The contents of this app are provided for educational purposes only and are not intended to diagnose, treat, cure, or prevent any disease or health condition. The information provided should not be considered as a substitute for the advice of a medical doctor or other healthcare professional.
Pathology (What is Fibromyalgia?)
Repeated nerve stimulation may cause changes in the brain in people who develop fibromyalgia.
Changes in the brain associated with fibromyalgia include an abnormal increase in levels of chemicals in the brain that signal pain (neurotransmitters).
Sometimes fibromyalgia develops gradually over time, with no single triggering event.
People who have fibromyalgia also tend to have tension headaches, temperomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression.
Allodynia, a heightened and painful response to pressure, is a characteristic feature of fibromyalgia.
The brains of people with fibromyalgia show functional and structural differences from those of healthy individuals.
Results from studies examining responses to experimental stimulation suggest that fibromyalgia patients may have heightened sensitivity of the nociceptive system, which senses pressure, heat, cold, electrical and chemical stimulation
Doctors do not fully understand what causes fibromyalgia.
Although there is no single established cause of fibromyalgia, it appears that there are a variety of factors working together that lead to this condition.
Trauma, either physical or emotional, has been associated with fibromyalgia.
People with a preexisting rheumatic disease, such as rheumatoid arthritis or lupus, may be more likely to develop fibromyalgia.
Psychological stress or illness can cause abnormalities in inflammatory and stress pathways that regulate mood and pain.
The pain of fibromyalgia appears to result primarily from main pain processing pathways functioning abnormally.
A systematic review found significant association between fibromyalgia and physical and sexual abuse in both childhood and adulthood, although the quality of studies was poor
Poor lifestyles including being a smoker, obesity and lack of physical activity may increase the risk of an individual developing fibromyalgia.
As the hippocampus plays crucial roles in maintenance of cognitive functions, sleep regulation, and pain perception, it was suggested that metabolic dysfunction of the hippocampus may be implicated in the appearance of these symptom
Some authors have proposed that, because exposure to stressful conditions can alter the function of the hypothalamic-pituitary-adrenal (HPA) axis, the development of fibromyalgia may stem from stress-induced disruption of the HPA axis.
In one study it was found that the best predictor of the experience of pain in male fibromyalgia patients was sleep quality.
There is also strong evidence for a role of dopamine in restless leg syndrome, which is a condition found frequently in patients with fibromyalgia.
The "dopamine hypothesis of fibromyalgia" proposes that the central abnormality responsible for symptoms associated with fibromyalgia is a disruption of normal dopamine-related neurotransmission
Levels of hormones under the direct or indirect control of growth hormone (GH), including insulin-like growth factor 1 (IGF-1), cortisol, leptin and neuropeptide Y may be abnormal in people with fibromyalgia.
Patients with fibromyalgia may have alterations of normal neuroendocrine function, characterized by mild hypocortisolemia, hyperreactivity of pituitary adrenocorticotropin hormone release in response to challenge, and glucocorticoid feedback resistance.
Other abnormalities include reduced responsivity of thyrotropin and thyroid hormones to thyroid-releasing hormone, a mild elevation of prolactin levels with disinhibition of prolactin release in response to challenge and hyposecretion of adrenal androgens.
One of the most reproduced laboratory finding in patients with fibromyalgia is an elevation in cerebrospinal fluid levels of substance P, a putative nociceptive neurotransmitter.
People with fibromyalgia report sleep disruption, awakening in the night because of body pain.
Many people with fibromyalgia have other sleep disorders, such as restless legs syndrome and sleep apnea.
Other symptoms associated with fibromyalgia include depression, headaches, and pain or cramping in the lower abdomen.
People with fibromyalgia may experience morning stiffness.
Patients with fibromyalgia may reports symptoms consistent with irritable bowel syndrome.
Women with fibromyalgia may experience particularly painful menstrual periods.
Some people with fibromyalgia report difficulty with swallowing.
Because fibromyalgia symptoms are not restricted to pain, the alternative term "fibromyalgia syndrome" may be used for this condition.
Historically, the diagnosis of fibromyalgia was based on the pain responses of 18 specific body areas.
