Fibromyalgia – What is it... Exactly?

There are many conditions that can be attributed to specific causes with a clear origin and means of diagnosis. However, there are also conditions that are obscure and can only be diagnosed by eliminating other, more common conditions. Fibromyalgia (FM) is one such condition in that the degree of pain and disability can be profound and life quality interrupting, yet all the tests come back negative and there are no other conditions to explain the collection of symptoms. It is at that point when the diagnosis of fibromyalgia is usually made.

FM is typically a chronic (symptoms have been present for at least three months) condition where the patient complains of widespread, generalized muscle, ligament, and tendon pain accompanied with fatigue and multiple tender points on the body that hurt when only light pressure is applied. To be considered “widespread,” the pain usually affects both sides of the body, as well as both above and below the waist. FM occurs in approximately 2% of the population in the United States and women are 3-4 times more likely to develop the condition. The risk of FM increases with age and can be secondary to other physical or emotional trauma, or it can occur all by itself. No obvious pattern exists as signs and symptoms can vary depending on weather, stress, physical activity, and even the time of day.

Sleep quality tends to be an issue with FM patients whereas restorative stages of sleep are seldom reached. Other sleep disorders frequently associated with FM include sleep apnea and restless leg syndrome.

Causation for the most part is unknown but genetics (family traits), infections (can trigger or worsen FM), and physical or emotional trauma (eg., post-traumatic stress disorder) have been linked to FM. An explanation as to why even the slightest touch can hurt so much centers around a theory called “central sensitization”. It’s thought FM patients have such a low threshold for pain because of increased sensitivity in the brain to incoming pain signals.

The American College of Rheumatology has established two diagnostic criteria that includes: 1) widespread pain lasting at least three months, and 2) at least 11 out of 18 positive tender points using just enough pressure to whiten the fingernail bed. There are no direct blood tests to confirm a diagnosis of FM but other conditions that can affect or cause FM can be diagnosed with blood testing. These include thyroid disease, inflammatory arthritis (such as rheumatoid), anemia, and infection.