FIBROMYALGIA IN BRIEF The fibromyalgia syndrome (FMS) is a chronic pain condition, usually accompanied by ongoing periods of exhaustion.  Most people with fibromyalgia have additional health problems that affect various functions in mind and body, and Sjogren’s Syndrome. The symptoms of fibromyalgia may be mild to severe.  A mild case is merely a nuisance. With a severe case, a person is often unable to hold down a paying job, and may find it hard to maintain the home or even to enjoy the company of friends and family. However, fibromyalgia itself causes no detectable damage to tissues or organs in the body. Main Characteristics People with fibromyalgia hurt all over.  That is, they feel widespread pain - in arms, legs, back, chest, hands, feet and even cheekbones and jaw.  No one knows what causes this pain, although studies have found a high level of substance P, a pain transmitter, in the spinal fluid of people who have the condition, as well as low levels of serotonin, a chemical that moderates pain.  The pain tends to get worse in the parts of the body that are used the most, and some early research concludes that muscles may lack sufficient oxygen or have a lowered ability to use oxygen as fuel. Other studies have shown a sleep disorder in the majority of FMS patients tested.  This disorder consists of constant interruptions of the deep, slow-wave sleep needed for rest and restoration of tissue.  It is a likely cause of the profound fatigue that is usual in fibromyalgia.  Stiffness amounting to more pain is also a common experience.  Some people with FMS cannot sit or maintain any other position for longer than twenty minutes without becoming stiff, and morning stiffness can take an hour or more to wear off.  It is worth noting that psychiatric conditions such as depression are not more common in FMS patients than in the general population. Other Health Problems Adverse health conditions that often go along with fibromyalgia mean a range of problems from skin to nerves to digestion.  Physical conditions include irritable bowel syndrome, numbness and tingling in hands and feet, migraine and “ordinary” headaches, itching skin, dizziness and blurring of vision, muscle spasms, sore throats and tender lymph nodes, as well as great sensitivity to environmental factors such as the weather and pollutants of many kinds. Mental and emotional problems include memory blanks, word mix-ups, confusion, trouble concentrating and panic attacks. Diagnosis Many of the symptoms of fibromyalgia can be found in other conditions as well.  Therefore a diagnosis of fibromyalgia starts with taking a patient’s medical history and prescribing laboratory tests in order to rule out these other conditions as the cause of the symptoms. Fibromyalgia is then diagnosed by two criteria; widespread pain for at least three months, and a number of “tender points” found in precise locations on the body.  This particular pattern of tender points occurs only in FMS. Treatment Treatment of fibromyalgia is aimed at alleviating its symptoms.  Medications are prescribed to improve sleep and reduce pain.  Exercise, tailored to individual ability, has been found to improve many symptoms.  Pillows that provide neck support while sleeping can help avoid pain emanating from neck and back.  Massage, heat and rest will often relieve pain temporarily. And stress management, including counseling, biofeedback and relaxation techniques, is often beneficial. Prevalence and Outlook Fibromyalgia is estimated to affect 2-5 percent of the population.  The ratio of women to men is 10:1, although more men are now being diagnosed with the condition.  Children and young people who have FMS are often mistakenly diagnosed as having growing pains or behavioural problems.  Fibromyalgia is not a new condition.  What is new is the vast number of people who are sidelined by its symptoms.  As this debilitating syndrome becomes more widely recognized, thousands more people are being diagnosed every week. FMS is a complex condition that can be triggered by a number of factors such as a fall or auto accident, childlbirth or hysterectomy or, often, a viral illness, suggesting a genetic predisposition.  With research going on into its many aspects, it is likely that more effective treatment will soon be found, if not a cure.

LHR Publications,     June