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06-13-2012, 02:33 PM
Fibromyalgia (FM or FMS) is a medical disorder characterized by chronic widespread pain and allodynia, a heightened and painful response to pressure.<sup>[1]</sup> Fibromyalgia symptoms are not restricted to pain, leading to the use of the alternative term fibromyalgia syndrome for the condition. Other symptoms include debilitating fatigue, sleep disturbance, and joint stiffness. Some patients<sup>[2]</sup> may also report difficulty with swallowing,<sup>[3]</sup> bowel and bladder abnormalities,<sup>[4]</sup> numbness and tingling,<sup>[5]</sup> and cognitive dysfunction.<sup>[6]</sup> Fibromyalgia is frequently comorbid with psychiatric conditions such as depression and anxiety and stress-related disorders such as posttraumatic stress disorder.<sup>[7]</sup><sup>[8]</sup> Not all people with fibromyalgia experience all associated symptoms.<sup>[9]</sup> Fibromyalgia is estimated to affect 24% of the population,<sup>[7]</sup> with a female to male incidence ratio of approximately 9:1.<sup>[10]</sup> The term "fibromyalgia" derives from new Latin, fibro-, meaning "fibrous tissues", Greek myo-, "muscle", and Greek algos-, "pain"; thus the term literally means "muscle and connective tissue pain")
The brains of fibromyalgia patients show structural and behavioral differences from those of healthy individuals, but it is unclear whether the brain anomalies cause fibromyalgia symptoms or are the product of an unknown underlying common cause. Some research suggests that these brain anomalies may be the result of childhood stress, or prolonged or severe stress.<sup>[8]</sup>
Historically, fibromyalgia has been considered either a musculoskeletal disease or neuropsychiatric condition. Although there is as yet no cure for fibromyalgia, some treatments have been shown by controlled clinical trials to effectively reduce symptoms, including medications, behavioral interventions, patient education, and exercise.<sup>[11]</sup><sup>[12]</sup><sup>[13]</sup><sup>[14]</sup><sup>[15]</sup><sup>[16]</sup> The most recent approach of a diagnosis of fibromyalgia involves pain index and a measure of key symptoms and severity.<sup>[17]</sup>
Fibromyalgia has been recognized as a diagnosable disorder by the US National Institutes of Health and the American College of Rheumatology.<sup>[18]</sup><sup>[19]</sup> Fibromyalgia, a central nervous system disorder, is described as a 'central sensitisation syndrome' caused by neurobiological abnormalities which act to produce physiological pain and cognitive impairments as well as neuro-psychological symptomatology.<sup>[20]</sup> Despite this, some health care providers do not consider fibromyalgia a disease because of a lack of abnormalities on physical examination and the absence of objective diagnostic tests.<sup>[21]</sup><sup>[22]</sup>
Signs and symptoms
The defining symptoms of fibromyalgia are chronic widespread pain, fatigue, and heightened pain in response to tactile pressure (allodynia). Other symptoms may include tingling of the skin, prolonged muscle spasms, weakness in the limbs, nerve pain, muscle twitching, palpitations,<sup>[23]</sup> functional bowel disturbances,<sup>[3]</sup> and chronic sleep disturbances.<sup>[24]</sup>
Many patients experience cognitive dysfunction<sup>[6]</sup> (known as "fibrofog"), which may be characterized by impaired concentration,<sup>[25]</sup> problems with short<sup>[7]</sup><sup>[25]</sup> and long-term memory, short-term memory consolidation,<sup>[7]</sup> impaired speed of performance,<sup>[7]</sup><sup>[25]</sup> inability to multi-task, cognitive overload,<sup>[7]</sup><sup>[25]</sup> and diminished attention span. Fibromyalgia is often associated with anxiety and depressive symptoms.<sup>[7]</sup>
Other symptoms often attributed to fibromyalgia that may possibly be due to a comorbid disorder include myofascial pain syndrome, also referred to as chronic myofascial pain, diffuse non-dermatomal paresthesias, functional bowel disturbances and irritable bowel syndrome, genitourinary symptoms and interstitial cystitis, dermatological disorders, headaches, myoclonic twitches, and symptomatic hypoglycemia. Although fibromyalgia is classified based on the presence of chronic widespread pain, pain may also be localized in areas such as the shoulders, neck, low back, hips, or other areas. Many sufferers also experience varying degrees of myofascial pain and have high rates of comorbid temporomandibular joint disorder. 2030% of patients with rheumatoid arthritis and systemic lupus erythematosus may also have fibromyalgia.<sup>[26]</sup>
