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What Is Fibromyalgia?
Fibromyalgia is the most common musculoskeletal condition after osteoarthritis. Still, it is often misdiagnosed and misunderstood. Its characteristics include widespread muscle and joint pain and fatigue, as well as other symptoms. Fibromyalgia can lead to depression and social isolation.
This overview of fibromyalgia syndrome (FMS) covers symptoms, diagnosis, and both standard and alternative treatments.
What Is Fibromyalgia Syndrome?
A syndrome is a set of symptoms. When they exist together, they imply the presence of a specific disease or a greater chance of developing the disease. With fibromyalgia syndrome, the following symptoms commonly occur together:
Anxiety or depression
Decreased pain threshold or tender points
Are Women More Likely to Get Fibromyalgia Than Men?
More than 12 million Americans have fibromyalgia. Most of them are women between ages 25 and 60. Women are 10 times more likely to get this disease than men.
What Are Fibromyalgia Symptoms?
Fibromyalgia causes you to ache all over. You may have symptoms of crippling fatigue -- even on arising. Specific tender points on the body may be painful to touch. You may experience disturbances in deep-level or restful sleep, and mood disturbances or depression.
Your muscles may feel like they have been overworked or pulled. They'll feel that way even without exercise or another cause. Sometimes, your muscles twitch, burn, or have deep stabbing pain.
Some patients with fibromyalgia have pain and achiness around the joints in the neck, shoulder, back, and hips. This makes it difficult for them to sleep or exercise. Other fibromyalgia symptoms include:
Dryness in mouth, nose, and eyes
Hypersensitivity to cold and/or heat
Inability to concentrate (called "fibro fog")
Irritable bowel syndrome
Numbness or tingling in the fingers and feet
Fibromyalgia can cause signs and feelings similar to osteoarthritis,bursitis, and tendinitis. Some experts include it in this group of arthritis and related disorders. However, while the pain of bursitis or tendinitisis localized to a specific area, pain and stiffness with fibromyalgia are widespread.
What Tests Are Used to Diagnose Fibromyalgia?
To make an accurate diagnosis, your doctor will rely on a comprehensive physical exam and your medical history. There is a blood test to help diagnose fibromyalgia. The test -- called FM/a -- identifies markers produced by immune system blood cells in people with fibromyalgia. However, more study is needed to test the efficacy of the test, which costs more than $700. Ask your doctor if the FM/a test is right for you.
To rule out more serious illnesses, your doctor may run some specific blood tests. For example, your doctor may ask for a complete blood count (CBC). The doctor may also ask for tests for chemicals, such as glucose, that can create problems similar to problems caused by fibromyalgia. A thyroid test may also be done. An under active thyroid (hypothyroidism) can cause problems similar to fibromyalgia. That includes fatigue, muscle aches, weakness, and depression.
Other laboratory tests used to rule out serious illnesses may include Lyme titers, antinuclear antibodies (ANA), rheumatoid factor (RF), erythrocyte (red blood cell) sedimentation rate (ESR), calcium level, and vitamin D level.
Your doctor may see if your symptoms satisfy the diagnostic criteria for fibromyalgia syndrome outlined by the American College of Rheumatology. These criteria include widespread pain that persists for at least three months. Widespread pain refers to pain that occurs in both the right and left sides of the body, both above and below the waist, and in the chest, neck, and mid or lower back. Criteria focus more on symptoms than on tender points on the body, which were formerly used to diagnose fibromyalgia.
The doctor will evaluate the severity of related symptoms such as fatigue, sleep disturbances, and mood disorders. This will help measure the impact FMS has on your physical and emotional function.
What Is the Standard Treatment for Fibromyalgia?
There is no fibromyalgia cure. And there is no treatment that will address all of the fibromyalgia symptoms. Instead, a wide array of traditional and alternative treatments has been shown to be effective in treating this difficult syndrome. A treatment program may include a combination of medications, exercises -- both strengthening and aerobic conditioning -- and behavioral techniques.
What Drugs Are Used to Treat Fibromyalgia?
According to the American College of Rheumatology, drug therapy for fibromyalgia primarily treats the symptoms. The FDA has approved three drugs to treat fibromyalgia: Lyrica, Cymbalta, and Savella. The FDA says Lyrica -- which is also used to treat nerve pain caused by shingles, diabetes, and spinal cord injuries -- can ease fibromyalgia pain for some patients. Cymbalta and Savella are in a class of drugs known as serotonin and norepinephrine reuptake inhibitors (SNRIs).
Reviewed by David Zelman, MD
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"My fibromyalgia started with chest pain twenty-two years ago. After many ER visits and a cardiologist reassuring me that my heart was fine, I was finally diagnosed with costochondritis and then later with fibromyalgia."
The Fibromyalgia Circle of Hope