The exam used to evaluate pain response in patients with fibromyalgia has been termed a tender point exam--the doctor presses firmly on various body areas to determine the relative degree of pain.
The tender point exam is no longer considered the standard test for diagnosing fibromyalgia.
Currently, the diagnosis of fibromyalgia is based on the patient's report of pain symptoms.
For some doctors, a report of widespread pain that has persisted for more than three months and involves all 4 quadrants of the body, with no identifiable underlying medical condition, is sufficient for the diagnosis of fibromyalgia.
The American College of Rheumatology (ACR) has established criteria for the diagnosis and classification of fibromyalgia, based on a Widespread Pain Index (WPI) and a symptom severity scale (SS).
The ACR diagnosis requires certain scores on the WPI and SS, combined with the presence of symptoms for at least 3 months and the exclusion of other disorders that would explain the pain.
There is no definitive laboratory test to confirm a diagnosis of fibromyalgia.
Ruling out other medical conditions is important in the diagnosis of fibromyalgia.
Doctors typically order a complete blood count (CBC), erythrocyte sedimentation rate (ESR) and thyroid function tests to exclude other medical diagnoses that have symptoms similar to fibromyalgia.
There is currently no definitive cure for fibromyalgia.
Although various treatment options are available, no one single treatment works for all symptoms.
Medications can reduce the pain of fibromyalgia and improve sleep.
Medications used to treat epilepsy can help reduce pain in people with fibromyalgia.
Counseling and psychotherapy can help patients with fibromyalgia cope with their illness and provide strategies for dealing with stressful situations.
Patients with fibromyalgia are encouraged to develop methods of self-care, including setting aside time for daily relaxation and making a conscious effort to reduce stress in their lives.
However, patients are encouraged not to quit work or drop all activities, as people who remain consistently active tend to do better than those who don't.
Some people find that using stress management techniques such as deep-breathing exercises and meditation helps with coping and pain relief.
Getting a good night's sleep is important to control fibromyalgia symptoms. Setting a regular sleep schedule, going to bed and getting up at the same time each day, and limiting daytime napping, are effective strategies to optimize restful sleep.
Although exercise may be painful initially, gradual and regular exercise often decreases symptoms.
Appropriate exercise for patients with fibromyalgia includes walking, swimming, cycling and water aerobics. Stretching, good posture and relaxation exercises are also helpful.
Maintaining a healthy lifestyle in general, by eating healthy foods, limiting caffeine intake and pursuing enjoyable and fulfilling activities, will help control the symptoms of fibromyalgia.
Some alternative therapies, such as meditation, yoga, acupuncture and massage therapy are safe and effective treatments for pain and stress relief in patients with fibromyalgia.
In children and teens, fibromyalgia is often treated with an intense physical and occupational therapy program for amplified musculoskeletal pain syndromes. These programs also employ counseling, art therapy, and music therapy. These programs are evidence-based and report long term total pain resolution rates as high as 88%.
The muscle relaxants cyclobenzaprine and tizanidine are sometimes used off-label to treat fibromyalgia.
Due to the cold sensitivities of people with fibromyalgia syndrome, aquatic therapy must take place in a warm pool. Not only that, but the air outside of the pool must also be heated to prevent fibromyalgia patients from getting chills and aches when out of the water. This involves a specialised pool facility, which makes this therapy more expensive and less accessible than regular swimming exercise.
The prevalence of fibromyalgia is about 2%, affecting an estimated 5.0 million adults in 200.5
The prevalence of fibromyalgia is much higher among women than men (3.4% vs 0.5% in 2005).
Although most people with fibromyalgia are women (Female: Male ratio 7:1), men and children can have the disorder.
Most people with fibromyalgia are diagnosed during middle age, and the prevalence increases with age.
Working age women with fibromyalgia hospitalized for occupational musculoskeletal disorders were almost 10 times less likely to return to work and 4 times less like to retain work at 1-year post hospitalization.
Working adults with fibromyalgia average almost 17 days of missed work per year compared to 6 days for persons without fibromyalgia.
