Fibromyalgia
Fibromyalgia is a term referring to pain in the fibrous tissues of the body, such as muscles, tendons, and ligaments.
Primary fibromyalgia syndrome (FMS) is a form of fibromyalgia where pain occurs in muscles, tendons, and ligaments throughout the body. The cause is not known. It is most common in young and middle-aged women, but can also be found in men, children, adolescents, and older adults.
Secondary fibromyalgia is a form of fibromyalgia that is caused by another disorder. In secondary fibromyalgia, the pain is often localized (it occurs in a specific area of the body). Men are more likely to have secondary fibromyalgia than primary fibromyalgia.
Concomitant fibromyalgia is a form of fibromyalgia that coexists with another condition that causes muscle pain, such as arthritis, or other diseases of the connective tissue.
Depression, anxiety, and sleep disturbances have all been linked to fibromyalgia.
The cause of fibromyalgia is not yet known. However, we do know that symptoms can be made worse by emotional stress, muscle strains, or overuse of muscles.
It has been suggested that people who have been infected with Lyme disease or the human immunodeficiency virus (HIV) are more likely to develop fibromyalgia. The nature of the link is unknown. Some studies suggest that people with fibromyalgia also frequently experience changes in mood, but it is not known whether that is a result of the fibromyalgia or whether it's related to its cause.
The main symptoms of fibromyalgia are achy pain; tenderness to touch; and stiffness in the muscles, tendons, and ligaments. The neck, shoulders, abdomen, lower back, and thighs are the parts most likely to be affected. The pain may be spread out evenly over a large area, but there are also "tender points" where the pain is more severe.
Other symptoms of fibromyalgia include difficulty sleeping and lack of energy. People with fibromyalgia can also suffer from changes in mood, anxiety, headaches, and irritable bowel syndrome.
There is no definitive medical test for fibromyalgia. The diagnosis of fibromyalgia is made by doing a physical exam and a thorough history. The doctor will check for pain and tenderness at 18 "tender points," areas where the pain is more severe. The doctor will also rule out other causes of muscle pain, such as lupus and arthritis. This may involve blood tests. Because there is no specific test for fibromyalgia, the diagnosis may be difficult to make at first.
Fibromyalgia is often treated in a multifaceted fashion, using both medications and non-medication methods to improve symptoms. Non-medication methods to relieve symptoms include regular sleep, regular stretching and aerobic exercises, hot compresses, and gentle massage.
Acetylsalicylic acid* (ASA) and other nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen) don't often help the pain of fibromyalgia, but they may be used by some people. Pregabalin may help treat the symptoms of fibromyalgia by reducing the efficiency with which pain messages are passed along the nerves, thereby reducing pain. Severe persistent pain that's focused in one point is sometimes treated with an injection of lidocaine, which may be used in combination with hydrocortisone.
Low doses of antidepressant medications (e.g., amitriptyline, paroxetine, citalopram, fluoxetine, fluvoxamine, paroxetine, sertraline) are often used to treat fibromyalgia. Antidepressants can improve sleep and may help with the pain. In higher doses, they can also be used to treat mood disorders in people who develop this condition along with their fibromyalgia.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.
