|
Fibromyalgia (FM) is classified as a musculoskeletal, non-inflamatory pain condition.
Fibromyalgia literally means pain in the muscles, ligaments, and tendons � the
soft fibrous tissues in the body. It effects 18-20 muscle groups throughout the body, sometimes more. The pain originates
from Tender Point locations, shown in the pictures to the left and right. Most people with FM
experience soreness, burning pain, and in extreme cases, partial to full disability can occur.
The earliest onset of Fibromyalgia can occur in childhood, although many believe their
pain originated in their early 20's and 30's. Fibromyalgia often runs in families,
suggesting an inherited predisposition. Fibromyalgia may lie dormant for many years
until triggered by stress, injury, or sleep disturbance. Although men and women are both
effected by Fibromyalgia, women make up the majority of those effected. No one knows why.
The cause of Fibromyalgia remains elusive, but there are many triggering events thought to
precipitate its onset. A few examples would be an infection (viral or bacterial), an
automobile accident or the development of another disorder, such as rheumatoid
arthritis, lupus, or hypothyroidism. These triggering events probably don't cause Fibromyalgia,
but rather, they may awaken an underlying physiological abnormality that is already
present.
What could this abnormality be? Theories pertaining to alterations in pain-related
chemical transmitters (particularly substance P, nerve growth factor, serotonin, and
norepinephrine), immune system function (e.g. abnormally elevated levels of cytokines
that form the communications link between your immunologic and neurologic systems),
sleep physiology, and hormonal irregularities are under investigation. In addition,
modern brain imaging techniques are being used to explore various aspects of
brain function. The body's response to exercise, stress, and alterations in the
operation of your autonomic nervous system (the one that operates in your peripheral tissues)
are also being evaluated. Substance P and nerve growth factor are increased threefold
and fourfold (respectively) in the spinal fluid of people with Fibromyalgia, but researchers are
working to figure out why these elevations exist. With regards to genetics, its role in Fibromyalgia
is also the focus of many investigations.
If you've been from one doctor to another looking for a correct diagnosis don't feel bad,
it takes most people five years to get an accurate diagnosis. Many times this is because
Fibromyalgia mimicks other conditions. Other times it's because many physicians don't
understand Fibromyalgia, or don't believe it to be a real illness.
There are no diagnositc lab or x-ray abnormalities with Fibromyalgia, so on typical tests
nothing shows up. However, there is a specific test for Fibromyalgia. The criteria used for
diagnosis is widespread pain for more than 3 months duration. Also pain in 11 of 18 Tender
Points sited on digital palpation, with pressure of 4 kg used.
While Fibromyalgia and Chronic Fatigue Syndrome are two different conditions, 50-70%
of Fibromyalgia patients meet the criteria for Chronic Fatigue Syndrome. People with CFS are
often tired, while those diagnosed with FMS complain of pain. People with CFS often have swollen
glands, sore throat and fever which many FMS patients don't have. However, it's not unusual for
FMS patients to have CFS also. Experts are still unsure if Fibromyalgia is the result of a virus,
while most doctors agree that CFS is viral in origin.
|
