Fibromyalgia is a long-term condition in which pain is felt throughout the body. It occurs more often in women than in men.
What it is
Fibromyalgia, or fibromyalgia syndrome, is a long-term condition whose main feature is pain throughout the body together with increased sensitivity to pain and to pressure. The name comes from the Latin fibro- (connective tissue), the Greek myo- (muscle) and algos (pain). It is estimated that the condition affects 2 to 8% of the population, and the ratio of women to men among patients ranges from 7:1 to 9:1; it is most often detected at the age of 20–50, although it also occurs in children and in older people. It is not made up: fibromyalgia is recognized by the US National Institutes of Health and the American College of Rheumatology. The term "fibromyalgia" was first used in 1976, and the first classification criteria were published by the American College of Rheumatology in 1990; they are not strictly diagnostic. Chronic widespread pain was described as far back as 19th-century literature, and before the current term appeared it was called "muscular rheumatism" and "neurasthenia."
Symptoms: not just pain
In addition to widespread pain, there may be:
- increased sensitivity to pain and muscle stiffness;
- difficulty falling asleep and sleeping, which causes fatigue during the day;
- "fibro fog" — difficulty concentrating and remembering;
- headache, symptoms of irritable bowel, sometimes numbness and tingling;
- irritability, anxiety or depressed mood.
Symptoms are variable: they can suddenly ease or worsen. Not every person has all the manifestations at once. Some patients complain of problems with swallowing, disorders of bowel and bladder function. A characteristic feature is the presence of so-called tender points on the body.
What is known about the causes
The exact cause is unknown. Abnormal levels of certain chemicals in the brain and changes in the way the central nervous system processes pain signals are being discussed. There is evidence of heritability: in a Swedish twin registry, a monozygotic twin with chronic widespread pain had a 15% chance that the other twin had the same pain, whereas for dizygotic pairs it was 7%. Physical or emotional events — trauma, infection, stress — often appear to be the trigger. One theory describes the condition as a syndrome of central sensitization: the pain sensitivity threshold in the cells of the spinal cord and brain is lower than in other people. The brains of people with fibromyalgia show functional and structural differences compared with healthy people. There is still no agreement on the nature of the condition: Frederick Wolfe, the lead author of the 1990 guidelines, called the causes "controversial."
How it is diagnosed and what it is confused with
There is no specific test, and the symptoms can resemble a number of other conditions — this is precisely why fibromyalgia can be difficult to diagnose. By some estimates, fibromyalgia may affect nearly every 20th person to one degree or another, and it is the difficulty of diagnosis that prevents an accurate picture of prevalence.
Fibromyalgia is often combined with depression, anxiety disorders, post-traumatic stress disorder, chronic fatigue syndrome and irritable bowel syndrome.
Who to turn to
If you suspect fibromyalgia, contact your family doctor. Treatment usually combines lifestyle changes, including exercise programs and relaxation techniques, talking therapies and medications; complete disappearance of symptoms is not promised, but some of them can be relieved. Physical exercise has separate benefits, in particular it reduces pain. Support groups provide a network of people with similar experience.
When to call 103 or 112: a threat to life includes, in particular, suspected stroke or heart attack and severe injury as a result of a road traffic accident.
Questions for the doctor: could the pain have another cause and which examinations will check this; how to distinguish a bad day from a real worsening; does sleep affect the symptoms; who to turn to if nothing changes within a few weeks.
This material is for reference and does not replace consultation with a doctor.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer