What Is Fibromyalgia/Arthritis?

Fibromyalgia is a chronic condition that causes pain, stiffness, and tenderness of muscles, tendons, and joints. It is also characterized by restless sleep, awakening feeling tired, chronic fatigue, anxiety, depression, and disturbances in bowel function. The condition is non-life-threatening and does not cause body damage, deformity, or injury to internal body organs. Fibromyalgia is sometimes referred to as fibromyalgia syndrome and abbreviated FMS. Fibromyalgia was formerly called fibrositis.



What Does the Name Fibromyalgia/Arthritis Mean?

The word fibromyalgia comes from the Latin term for fibrous tissue ("fibro" and the Greek terms for muscle ("myo" and pain ("algia" .

Is Fibromyalgia a Form of Arthritis?

Fibromyalgia is considered an arthritis-related condition. However, it is not a form of arthritis (a disease of the joints) since it does not cause inflammation in the joints, muscles, or other tissues or damage thembut rather a muscle disorder. But fibromyalgia can (like arthritis) cause significant pain and fatigue, and it can similarly interfere with a person's ability to carry on daily activities.

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 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. 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.

What Are Symptoms and Signs of Fibromyalgia?

Fibromyalgia is not always easy to diagnose because symptoms vary from person to person, many of the symptoms mimic those of other disorders, there are no visible signs of the disorder that a physician can see, and there is no definitive laboratory test for fibromyalgia. The next several slides review some of the more common symptoms of the disorder. Keep in mind each patient with fibromyalgia is unique. Any of the following symptoms can occur intermittently and in different combinations.

Fibromyalgia Tender Points
Fibromyalgia "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.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.


Fibromyalgia Symptoms: Pain
The universal symptom of fibromyalgia is pain. As mentioned earlier, the pain in fibromyalgia is not caused by tissue inflammation. Instead, these patients seem to have an increased sensitivity to many different sensory stimuli and an unusually low pain threshold. 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. The body pain of fibromyalgia can be aggravated by noise, weather change, and emotional stress.

Fibromyalgia Symptoms: Fatigue

Fatigue occurs in 90% of patients. Fatigue may be related to abnormal sleep patterns. 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. Patients with fibromyalgia lack the deep, restorative level of sleep, called "non-rapid eye movement" (non-REM) sleep. Consequently, patients 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!

Fibromyalgia Symptoms: Mental and/or Emotional Disturbances

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 can be challenging and no confirmatory laboratory tests are available, patients with fibromyalgia are often misdiagnosed as having depression as their primary underlying problem.


Fibromyalgia Symptoms: Additional Symptoms

Other symptoms 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.
How Is Fibromyalgia Diagnosed?
There are no blood tests or X-rays that specifically point the doctor to the diagnosis of fibromyalgia. Tests are often done to exclude other possible diagnoses. Ultimately, the diagnosis of fibromyalgia is made purely on clinical grounds based on the doctor's history and physical examination. In patients with chronic widespread body pain, the diagnosis of fibromyalgia can be made by identifying point tenderness areas (typically, but not always, patients will have at least 11 of the 18 classic fibromyalgia tender points), by finding no accompanying tissue swelling or inflammation, and by excluding other medical conditions that can mimic fibromyalgia. According to the American College of Rheumatology, before the diagnosis of fibromyalgia can be made, the muscle pain must be present for longer than three months.


Conditions That Mimic Fibromyalgia
As mentioned, no simple blood test or X-ray can tell you if you have fibromyalgia. Because many medical conditions can cause pain in different areas of the body, your doctor may still want to do blood tests or X-rays to rule out illnesses that mimic fibromyalgia. Conditions that mimic fibromyalgia are listed on this slide.