Fibromyalgia is a clinical syndrome and is an often misunderstood, even unrecognized, disorder that causes widespread muscle pain and tenderness, which tends to come and go and moves about the body. This common and chronic condition can also be associated with fatigue, sleep disturbances, anxiety and depression, irritable bowel syndrome, memory problems, and many other symptoms. These symptoms can vary in intensity and, like the pain of fibromyalgia, wax and wane over time.
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Explore This IssueFebruary 2009
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No one knows what causes fibromyalgia. However, people with fibromyalgia can have abnormal levels of Substance P—a chemical that helps transmit and amplify pain signals to and from the brain—in their spinal fluid. “For the person with fibromyalgia, it is as though the ’volume control‘ is turned up too high in the brain’s pain processing areas,” write patient fact sheet authors Daniel J. Clauw, MD, and Denise Taylor-Moon, both of the Chronic Pain and Fatigue Research Center at the University of Michigan in Ann Arbor. Genetics also appear to play a role, leading to a familial tendency to develop fibromyalgia as well as everyday life exposure to physical, emotiona,l or environmental stressors that may trigger the initiation of fibromyalgia symptoms.
While men and adolescents can develop fibromyalgia, this condition is more common in women. The disorder tends to develop during early and middle adulthood or during a woman’s childbearing years. Those who have a rheumatic disease such as lupus, rheumatoid arthritis, or ankylosing spondylitis are also at risk for developing fibromyalgia.
Unfortunately, there are no objective markers for fibromyalgia—evidence on X-rays, blood tests, or muscle biopsies, for example—so patients have to be diagnosed based on the symptoms they are experiencing. Because pain and tenderness are the defining characteristics of fibromyalgia, medical care providers focus on the features of the pain to distinguish it from other rheumatic disorders. Occasionally, fibromyalgia can be confused with other rheumatic disorders such as rheumatoid arthritis or lupus, but there is a difference, because these conditions cause inflammation in the joints and tissues.
Fibromyalgia must be managed as a chronic condition, and should include both medication and nonmedication treatments for symptoms. Drug therapy for fibromyalgia is largely symptomatic. “Even with therapeutic options, patient self-management is integral to a meaningful improvement in symptoms and daily function,” the fact sheet explains.
Establishing healthy lifestyle behaviors in concert with medical treatment can reduce pain, increase sleep quality, lessen fatigue, and help patients cope effectively with fibromyalgia.