Definition Fibromyalgia is a syndrome that causes chronic pain of the muscles and skeleton. The cause is not known.
What is going on in the body? Fibromyalgia is hard to classify and define scientifically. People with the disease have chronic and widespread pain and stiffness in the muscles. They also have fatigue and abnormal sleeping patterns. The disease disrupts the normal stages of sleep. It is suspected that disorders in certain biochemicals in the body may cause fibromyalgia. There are no diseases of other internal organs associated with fibromyalgia.
What are the signs and symptoms of the condition? Symptoms of fibromyalgia include prolonged pain and certain tender musculoskeletal points called trigger points. People experience stiffness, especially in the morning. This aching and stiffness can vary from day to day. Other symptoms are
fatigue
headaches
abdominal cramping with constipation and/or diarrhoea
tingling of the skin that involves numbness or burning
Some tender points include elbows, hips, knees, neck and shoulders.
Clinical depression is common. A clinical examination will not show much except for depression and tender spots.
What are the causes and risks of the condition? The cause of fibromyalgia is uncertain. Women account for 75 percent (75%) of those with the disease. Two to three hundred thousand Australians have this disorder. Most women get it when 30 to 50 years old. No cause has been found for this syndrome.
What can be done to prevent the condition? There is no known way to prevent fibromyalgia. Treatment works to prevent pain and other disabilities.
How is the condition diagnosed? Diagnosis is by a clinical evaluation and physical examination. There are no laboratory tests like biopsies or x-rays for this disease. These tests are sometimes used to rule out other medical illnesses.
The following are guidelines for a diagnosis:
widespread pain for more than 3 months
pain involving any or all areas of the spine
tenderness at more than half of the fibromyalgia tender-point sites
What are the long-term effects of the condition? A long-term effect of chronic pain is often clinical depression. The ability to work may be lost. Fibromyalgia is not thought to be a progressive disease.
What are the risks to others? This is not a contagious disease. Others are not put at risk.
What are the treatments for the condition? There is no cure for fibromyalgia. Many people are not helped by treatment. There is no recommended treatment of choice. The best results in treatment have come from the use of antidepressants.
Many alternative treatments have been tried. These include:
All of these treatments may help some people. If a treatment is helping and the side effects are tolerable, the treatment should be continued.
What are the side effects of the treatments? Side effects of antidepressants include:
dry mouth
constipation
weight gain
postural hypotension, which is a drop in blood pressure when standing up
agitation
sexual dysfunction
anxiety
These symptoms can occur in 20 to 50 percent (20% to 50%) of individuals.
Injecting local anaesthetics can make the chronic pain worse without benefit.
Alternative treatments will probably not make the condition worse. Side effects are generally not a problem. Alternative treatments can be expensive and time consuming.
What happens after treatment for the condition? Treatment is usually unsatisfactory and recurrences are frequent. The emotional aspect of this disease is a contributing factor to the continuing symptoms.
How is the condition monitored? Self-monitoring of symptoms is important. Keeping a daily log is helpful. People can document the severity of pain, fatigue, stiffness and mood. This information can help in treatment plans.
Author: Thomas Fisher, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