Diagnosis
There is no single test that can fully diagnose fibromyalgia and there is debate over what should be considered essential diagnostic criteria and whether an objective diagnosis is possible. In most cases, patients with fibromyalgia symptoms may also have laboratory test results that appear normal and many of their symptoms may mimic those of other rheumatic conditions such as arthritis or osteoporosis. In general, most doctors diagnose patients with a process called differential diagnosis, which means that doctors consider all of the possible things that might be wrong with the patient based on the patient's symptoms, gender, age, geographic location, medical history and other factors. They then narrow down the diagnosis to the most likely one. The most widely accepted set of classification criteria for research purposes was elaborated in 1990 by the Multicenter Criteria Committee of the American College of Rheumatology. These criteria, which are known informally as "the ACR 1990", define fibromyalgia according to the presence of the following criteria:
My link
See also
Check Your Fibromyalgia Symptoms
How Does Fibromyalgia Affect Your Life?
Fibromyalgia causes you to hurt all over. Fibromyalgia pain can come from painful tender points, aching muscles, chronic headaches, or neck and back pain. It also can cause fatigue, anxiety, and depression that affect your sleep, your career, or your ability to lead an active life. Take a minute to think about how you have felt over the last six months. Which of these statements describes how fibromyalgia affects your life?
Ease Your Pain
You can break the pain cycle.
You may feel that fibromyalgia pain has now become a part of your daily existence. See your doctor and ask about treatments to reduce your pain and help you reclaim an active life.
Pain from fibromyalgia is chronic and widespread. You may hurt all over -- from painful tender points, deep muscle pain, headaches, unending back pain or neck pain, or other muscle aches. The chronic pain of fibromyalgia also disturbs sleep, causing you to awaken frequently. Without good sleep, you may have increased achiness, morning stiffness, and daytime fatigue. In addition, about 30% of patients with fibromyalgia have major depression at the time of diagnosis.
While fibromyalgia is a chronic condition, by working with your doctor you can get relief of fibromyalgia symptoms and reclaim your active life. Eating a healthy diet, making sure you get enough sleep, and exercising also can help reduce pain. A physical therapist can help you design an exercise program that's right for you.
The brains of fibromyalgia patients show structural and behavioral differences from those of healthy individuals, but it is unclear whether the brain anomalies cause fibromyalgia symptoms or are the product of an unknown underlying common cause. Some research suggests that these brain anomalies may be the result of childhood stress, or prolonged or severe stress.<sup>[8]</sup>
Historically, fibromyalgia has been considered either a musculoskeletal disease or neuropsychiatric condition. Although there is as yet no cure for fibromyalgia, some treatments have been shown by controlled clinical trials to effectively reduce symptoms, including medications, behavioral interventions, patient education, and exercise.<sup>[11]</sup><sup>[12]</sup><sup>[13]</sup><sup>[14]</sup><sup>[15]</sup><sup>[16]</sup> The most recent approach of a diagnosis of fibromyalgia involves pain index and a measure of key symptoms and severity.<sup>[17]</sup>
Fibromyalgia has been recognized as a diagnosable disorder by the US National Institutes of Health and the American College of Rheumatology.<sup>[18]</sup><sup>[19]</sup> Fibromyalgia, a central nervous system disorder, is described as a 'central sensitisation syndrome' caused by neurobiological abnormalities which act to produce physiological pain and cognitive impairments as well as neuro-psychological symptomatology.<sup>[20]</sup> Despite this, some health care providers do not consider fibromyalgia a disease because of a lack of abnormalities on physical examination and the absence of objective diagnostic tests.<sup>[21]</sup><sup>[22]</sup>
Signs and symptoms
The defining symptoms of fibromyalgia are chronic widespread pain, fatigue, and heightened pain in response to tactile pressure (allodynia). Other symptoms may include tingling of the skin, prolonged muscle spasms, weakness in the limbs, nerve pain, muscle twitching, palpitations,<sup>[23]</sup> functional bowel disturbances,<sup>[3]</sup> and chronic sleep disturbances.<sup>[24]</sup>
