Fibromyalgia (cont.)

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What causes fibromyalgia?

The cause of fibromyalgia is not known. Those affected experience pain in response to stimuli that are normally not perceived as painful. Researchers have found elevated levels of a nerve chemical signal, called substance P, and nerve growth factor in the spinal fluid of fibromyalgia patients. Levels of the brain chemical serotonin are also relatively low in patients with fibromyalgia. Studies of pain in fibromyalgia have suggested that the central nervous system (brain) may be somehow supersensitive. Scientists note that there seems to be a diffuse disturbance of pain perception in patients with fibromyalgia.

Also, patients with fibromyalgia have an impaired non-rapid eye movement, or non-REM, sleep phase (which likely, at least in part, explains the common feature of waking up fatigued and unrefreshed in these patients). The onset of fibromyalgia has been associated with psychological distress, trauma, and infection.

Whom does fibromyalgia affect?

Fibromyalgia affects predominantly women (over 80% of those affected are women) between the ages of 35 and 55. Less commonly, fibromyalgia can also affect men, children, and the elderly. It can occur independently or can be associated with another disease, such as systemic lupus or rheumatoid arthritis. The prevalence of fibromyalgia varies in different countries. In Sweden and Britain, 1% of the population is affected by fibromyalgia. In the United States, approximately 4% of the population has fibromyalgia.

What are fibromyalgia symptoms and signs?

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The universal symptom of fibromyalgia is pain. As described earlier, the pain in fibromyalgia is not caused by tissue inflammation. Instead, those affected seem to have an increased sensitivity to many different sensory stimuli and an unusually low pain threshold. Minor sensory stimuli that ordinarily would not cause pain in normal individuals can cause disabling, sometimes severe pain in people with fibromyalgia. The body pain of fibromyalgia can be aggravated by noise, weather change, and emotional stress.

The pain of fibromyalgia is generally widespread, involving both sides of the body. Pain usually affects the neck, buttocks, shoulders, arms, the upper back, and the chest. "Tender points" are localized areas of the body that are tender to light touch. Fibromyalgia tender points, or pressure points, are commonly found around the elbows, shoulders, knees, hips, back of the head, and the sides of the breastbone and are typical signs of fibromyalgia.

Fibromyalgia Tender Points Diagram
Fibromyalgia Illustration - Fibromyalgia Tender Points Picture
Fibromyalgia "tender points" are sometimes incorrectly referred to as "trigger points," which is terminology that is used to describe a situation whereby pressing on certain trigger points can initiate a sequence of symptoms. This is not the case with fibromyalgia tender points, which are chronically a focus of pain and tenderness in the particular area involved.

Fatigue occurs in nearly all people with fibromyalgia. Fatigue may be related to abnormal sleep patterns commonly observed in these patients. Normally, there are several levels of depth of sleep. Getting enough of the deeper levels of sleep may be more important in refreshing a person than the total number of hours of sleep. People with fibromyalgia lack the deep, restorative level of sleep, called "non-rapid eye movement" (non-REM) sleep. Consequently, those with fibromyalgia often awaken in the morning without feeling fully rested, even though they seem to have had an adequate number of hours of sleep time. Some patients awaken with muscle aches or a sensation of muscle fatigue as if they had been "working out" all night!

Mental and/or emotional disturbances occur in over half of people with fibromyalgia. These symptoms include poor concentration, forgetfulness, and memory problems, as well as mood changes, irritability, depression, and anxiety. Since a firm diagnosis of fibromyalgia is difficult and no confirmatory laboratory tests are available, patients with fibromyalgia are often misdiagnosed as having depression as their primary underlying problem.

Other symptoms of fibromyalgia include migraine and tension headaches, numbness or tingling of different parts of the body, abdominal pain related to irritable bowel syndrome ("spastic colon"), and irritable bladder, causing painful and frequent urination. Like fibromyalgia, irritable bowel syndrome can cause chronic abdominal pain and other bowel disturbances without detectable inflammation of the stomach or the intestines.

Each patient with fibromyalgia is unique. Any of the above symptoms can occur intermittently and in different combinations.

Medically Reviewed by a Doctor on 7/1/2013

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Fibromyalgia - Symptoms Question: The symptoms of fibromyalgia can vary greatly from patient to patient. What were your symptoms at the onset of your disease?
Fibromyalgia - Treatments Question: What treatment has been effective for your fibromyalgia?
Fibromyalgia - Lifestyle Changes Question: What lifestyle changes (diet, exercise, etc.) have you found helpful in relieving fibromyalgia pain?