Certain medications, including antidepressants and pain relievers, can be helpful. A gradual exercise program designed to increase flexibility, build endurance, and enhance cardiac fitness is also important. Additional therapies may involve heat or cold applications, massage, weight control, psychological counseling, and participation in support groups.
The American Academy of Orthopaedic Surgeons
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