Questions and Answers About Fibromyalgia

If you suffer from fibromyalgia, sometimes called fibrositis, you may experience widespread musculoskeletal pain, fatigue, and tender points; also see the separate page “Fibromyalgia Research”.

What Is Fibromyalgia?

Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and multiple tender points. “Tender points” refers to tenderness that occurs in precise, localized areas, particularly in the neck, spine, shoulders, and hips. People with this syndrome may also experience sleep disturbances, morning stiffness, irritable bowel syndrome, anxiety, and other symptoms.

How Many People Have Fibromyalgia?

According to the American College of Rheumatology, fibromyalgia affects 3 to 6 million Americans. It primarily occurs in women of childbearing age, but children, the elderly, and men can also be affected.

What Causes Fibromyalgia?

Although the cause of fibromyalgia is unknown, researchers have several theories about causes or triggers of the disorder. Some scientists believe that the syndrome may be caused by an injury or trauma. This injury may affect the central nervous system. Fibromyalgia may be associated with changes in muscle metabolism, such as decreased blood flow, causing fatigue and decreased strength. Others believe the syndrome may be triggered by an infectious agent such as a virus in susceptible people, but no such agent has been identified.

How Is Fibromyalgia Diagnosed?

Fibromyalgia is difficult to diagnose because many of the symptoms mimic those of other disorders. The physician reviews the patient’s medical history and makes a diagnosis of fibromyalgia based on a history of chronic widespread pain that persists for more than 3 months. The American College of Rheumatology (ACR) has developed criteria for fibromyalgia that physicians can use in diagnosing the disorder. According to ACR criteria, a person is considered to have fibromyalgia if he or she has widespread pain in combination with tenderness in at least 11 of 18 specific tender point sites.

How Is Fibromyalgia Treated?

Treatment of fibromyalgia requires a comprehensive approach. The physician, physical therapist, and patient may all play an active role in the management of fibromyalgia. Studies have shown that aerobic exercise, such as swimming and walking, improves muscle fitness and reduces muscle pain and tenderness. Heat and massage may also give short-term relief. Antidepressant medications may help elevate mood, improve quality of sleep, and relax muscles. Patients with fibromyalgia may benefit from a combination of exercise, medication, physical therapy, and relaxation.

What Research Is Being Conducted on Fibromyalgia?

The NIAMS is sponsoring research that will increase understanding of the specific abnormalities that cause and accompany fibromyalgia with the hope of developing better ways to diagnose, treat, and prevent this disorder.

Recent NIAMS studies show that abnormally low levels of the hormone cortisol may be associated with fibromyalgia. At Brigham and Women’s Hospital in Boston, Massachusetts, and at the University of Michigan Medical Center in Ann Arbor, researchers are studying regulation of the function of the adrenal gland (which makes cortisol) in fibromyalgia. People whose bodies make inadequate amounts of cortisol experience many of the same symptoms as people with fibromyalgia. It is hoped that these studies will increase understanding about fibromyalgia and may suggest new ways to treat the disorder.

NIAMS research studies are looking at different aspects of the disorder. At the University of Alabama in Birmingham, researchers are concentrating on how specific brain structures are involved in the painful symptoms of fibromyalgia. At George Washington University in Washington, DC, scientists are investigating the causes of a post-Lyme disease syndrome as a model for fibromyalgia. Some patients develop a fibromyalgia-like condition following Lyme disease, an infectious disorder associated with arthritis and other symptoms.

NIAMS-supported research on fibromyalgia also includes several projects at the Institute’s Multipurpose Arthritis and Musculoskeletal Diseases Centers. Researchers at these centers are studying individuals who do not seek medical care, but who meet the criteria for fibromyalgia. (Potential subjects are located through advertisements in local newspapers asking for volunteers with widespread pain or aching.) Other studies at the Centers are attempting to uncover better ways to manage the pain associated with the disorder through behavioral interventions such as relaxation training.

In March 1998, NIAMS and several other NIH institutes and offices issued a Request for Proposals to promote research studies of fibromyalgia. As a result of this request, NIAMS and its partners recently funded 15 new fibromyalgia projects totaling more than $3.6 million.

The NIAMS supports and encourages outstanding basic and clinical research that increases the understanding of fibromyalgia. However, much more research needs to be done before fibromyalgia can be successfully treated or prevented.

The Federal Government, in collaboration with researchers, physicians, and private voluntary health organizations, is committed to research efforts that are directed at significantly improving the health of all Americans afflicted with fibromyalgia.

Where Can People Get More Information About Fibromyalgia?

