Fibromyalgia (FM or FMS) is a chronic syndrome (constellation of signs and symptoms) characterized by diffuse or specific muscle, joint, or bone pain, fatigue, and a wide range of other symptoms. It is not contagious, and recent studies suggest that people with fibromyalgia may be genetically predisposed. It affects more females than males, with a ratio of 9:1 by ACR (American College of Rheumatology) criteria.

 

Fibromyalgia is seen in 3% to 6% of the general population, recent times have seen an increase in numbers, which is assumed to be associated with better identification of the disorder. It is most commonly diagnosed in individuals between the ages of 20 and 50, though onset can occur in childhood. The disease is not life-threatening, though the degree of symptoms may vary greatly from day to day with periods of flares (severe worsening of symptoms) or remission.

The syndrome is generally perceived as non-progressive, yet that issue is still debated. Fibromyalgia may actually be composed of several clinical entities, ranging from a mild, idiopathic inflammatory process in some individuals, to a somatoform disorder resulting from clinical depression in others, with probable overlaps in between.Current diagnostic criteria are insufficient to differentiate these entities.

Symptoms

The defining symptoms of fibromyalgia are chronic, widespread pain and tenderness to light touch, and usually moderate to severe fatigue. Those affected may also experience heightened sensitivity of the skin (also called allodynia), tingling of the skin (often needle-like), achiness in the muscle tissues, prolonged muscle spasms, weakness in the limbs, and nerve pain. Chronic sleep disturbances are also characteristic of fibromyalgia -- and not just from discomfort: some studies suggest that these sleep disturbances are the result of a sleep disorder called alpha-delta sleep, a condition in which deep sleep (associated with delta EEG waves) is frequently interrupted by bursts of brain activity similar to wakefulness (i.e. alpha waves). Deeper stages of sleep (stages 3 & 4) are often dramatically reduced.

In addition, many patients experience cognitive dysfunction (known as "brain fog" or "fibrofog"), which may be characterized by impaired concentration and short-term memory consolidation, impaired speed of performance, inability to multi-task, and cognitive overload. Many experts suspect that "brain fog" is directly related to the sleep disturbances experienced by sufferers of fibromyalgia. However, the relationship has not been strictly established.

Other symptoms often attributed to fibromyalgia (possibly due to another comorbid disorder) may include myofascial pain syndrome, chronic paresthesia, physical fatigue, irritable bowel syndrome, genitourinary symptoms (such as those associated with the chronic bladder condition interstitial cystitis), dermatological disorders, headaches, myoclonic twitches, and symptomatic hypoglycemia. Although it is common in people with fibromyalgia for pain to be widespread, it may also be localized in areas such as the shoulders, neck, back, hips, or other areas. Many sufferers also experience varying degrees of temporomandibular joint disorder. Not all patients have all symptoms.

Fibromyalgia can, but does not always, start as a result of some trauma (such as a traffic accident), major surgery, or disease. Some evidence shows that Lyme Disease may be a trigger of fibromyalgia symptoms in some individuals. However, there is currently no known strong correlation between any specific type of trigger and the subsequent initiation of symptoms. Symptoms can have a slow onset, and many patients have mild symptoms beginning in childhood, that are often misdiagnosed as growing pains. Symptoms are often aggravated by unrelated illness or changes in the weather.

They can become more tolerable or less tolerable throughout daily or yearly cycles; however, many people with fibromyalgia find that, at least some of the time, the condition prevents them from performing normal activities such as driving a car or walking up stairs. The syndrome does not cause inflammation as is present in rheumatoid arthritis, although some NSAIDs may temporarily reduce pain symptoms in some patients. Their use however is limited, and often of little to no value in pain management.

Variability of symptoms

The following factors have been proposed to exacerbate symptoms of pain in patients:

• Increased psychosocial stress
• Excessive physical exertion (exercise seems to decrease the pain threshold of people with Fibromyalgia but increase it in healthy individuals)
• Lack of slow-wave sleep
• Changes in humidity and barometric pressure

Treatment

As with many other disorders, there is no universally accepted cure for fibromyalgia, though some physicians claim to have found cures. However, a steady interest in the disorder on the part of academic researchers as well as pharmaceutical interests has led to improvements in its treatment, which ranges from symptomatic prescription medication to alternative and complementary medicine.

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