Fibromyalgia syndrome is a chronic disorder characterized by widespread pain and reduced pressure pain threshold (tender points). People with fibromyalgia may also experience fatigue, sleep disturbances, morning stiffness, increased headaches or facial pain, irritable bowel syndrome, depression, anxiety, difficulty concentrating, forgetfulness and problems multitasking. Patients with fibromyalgia frequently report functional impairment and diminished quality of life.
The cause of fibromyalgia is unknown, but recent evidence suggests that fibromyalgia is associated with abnormalities in the central nervous system processing of pain. Fibromyalgia patients develop an increased response to painful stimuli and experience pain from non-painful stimuli such as touch. This is thought to be reflective of enhanced pain processing that is characteristic of central pain sensitization. Patients with fibromyalgia have been found to have elevated levels of substance P in their spinal fluid, a chemical that helps transmit pain signals from the brain. Scientists are currently investigating how the brain and spinal cord process pain and how substance P and other neurotransmitters fit into the process. Recent studies have also found that fibromyalgia runs in families, suggesting a genetic predisposition to the disorder.
Diagnosing fibromyalgia has been controversial because there are no specific laboratory tests to identify the disorder. Until recently, many health care professionals thought fibromyalgia was primarily caused by psychological factors. In recent years, however, health care professionals have come to understand that psychological factors do not necessarily cause fibromyalgia but rather may contribute to an increased risk for disability associated with fibromyalgia. Furthermore depression and anxiety disorders may actually share some of the pathophysiological mechanisms that are associated with fibromyalgia.
It is estimated that 2 percent of the U.S. adult population has fibromyalgia. This condition occurs more commonly in women of childbearing age (as many as 80 percent of those diagnosed with fibromyalgia are women), but children, postmenopausal women, the elderly and men can be affected.
The severity of fibromyalgia symptoms varies. For some women, pain or other symptoms can be so intense that they interfere with daily activities. For others, symptoms may cause discomfort but are not incapacitating. However, the condition is quite disabling in many people. In the 2006 annual Fibromyalgia and Fatigue Survey from the Fibromyalgia & Fatigue Centers, Inc., 70 percent of those surveyed rated their quality of life as "poor," "very poor" or "awful."
Treating fibromyalgia requires a comprehensive approach encompassing symptom management and lifestyle adaptation. It also requires a team approach between health care professionals including physicians, physical therapists and cognitive therapists, as well as the patient.
Read Living with Fibromyalgia, a personal story.