Arthritis Foundation
1330 West Peachtree Street
Atlanta, GA 30309
404/872-7100
800/283-7800 or call your local chapter (listed in the telephone directory)
World Wide Web address: http://www.arthritis.org

This is the main voluntary organization devoted to all forms of arthritis. The Foundation publishes a pamphlet on fibrositis. Single copies are free with a self-addressed stamped envelope. The Foundation also can provide physician referrals.

Fibromyalgia Network
P.O. Box 31750
Tucson, AZ 85751-1750
800/853-2929
Contact: Ms. Kristin Thorson

Fibromyalgia Partnership (formerly Fibromyalgia Association of Greater Washington)
P.O. Box 160
Linden, VA 22642-0160
(toll free) 866/725-4404
Fax: 866-666-2727
World Wide Web address: http://www.fmpartnership.org

National Fibromyalgia Association
2200 N. Glassell Street, Suite A
Orange, CA 92865
714/921-0150
E-mail: fna@fmaware.org
Web site: fmaware.org

These are the main organizations devoted to fibromyalgia. They publish newsletters and provide pamphlets on the disease.

Publication Date: December 1999

Source: NIAMS

The National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse is a public service sponsored by the NIAMS that provides health information and information sources. The NIAMS, a component of the National Institutes of Health, leads and coordinates the Federal medical effort in arthritis, musculoskeletal, bone, muscle, and skin diseases by conducting and supporting research projects, research training, clinical trials, and epidemiological studies, and by disseminating information on research initiatives and research results.

Keywords

Analgesic
A medication or treatment that relieves pain.
Arthritis
Literally means joint inflammation, but is often used to indicate a group of more than 100 rheumatic diseases. These diseases affect not only the joints but also other connective tissues of the body, including important supporting structures such as muscles, tendons, and ligaments, as well as the protective covering of internal organs.
Autoimmune disease
One in which the immune system destroys or attacks the patient’s own body tissue.
Cartilage
A tough, resilient tissue that covers and cushions the ends of the bones and absorbs shock.
Chronic disease
An illness that lasts for a long time.
Collagen
The main structural protein of skin, tendon, bone cartilage, and connective tissues.
Connective tissue
The supporting framework of the body and its internal organs.
Fibromyalgia
Sometimes called fibrositis, a chronic disorder that causes pain and stiffness throughout the tissues that support and move the bones and joints. Pain and localized tender points occur in the muscles, particularly those that support the neck, spine, shoulders, and hips. The disorder includes widespread pain, fatigue, and sleep disturbances.
Fibrous capsule
A tough wrapping of tendons and ligaments that surrounds the joint.
Flare
A period in which disease symptoms reappear or become worse.
Genetic marker
A specific tissue type or gene, similar to a blood type, that is passed on from parents to their children. Some genetic markers are linked to certain rheumatic diseases.
Immune response
The reaction of the immune system against foreign substances. When this reaction occurs against substances or tissues within the body, it is called an autoimmune reaction.
Immune system
A complex system that normally protects the body from infections. It combines groups of cells, the chemicals that control them, and the chemicals they release.
Inflammation
A characteristic reaction of tissues to injury or disease. It is marked by four signs: swelling, redness, heat, and pain.
Joint
A junction where two bones meet. Most joints are composed of cartilage, joint space, fibrous capsule, synovium, and ligaments.
Joint space
The volume enclosed within the fibrous capsule and synovium.
Ligaments
Bands of cordlike tissue that connect bone to bone.
Muscle
A structure composed of bundles of specialized cells that, when stimulated by nerve impulses, contract and produce movement.
Myopathies
Inflammatory and noninflammatory diseases of muscle.
Myositis
Inflammation of a muscle.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
A group of drugs, such as aspirin and aspirin-like drugs, used to reduce inflammation that causes joint pain, stiffness, and swelling.
Raynaud’s phenomenon
A circulatory condition associated with spasms in the blood vessels of the fingers and toes causing them to change color. After exposure to cold, these areas turn white, then blue, and finally red.
Remission
A period during which symptoms of disease are reduced (partial remission) or disappear (complete remission).
Sicca syndrome
A condition manifested by dry eyes and dry mouth.
Sleep disorder
One in which a person has difficulty achieving restful, restorative sleep. In addition to other symptoms, patients with fibromyalgia usually have a sleep disorder.
Synovium
A tissue that surrounds and protects the joints. It produces synovial fluid that nourishes and lubricates the joints.
Tender points
Specific locations on the body that are painful, especially when pressed.
Tendons
Fibrous cords that connect muscle to bone.
Vasculitis
Inflammation in the blood vessels. It may occur throughout the body.

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