Fibromyalgia

What is fibromyalgia?

Fibromyalgia is a state of chronic widespread pain and tenderness in the absence of tissue damage ^[1,10]. The word fibromyalgia literally means pain in the fibrous connective tissue (tendons and ligaments) and muscles ^[3].

Current evidence suggests that fibromyalgia develops due to inability to cope with psychological or physical stress ^[4,5,6].

Perfectionists who have unrealistic ideas have a problem with reaching their goals, so they can develop strong emotions of sadness, anger, fear and helplessness ^[7]. These emotions, when sustained, can trigger chemical changes in the central nervous system (the brain and spinal cord) that lead to increased sensitivity to pain ^[8,9].

Similarly, unsuccessful coping with physical stress, trauma or infection may trigger the onset of fibromyalgia ^[4,7].

Fibromyalgia is also called fibromyalgia syndrome ^[8]. A syndrome means a cluster of symptoms, so fibromyalgia should be viewed as such and not as a disease ^[16].

Fibromyalgia most commonly occurs in young and middle-aged women, but also in men and children, especially adolescents ^[3,9].

Fibromyalgia is NOT ^[10]:

• Dangerous or fatal
• Contagious
• Malingering
• “All in your head”

The old and technically incorrect names for fibromyalgia are fibrositis, fibromyositis and muscular rheumatism ^[11].

Symptoms and Signs

Typical symptoms of fibromyalgia include ^[12,13]:

• Widespread pain and tenderness
• Tingling and numbness
• Fatigue
• Depression and anxiety
• “Fibro fog” (poor memory and concentration)
• Disturbed sleep and morning stiffness

A typical sign of fibromyalgia are symmetrical tender points in most body regions ^[15].

Causes

Fibromyalgia can be triggered by unsuccessful coping with ^[4,10,13]:

• Emotional trauma, sexual abuse, neglect or alcoholism in the family
• Excessive physical work
• Physical trauma, such as whiplash injury or surgery
• Childbirth

Diagnosis

A doctor can make a diagnosis of fibromyalgia from:

• The history of widespread pain and fatigue
• Presence of tender points
• Exclusion of other conditions

Investigations, such as laboratory tests and imaging (X-ray, CT, MRI), are not useful in diagnosing fibromyalgia but can help to detect other health disorders ^[9,15].

Treatment

The approach to the treatment of fibromyalgia should be holistic, that is involving the whole person ^[2,5]:

• Become aware of the emotions of peace and joy and adjust work and relationships accordingly.
• Set clear goals and stick with them.
• Stay physically active (walking, cycling).
• Share your problems with a person you trust.

• References

  1. Meeus M et al, 2007, Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome  PubMed Central
  2. Busch AJ et al, 2007, Aerobic exercise for fibromyalgia  Cochrane
  3. Questions and answers about fibromyalgia  National Institute of Arthritis and Musculoskeletal and Skin Diseases
  4. Bradley LA, 2009, Pathophysiology of fibromyalgia  PubMed Central
  5. Martinez-Lavin M et al, 20017, Biology and therapy of fibromyalgia. Stress, the stress response system, and fibromyalgia  PubMed Central
  6. Fibromyalgia  Cleveland Clinic
  7. Martinez-Lavin M, 2012, Fibromyalgia: When Distress Becomes (Un)sympathetic Pain  PubMed Central
  8. Bellato E et al, 2012, Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment  PubMed Central
  9. Boomershine CS, Fibromyalgia  Emedicine
  10. Fibromyalgia  American College of Rheumatology
  11. Fibromyalgia WebMD
  12. What are the symptoms of fibromyalgia?  Arthritis Research UK
  13. Bennet RM et al 2007, An internet survey of 2,596 people with fibromyalgia  PubMed Central
  14. Levine TD et al, Routine use of punch biopsy to diagnose small fiber neuropathy in fibromyalgia patients  PubMed Central
  15. Clauw DJ, 2014, Fibromyalgia clinical review  CiteSeerX
  16. Sammaritano LR, An In-Depth Overview of Fibromyalgia  Hospital for Special Surgery