Fibromyalgia is a common syndrome in which people experience long-term, body-wide pain and tender points in joints, muscles, tendons, and other soft tissues.
Fibromyalgia has also been linked to fatigue, sleep problems, headaches, depression, anxiety, and other symptoms.
Alternative NamesFibromyositis; Fibrositis
Causes, incidence, and risk factorsThe cause of this disorder is unknown. Although none have been well proven, possible causes or triggers of fibromyalgia include:
Men and women of all ages get fibromyalgia, but the disorder is most common among women aged 20 to 50.
The following conditions may be seen with fibromyalgia or mimic its symptoms:
The primary symptom of fibromyalgia is pain.
Fatigue and problems with sleep are seen in almost all patients with fibromyalgia. Many complain that they can't get to sleep or stay asleep, and they feel tired when they wake up.
Other symptoms may include:
Diagnosis of fibromyalgia requires a history of a least 3 months of widespread pain, and pain and tenderness in at least 11 of 18 tender-point sites. These tender-point sites include fibrous tissue or muscles of the:
Sometimes, laboratory and x-ray tests are done to help confirm the diagnosis by ruling out other conditions that may have similar symptoms.
TreatmentTreatment should focus on not only relieving symptoms, but also on helping patients learn how to cope with their symptoms.
Treatments usually involve trial and error:
Eating a well-balanced diet and avoiding caffeine may help with problems sleeping, and may help reduce the severity of the symptoms. Lifestyle measures to improve the quality of sleep can be effective for fibromyalgia. See: Sleeping difficulty
Reducing stress and improving coping skills may also help reduce painful symptoms.
Improved fitness through exercise is recommended.
Starting slowly helps stretch and mobilize tight, sore muscles, which may be relieved by gentle stretching and light massage, as well as acupressure, acupuncture, and relaxation techniques.
Cognitive therapy usually lasts for 6 to 20 1-hour sessions. During this therapy, people with fibromyalgia learn to:
The goal of using medication is to improve sleep and pain tolerance. Patients should receive drug treatments along with exercise, patient education, and behavioral therapies.
Duloxetine (Cymbalta), pregabalin (Lyrica), and milnacipran (Savella) are medications that are approved specifically for treating fibromyalgia.
However, many other drugs are also used to treat the condition, including:
Severe cases of fibromyalgia may require a referral to a pain clinic.
Expectations (prognosis)Fibromyalgia is a common and chronic problem. The symptoms sometimes improve. At other times, the symptoms may worsen and continue for months or years. The key is seeking professional help which includes a multi-faceted approach to the management and treatment of the disease. There is no proof that fibromyalgia syndrome results in an increased Death Rate.
Calling your health care providerCall your health-care provider if you have symptoms of fibromyalgia.
PreventionThere is no proven prevention for this disorder. However, over the years, the treatment and management of the disease have improved.
ReferencesAbeles M, Solitar BM, Pillinger MH, Abeles AM. Update on fibromyalgia therapy. Am J Med. 2008;121:555-561.
Heuser W, Bernardy K, Uceyler N, Sommer C. Treatment of fibromyalgia syndrome with antidepressants. JAMA. 2009;301:198-209.
Wolfe F, Rasker JJ. Fibromyalgia. In: Firestein GS, Budd RC, Harris ED Jr., et al., eds. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 38.
Fibromyalgia is a common syndrome in which a person has long-term, body-wide pain and tenderness in the joints, muscles, tendons, and other soft tissues.
Fibromyalgia has also been linked to fatigue, sleep problems, headaches, depression, and anxiety.
Alternative NamesFibromyositis; Fibrositis
Causes, incidence, and risk factorsThe cause is unknown. Possible causes or triggers of fibromyalgia include:
Fibromyalgia is most common among women aged 20 to 50.
The following conditions may be seen with fibromyalgia or mimic its symptoms:
Pain in the main symptom of fibromyalgia. It may be mild to severe.
People with fibromyalgia tend to wake up with body aches and stiffness. For some patients, pain improves during the day and gets worse at night. Some patients have pain all day long.
Pain may get worse with activity, cold or damp weather, anxiety, and stress.
Fatigue, depressed mood, and sleep problems are seen in almost all patients with fibromyalgia. Many say that they can't get to sleep or stay asleep, and they feel tired when they wake up.
Other symptoms of fibromyalgia may include:
To be diagnosed with fibromyalgia, you must have had at least 3 months of widespread pain, and pain and tenderness in at least 11 of 18 areas, including
Blood and urine tests are usually normal. However, tests may be done to rule out other conditions that may have similar symptoms.
TreatmentThe goal of treatment is to help relieve pain and other symptoms, and to help a person cope with the symptoms.
The first type of treatment may involve:
If these treatments do not work, your doctor may prescribe an antidepressant or muscle relaxant. The goal of medication is to improve sleep and pain tolerance. Medicine should be used along with exercise and behavior therapy. Duloxetine (Cymbalta), pregabalin (Lyrica), and milnacipran (Savella) are medications that are approved specifically for treating fibromyalgia.
However, many other drugs are also used to treat the condition, including:
Cognitive-behavioral therapy is an important part of treatment. This therapy helps you learn how to:
Support groups may also be helpful.
Other recommendations include:
Severe cases of fibromyalgia may require a referral to a pain clinic.
Expectations (prognosis)Fibromyalgia is a long-term disorder. Sometimes, the symptoms improve. Other times, the pain may get worse and continue for months or years.
Calling your health care providerCall your health-care provider if you have symptoms of fibromyalgia.
PreventionThere is no known prevention.
ReferencesAbeles M, Solitar BM, Pillinger MH, Abeles AM. Update on fibromyalgia therapy. Am J Med. 2008;121:555-561.
Hauser W, Bernardy K, Uceyler N, Sommer C. Treatment of fibromyalgia syndrome with antidepressants. JAMA. 2009;301:198-209.
Wolfe F, Rasker JJ. Fibromyalgia. In: Firestein GS, Budd RC, Harris ED Jr., et al., eds. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 38.
Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res. 2010;62(5):600-610.
Reviewed ByReview Date: 02/14/2011
Michael E. Makover, MD is a professor and attending in rheumatology at the New York University Medical Center, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
www.webmd.com/fibromyalgia/fibromyalgia-pain-10/default.htm www.webmd.com/fibromyalgia/.../treating-fibromyalgia-pain-medica... www.themediteckwellnessgateway.com ... Holistic Healing
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