What Is Fibromyalgia?
Fibromyalgia is a chronic disorder characterized by
widespread musculoskeletal pain, fatigue, and multiple tender points.
"Tender points" refers to tenderness that occurs in precise, localized
areas, particularly in the neck, spine, shoulders, and hips. People with
this syndrome may also experience sleep disturbances, morning stiffness,
irritable bowel syndrome, anxiety, and other symptoms.
How Many People Have Fibromyalgia?
According to the American College of Rheumatology,
fibromyalgia affects 3 to 6 million Americans. It primarily occurs in women
of childbearing age, but children, the elderly, and men can also be
affected.
What Causes Fibromyalgia?
Although the cause of fibromyalgia is unknown, researchers
have several theories about causes or triggers of the disorder. Some
scientists believe that the syndrome may be caused by an injury or trauma.
This injury may affect the central nervous system. Fibromyalgia may be
associated with changes in muscle metabolism, such as decreased blood flow,
causing fatigue and decreased strength. Others believe the syndrome may be
triggered by an infectious agent such as a virus in susceptible people, but
no such agent has been identified.
How Is Fibromyalgia Diagnosed?
Fibromyalgia is difficult to diagnose because many of the
symptoms mimic those of other disorders. The physician reviews the patient's
medical history and makes a diagnosis of fibromyalgia based on a history of
chronic widespread pain that persists for more than 3 months. The American
College of Rheumatology (ACR) has developed criteria for fibromyalgia that
physicians can use in diagnosing the disorder. According to ACR criteria, a
person is considered to have fibromyalgia if he or she has widespread pain
in combination with tenderness in at least 11 of 18 specific tender point
sites.
How Is Fibromyalgia Treated?
Treatment of fibromyalgia requires a comprehensive approach.
The physician, physical therapist, and patient may all play an active role
in the management of fibromyalgia. Studies have shown that aerobic exercise,
such as swimming and walking, improves muscle fitness and reduces muscle
pain and tenderness. Heat and massage may also give short-term relief.
Antidepressant medications may help elevate mood, improve quality of sleep,
and relax muscles. Patients with fibromyalgia may benefit from a combination
of exercise, medication, physical therapy, and relaxation.
What Research Is Being Conducted on Fibromyalgia?
The NIAMS is sponsoring research that will increase
understanding of the specific abnormalities that cause and accompany
fibromyalgia with the hope of developing better ways to diagnose, treat, and
prevent this disorder.
Recent NIAMS studies show that abnormally low levels of the
hormone cortisol may be associated with fibromyalgia. At Brigham and Women's
Hospital in Boston, Massachusetts, and at the University of Michigan Medical
Center in Ann Arbor, researchers are studying regulation of the function of
the adrenal gland (which makes cortisol) in fibromyalgia. People whose
bodies make inadequate amounts of cortisol experience many of the same
symptoms as people with fibromyalgia. It is hoped that these studies will
increase understanding about fibromyalgia and may suggest new ways to treat
the disorder.
NIAMS research studies are looking at different aspects of
the disorder. At the University of Alabama in Birmingham, researchers are
concentrating on how specific brain structures are involved in the painful
symptoms of fibromyalgia. At George Washington University in Washington, DC,
scientists are investigating the causes of a post-Lyme disease syndrome as a
model for fibromyalgia. Some patients develop a fibromyalgia-like condition
following Lyme disease, an infectious disorder associated with arthritis and
other symptoms.
NIAMS-supported research on fibromyalgia also includes
several projects at the Institute's Multipurpose Arthritis and
Musculoskeletal Diseases Centers. Researchers at these centers are studying
individuals who do not seek medical care, but who meet the criteria for
fibromyalgia. (Potential subjects are located through advertisements in
local newspapers asking for volunteers with widespread pain or aching.)
Other studies at the Centers are attempting to uncover better ways to manage
the pain associated with the disorder through behavioral interventions such
as relaxation training.
In March 1998, NIAMS and several other NIH institutes and
offices issued a Request for Proposals to promote research studies of
fibromyalgia. As a result of this request, NIAMS and its partners recently
funded 15 new fibromyalgia projects totaling more than $3.6 million.