Many patients experience cognitive dysfunction<sup>[6]</sup> (known as "fibrofog"), which may be characterized by impaired concentration,<sup>[25]</sup> problems with short<sup>[7]</sup><sup>[25]</sup> and long-term memory, short-term memory consolidation,<sup>[7]</sup> impaired speed of performance,<sup>[7]</sup><sup>[25]</sup> inability to multi-task, cognitive overload,<sup>[7]</sup><sup>[25]</sup> and diminished attention span. Fibromyalgia is often associated with anxiety and depressive symptoms.<sup>[7]</sup>
Other symptoms often attributed to fibromyalgia that may possibly be due to a comorbid disorder include myofascial pain syndrome, also referred to as chronic myofascial pain, diffuse non-dermatomal paresthesias, functional bowel disturbances and irritable bowel syndrome, genitourinary symptoms and interstitial cystitis, dermatological disorders, headaches, myoclonic twitches, and symptomatic hypoglycemia. Although fibromyalgia is classified based on the presence of chronic widespread pain, pain may also be localized in areas such as the shoulders, neck, low back, hips, or other areas. Many sufferers also experience varying degrees of myofascial pain and have high rates of comorbid temporomandibular joint disorder. 2030% of patients with rheumatoid arthritis and systemic lupus erythematosus may also have fibromyalgia.<sup>[26]</sup>
Diagnosis
There is no single test that can fully diagnose fibromyalgia and there is debate over what should be considered essential diagnostic criteria and whether an objective diagnosis is possible. In most cases, patients with fibromyalgia symptoms may also have laboratory test results that appear normal and many of their symptoms may mimic those of other rheumatic conditions such as arthritis or osteoporosis. In general, most doctors diagnose patients with a process called differential diagnosis, which means that doctors consider all of the possible things that might be wrong with the patient based on the patient's symptoms, gender, age, geographic location, medical history and other factors. They then narrow down the diagnosis to the most likely one. The most widely accepted set of classification criteria for research purposes was elaborated in 1990 by the Multicenter Criteria Committee of the American College of Rheumatology. These criteria, which are known informally as "the ACR 1990", define fibromyalgia according to the presence of the following criteria:
- A history of widespread pain lasting more than three monthsaffecting all four quadrants of the body, i.e., both sides, and above and below the waist.
- Tender pointsthere are 18 designated possible tender points (although a person with the disorder may feel pain in other areas as well). The patient must feel pain at 11 or more of these points for fibromyalgia to be considered.<sup>[103]</sup>
My link
See also
- Living With Fibromyalgia, documentary film
Check Your Fibromyalgia Symptoms
How Does Fibromyalgia Affect Your Life?
Fibromyalgia causes you to hurt all over. Fibromyalgia pain can come from painful tender points, aching muscles, chronic headaches, or neck and back pain. It also can cause fatigue, anxiety, and depression that affect your sleep, your career, or your ability to lead an active life. Take a minute to think about how you have felt over the last six months. Which of these statements describes how fibromyalgia affects your life?
Ease Your Pain
You can break the pain cycle.
You may feel that fibromyalgia pain has now become a part of your daily existence. See your doctor and ask about treatments to reduce your pain and help you reclaim an active life.
Pain from fibromyalgia is chronic and widespread. You may hurt all over -- from painful tender points, deep muscle pain, headaches, unending back pain or neck pain, or other muscle aches. The chronic pain of fibromyalgia also disturbs sleep, causing you to awaken frequently. Without good sleep, you may have increased achiness, morning stiffness, and daytime fatigue. In addition, about 30% of patients with fibromyalgia have major depression at the time of diagnosis.
While fibromyalgia is a chronic condition, by working with your doctor you can get relief of fibromyalgia symptoms and reclaim your active life. Eating a healthy diet, making sure you get enough sleep, and exercising also can help reduce pain. A physical therapist can help you design an exercise program that's right for you.