About Fibromyalgia
What is Fibromyalgia?
Fibromyalgia (FM) means “soft tissue and muscle pain.” The soft tissues are the tendons or ligaments. The pain can be severe enough to interfere with routine daily activities. It migrates, can be achy, burning, throbbing, shooting, or stabbing, and is worse in areas used most, such as the neck or back.
FM may be associated with “tender points” or generalized muscle pain. Fatigue can be present and is usually secondary to pain. Other symptoms are common to fibromyalgia, including stiffness on waking, memory and concentration problems, excessive sensitivity of the senses, headaches, Temporomandibular Joint Syndrome (TMJ), irritable bowel, and bladder and muscle spasm.
Like ME/CFS patients, blood tests for FM patients often come back normal. There is also no biomarker for FM. FM and ME/CFS have overlapping symptoms, and can be co-occurring illnesses, which can make diagnosing the two complicated. FM symptoms focus on pain and patients do not have PEM, whereas ME/CFS is characterized by PEM. Presence of PEM in FM patients indicates co-occurring ME/CFS. Exercise, which is indicated for FM, is not indicated for ME/CFS and may be harmful.
Diagnosis of FM
In May 2010, the American College of Rheumatology (ACR) released new criteria for the clinical diagnosis of Fibromyalgia and a 2011 modification of the self-report survey. This current criteria recommends that previous tender point examination be replaced with a combination of a widespread pain index (WPI) and severity scale of symptoms (SSS.) The WPI requires pain in at least 4 out of 5 regions of the body. The values and ranges allowed for the WPI and the SS scales need to meet certain ranges and scales. Symptoms must persist at this level for 3 months, and the patient must not have any other disorder or cause to explain the pain.
Read more about the diagnosis of FM on the American Fibromyalgia Syndrome Website.
Who treats FM?
Medically, FM is classified as a rheumatological illness, and FM is most commonly diagnosed and treated by rheumatologists.
How is FM treated?
There is presently no cure for FM. Treatment is aimed at reducing pain and improving sleep.
Most often prescribed medications include anti-inflammatories, tricyclics, and pain medications. Recently three medications, Cymbalta, Lyrica, and Savella, have been approved for use in the treatment of FM.
Lifestyle measures to lessen stress, balance exercise and rest, and the avoidance of factors that aggravate symptoms are helpful. Many individuals have also benefited from incorporating nutritional approaches, physical or occupational therapy, counseling, and peer support groups as part of their treatment.
Where can I find out more about FM?
There is a great deal of excellent research and clinical information about fibromyalgia. The National Fibryomyalgia Association and the American Fibromylagia Association are excellent websites to learn more about diagnosis, treatment, and other important patient concerns such as coping.