The NIAMS supports and encourages outstanding basic and
clinical research that increases the understanding of fibromyalgia. However,
much more research needs to be done before fibromyalgia can be successfully
treated or prevented.
The Federal Government, in collaboration with researchers,
physicians, and private voluntary health organizations, is committed to
research efforts that are directed at significantly improving the health of
all Americans afflicted with fibromyalgia.
Where Can People Get More Information About
Fibromyalgia?
| Analgesic: |
A medication or
treatment that relieves pain. |
| Arthritis: |
Literally means
joint inflammation, but is often used to indicate a group of more than
100 rheumatic diseases. These diseases affect not only the joints but
also other connective tissues of the body, including important
supporting structures such as muscles, tendons, and ligaments, as well
as the protective covering of internal organs. |
| Autoimmune
disease: |
One in which the
immune system destroys or attacks the patient's own body tissue. |
| Cartilage: |
A tough,
resilient tissue that covers and cushions the ends of the bones and
absorbs shock. |
| Chronic disease:
|
An illness that
lasts for a long time. |
| Collagen: |
The main
structural protein of skin, tendon, bone cartilage, and connective
tissues. |
| Connective
tissue: |
The supporting
framework of the body and its internal organs. |
| Fibromyalgia:
|
Sometimes called
fibrositis, a chronic disorder that causes pain and stiffness throughout
the tissues that support and move the bones and joints. Pain and
localized tender points occur in the muscles, particularly those that
support the neck, spine, shoulders, and hips. The disorder includes
widespread pain, fatigue, and sleep disturbances. |
| Fibrous capsule:
|
A tough wrapping
of tendons and ligaments that surrounds the joint. |
| Flare: |
A period in which
disease symptoms reappear or become worse. |
| Genetic marker:
|
A specific tissue
type or gene, similar to a blood type, that is passed on from parents to
their children. Some genetic markers are linked to certain rheumatic
diseases. |
| Immune response:
|
The reaction of
the immune system against foreign substances. When this reaction occurs
against substances or tissues within the body, it is called an
autoimmune reaction. |
| Immune system:
|
A complex system
that normally protects the body from infections. It combines groups of
cells, the chemicals that control them, and the chemicals they release.
|
| Inflammation:
|
A characteristic
reaction of tissues to injury or disease. It is marked by four signs:
swelling, redness, heat, and pain. |
| Joint: |
A junction where
two bones meet. Most joints are composed of cartilage, joint space,
fibrous capsule, synovium, and ligaments. |
| Joint space: |
The volume
enclosed within the fibrous capsule and synovium. |
| Ligaments: |
Bands of cordlike
tissue that connect bone to bone. |
| Muscle: |
A structure
composed of bundles of specialized cells that, when stimulated by nerve
impulses, contract and produce movement. |
| Myopathies: |
Inflammatory and
noninflammatory diseases of muscle. |
| Myositis: |
Inflammation of a
muscle. |
| Nonsteroidal
anti-inflammatory drugs (NSAIDs): |
A group of drugs,
such as aspirin and aspirin-like drugs, used to reduce inflammation that
causes joint pain, stiffness, and swelling. |
| Raynaud's
phenomenon: |
A circulatory
condition associated with spasms in the blood vessels of the fingers and
toes causing them to change color. After exposure to cold, these areas
turn white, then blue, and finally red. |
| Remission: |
A period during
which symptoms of disease are reduced (partial remission) or disappear
(complete remission). |
| Sicca syndrome: |
A condition
manifested by dry eyes and dry mouth. |
| Sleep disorder:
|
One in which a
person has difficulty achieving restful, restorative sleep. In addition
to other symptoms, patients with fibromyalgia usually have a sleep
disorder. |
| Synovium: |
A tissue that
surrounds and protects the joints. It produces synovial fluid that
nourishes and lubricates the joints. |
| Tender points:
|
Specific
locations on the body that are painful, especially when pressed. |
| Tendons: |
Fibrous cords
that connect muscle to bone. |
| Vasculitis: |
Inflammation in
the blood vessels. It may occur throughout the body. |
Therapeutic
Dosage
