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Fibromyalgia

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of fibromyalgia.

Alternative Names

Fibromyositis; Fibrositis; Myofascial pain syndrome

Introduction

Fibromyalgia is a syndrome of unknown causes that results in lasting, sometimes debilitating, muscle pain and fatigue. Fibromyalgia is also known as fibrositis or fibromyositis.

General Description of Fibromyalgia Symptoms

Pain. The primary symptom of fibromyalgia is pain. The pain can be in one place or all over. The exact locations of the pain are called tender points. The pain of fibromyalgia is often is described as follows:

• Tender point pain occurs in local sites, usually in the neck and shoulders. The pain then spreads out from these areas. The actual pain starts at the muscles. The joints are not affected. There are no lumps or nodes associated with these points of pain, and there are no signs of inflammation (swelling). Those who are diagnosed with fibromyalgia feel pain in at least 11 of 18 specific tender points. [See section on Diagnosis: Criteria for Classifying Fibromyalgia .]
• Widespread pain is similar to that of arthritis and has been described as stiffness, burning, and aching. The pain also radiates, which means it spreads from the original point to nearby areas. Most patients report feeling some pain all the time, and many describe it as "exhausting." The pain can vary depending on the time of day, weather changes, physical activity, and the presence of stressful situations. The pain is often more intense after disturbed sleep.

Fatigue and Sleep Disturbances. Another major complaint is fatigue, which some patients report as being more unbearable than the pain. Sleep disturbances, particularly restless legs syndrome, are also very common. Fatigue and sleep disturbances are, in fact, almost universal in patients with fibromyalgia. Some experts believe that if these symptoms are not present, doctors should seek a diagnosis other than fibromyalgia.

Depression and Mood. Up to a third of patients experience depression. Disturbances in mood and concentration are also very common.

Other Symptoms. The following symptoms may also be present:

• Dizziness
• Tension or migraine headaches
• Tingling or numbness in the hands and feet
• Digestive problems, including irritable bowel syndrome with gas, and alternating diarrhea and constipation
• Urinary frequency caused by bladder spasms
• Painful menstrual periods

Symptoms in Children. Although children and adults have similar fibromyalgia symptoms, some experts suggest that children may not have a set number of pain tender points. In one study, children had an average of 9.7 tender point locations compared to the minimum of 11 in adults. In general, children with fibromyalgia most often experience sleep disorders and widespread pain.

• Review Date: 12/15/2006
• Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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