Fibromyalgia has been associated with lower levels of health-related quality-of-life and more work productively loss.
Mortality among adults with fibromyalgia is similar to the general population, although death rates from suicide and injuries are higher among fibromyalgia patients.
Women have higher hospitalization rates than men at all ages. Persons hospitalized with primary cardiovascular conditions more had a high prevalence of reporting fibromyalgia as a secondary condition.
People with fibromyalgia have approximately 1 hospitalization every 3 years.
Average yearly direct medical costs/person range from $3400 to $3600.
Total annual costs (direct and indirect)/person = $5,945
Office and emergency room visits, procedures and tests, and hospitalizations are the largest components of direct medical costs among patients with fibromyalgia.
Adults with fibromyalgia are 3.4 times more likely to have major depression than peers without fibromyalgia.
Monozygotic twins with CWP have a 15% chance that their twin has CWP.
Dizygotic twins with CWP have a 7% chance that their twin has CW.
Research has also demonstrated that fibromyalgia is potentially associated with polymorphisms of genes in the serotoninergic, dopaminergic and catecholaminergic system
A large study of US fibromyalgia patients found that between 2005 and 2007 37.4% were prescribed short-acting opioids and 8.3% were prescribed long-acting opioids, with around 10% of those prescribed short-acting opioids using tramadol; and a 2011 Canadian study of 457 FM patients found 32% used opioids and two thirds of those used strong opioids.
FIbromyalgia is most commonly diagnosed in individuals between the ages of 20 and 50, though onset can occur in childhood.
Chronic widespread pain had already been described in the literature in the 19th century but the term fibromyalgia was not used until 1976 when Dr P.K. Hench used it to describe these symptoms.
Fibromyalgia is from the Latin fibra (fiber) and the Greek words myo (muscle) andalgos (pain).
Although in itself neither degenerative nor fatal, the chronic pain of fibromyalgia is pervasive and persistent. Most fibromyalgia patients report that their symptoms do not improve over time.
Pathology (What is Fibromyalgia?)
Fibromyalgia is a condition characterized by widespread musculoskeletal pain, fatigue, sleep, memory and mood issues.
Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals.
People with fibromyalgia react strongly (abnormal pain perception processing) to things that other people would not find painful.
Nerve cell receptors in the brains of people with fibromyalgia appear to develop a memory of the initial pain that makes the receptors more sensitive to future pain. This may create an overreaction to pain signals.
The condition sometimes begins following some type of physical trauma, surgery, infection or psychological stress.
The central symptom of fibromyalgia, widespread pain, appears to result from neuro-chemical imbalances, including the activation of inflammatory pathways in the brain that lead to abnormalities pain processing.
Fibromyalgia does tend to run in families, so there may be certain genetic mutations that may make you more susceptible to developing the disorder.
Infections may be a contributing factor. Some infectious illnesses seem to trigger or aggravate fibromyalgia symptoms.
Obesity has been identified as a possible contributing factor to the development of fibromyalgia.
Some of the neurochemical abnormalities that occur in fibromyalgia also regulate mood, sleep and energy, explaining why mood, sleep and fatigue problems often occur with fibromyalgia.
Widespread pain that is not limited to any specific body area(s) is the hallmark symptom of fibromyalgia.
The pain of fibromyalgia is described as a constant dull ache, on both sides of the body and above and below the waist.
People with fibromyalgia often wake up feeling tired, even after they have slept for long periods of time.
Fibromyalgia can be associated with difficulties thinking or concentrating, sometimes referred to as "fibro fog," an impaired ability to focus, pay attention and concentrate on mental tasks.
Tingling or numbness in the hands and feet can be a symptom of fibromyalgia.
Over-the-counter pain relievers such as ibuprofen, acetaminophen and naproxen sodium may be helpful.
Doctors may prescribe tramadol, an opioid analgesic used to treat moderate-to severe pain.
Narcotics are not recommended, because they can lead to dependence and may even worsen the pain over time.
Certain antidepressants may help ease the pain and fatigue associated with fibromyalgia.
Massage therapy can reduce heart rate, improve the range of motion of joints, and increase the production of the body's natural painkillers.