Fibromyalgia

Fibromyalgia is a chronic musculoskeletal syndrome characterized by pain, achiness, tenderness, and stiffness in the muscle tissue, ligaments, and tendons. It most frequently affects the neck, shoulders, chest, legs, and lower back. Pain is generally accompanied by sleep disorders, fatigue, gastrointestinal disorders, and depression. Many of its symptoms are similar to those of chronic fatigue syndrome, myofascial pain syndrome, and temporomandibular joint syndrome (TMJ).

Incidence and Prevalence

It is estimated that 6 to 8 million people in the United States suffer from fibromyalgia. About 80% of patients are women. While fibromyalgia can occur at any age, the highest incidence occurs among women 20 to 40 years of age.

There have been reports of fibromyalgia in children. What may be considered "growing pains" might in fact be fibromyalgia, especially if the child complains of having difficulty sleeping.

Risk Factors

Risk factors for fibromyalgia include the following:

Age (more common in young adults)
Gender (more common in women than men)
Genetic (familial patterns suggest the disorder may be inherited)
Sleep disorders (whether sleep difficulties are a cause or a result of fibromyalgia is unknown)

Causes

Causes of fibromyalgia are not known. The condition produces vague symptoms that may be associated with diminished blood flow to certain parts of the brain and increased amounts of substance P, which is thought to be a sensory neurotransmitter involved in the communication of pain, touch, and temperature from the body to the brain. Researchers have identified several other possible causes, including the following:

Autonomic nervous system dysfunction
Chronic sleep disorders
Emotional stress or trauma
Immune or endocrine system dysfunction
Upper spinal cord injury
Viral or bacterial infection

Signs and Symptoms

While the symptoms of fibromyalgia can be debilitating, they are not life threatening. Symptoms vary, depending on stress level, physical activity, time of day, and the weather. Pain is the primary symptom, found in virtually 100% of cases—specifically, pain and tenderness in certain areas of the body when pressure is applied to them. These areas, which sometimes are called tender points, include:

Back of the head
Elbows
Hips
Knees
Neck
Upper back
Upper chest
Pain may be aching, burning, throbbing, or move around the body (migratory). Many patients also experience muscle tightness, soreness, and spasms. The patient may be unable to carry out normal daily activities, even though muscle strength is not affected. The pain is often worse in the morning, improves throughout the day, and worsens at night.

Fibromyalgia is a chronic condition and symptoms may be constant or intermittent for years or even a lifetime. Other common symptoms of fibromyalgia include:

Sleep disorders (e.g., restless leg syndrome, sleep apnea)
Gastrointestinal (e.g., abdominal pain, bloating, gas, cramps, alternating diarrhea and constipation)
Numbness or tingling sensations
Chronic headaches (may include facial and jaw pain)
Heightened sensitivity to odors, loud noises, bright lights, various foods, medicines, and changes in weather
Painful menstrual periods (dysmenorrhea) and painful sexual intercourse (dyspareunia)
Frequent urination, strong urge to urinate, and painful urination (dysuria)
Rapid or irregular heart rate, and shortness of breath
Sensation of swelling (edema) in the hands and feet, even though swelling is not present