Overview of fibromyalgia
Fibromyalgia is a long-term (chronic) disorder characterized by pain in the muscles and bones in various parts of the body including the joints. The cause of such pain is unknown and the affected individual may have numerous specific points in the body that are painful to touch.1 Fibromyalgia is 10 times more common in women when compared to men and is generally noted between the ages 20 and 50 years. About 0.5% of men are affected by this condition, which may also be noted in children and adolescents.2
Signs and Symptoms of fibromyalgia
Fibromyalgia is often characterized by vague muscle pain at different areas of the body that may be associated with general tiredness and lack of sleep. Lower back region is the site often affected and the pain may also be felt in the buttocks and legs. Other sites that may be affected include the upper part of the shoulders on the back and neck regions. The pain is often chronic and may be persistent for more than 3 months.
Stiffness that usually improves with activity may be noted in the mornings while frequent awakening from sleep may be disturbing in the nights. Individuals suffering from fibromyalgia may feel exhausted after performing simple tasks such as walking. The individual may feel that the joints are swollen and have become numb.
The affected individuals may also suffer from a diverse range of signs and symptoms that include inability to remember things at times, poor vocabulary, headaches, anxiety or depression. These symptoms may often be relieved when the individuals are in a warm and dry weather, get enough sleep and perform moderate physical activities.1
Causes of fibromyalgia
Although the exact cause of fibromyalgia is not known, it has been observed in the members of the same family suggesting that it may be a hereditary condition. Other general factors that may have a role in the occurrence of this condition include environmental factors, divorce and small income. Individuals who suffer from depression or who have a family history of depression, anxiety or other psychiatric disorder are more prone to develop fibromyalgia. These factors may affect the normal functioning of the nerves that carry pain sensation to the brain and result in the symptoms.3, 4
Risk Factors for fibromyalgia
Family history of fibromyalgia or depression, a personal history of psychiatric disorders, female gender, low level of education, being divorced, loss of parents, history of child abuse and earning small incomes are some of the factors that may interplay in susceptible individuals.
Diagnosis of fibromyalgia
The diagnosis is generally based on the clinical evaluation of the signs and symptoms noticed. The doctor usually enquires about the family and personal history for the identification of the risk factors to arrive at a conclusion. The doctor also performs physical examination to verify the presence of tenderness at certain areas recognized by the American College of Rheumatology as diagnostic for fibromyalgia. Evaluation of the blood cells and thyroid hormone levels may also be advised to rule out the presence of other underlying conditions. A psychiatric evaluation and other specific tests may be advised if the diagnosis is not confirmed.1, 5
Treatment of fibromyalgia
Various drugs that belong to the group of antidepressant medications and narcotic analgesics have been found to be effective in relieving the pain in individuals suffering from fibromyalgia. Nonsteroidal antiinflammatory drugs are also advised in certain instances. Certain anticonvulsant medications are being tried that have demonstrated reasonable amount of relief from pain.1
Alternative therapies for fibromyalgia
Moderate exercises such as aerobics, counselling, educating the affected individuals about the condition have been proven to be useful in relieving the symptoms when associated with the administration of medications. Acupuncture, yoga, massage therapy and magnetic therapy are also suggested to be useful though not proven by a sufficient number of studies.6, 7
Prevention of fibromyalgia
There are no methods of prevention of fibromyalgia listed in the scientific literature available. Nevertheless, exercise, acupuncture, yoga, magnetic therapy and various other alternative therapies have certain adjuvant effect in relieving the symptoms associated with fibromyalgia that would prevent disability due to the pain.8
Complications of fibromyalgia
Untreated individuals may suffer from severe depression due to the features such as constant nagging pain, headaches, anxiety and sleeplessness associated with fibromyalgia.
Living with fibromyalgia
Fibromyalgia is a chronic condition with periods of complete relief and worsening of symptoms. However, with the advent of new therapies the symptoms can be managed in a much better way than earlier. Proper compliance with the treatment protocols is often helpful in reducing the severity of symptoms.
- Chakrabarty S, Zoorob R. Fibromyalgia. Am Fam Physician. 2007; 76: 247–254.
- Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum. 1995; 38: 19–28.
- Neumann L, Buskila D. Epidemiology of fibromyalgia. Curr Pain Headache Rep. 2003; 7: 362–368.
- White KP, Harth M. Classification, epidemiology, and natural history of fibromyalgia. Curr Pain Headache Rep. 2001; 5: 320–329.
- Yunus MB. A comprehensive medical evaluation of patients with fibromyalgia syndrome. Rheum Dis Clin North Am. 2002; 28: 201–2017, v–vi.
- Burckhardt CS. Nonpharmacologic management strategies in fibromyalgia. Rheum Dis Clin North Am. 2002; 28: 291–304.
- Crofford LJ, Appleton BE. Complementary and alternative therapies for fibromyalgia. Curr Rheumatol Rep. 2001; 3: 147–156.
8. Goldenberg DL, Burckhardt C, Crofford L. Management of fibromyalgia syndrome. JAMA. 2004; 292(19): 2388–2395.