Fibromyalgia

Health and Nutrition > Diseases > F Written by Dr Badal Pal, consultant rheumatologist

What is fibromyalgia?

Fibromyalgia (previously called fibrositis) is a common 'rheumatic' disorder - where complaints arise from muscles, tendons and ligaments rather than the joints. Although the tissues involved do not suffer long-lasting damage, the symptoms may continue for months or even years.

What causes fibromyalgia?

The cause is unknown. Research indicates there is disturbance of deep sleep in people with fibromyalgia and a special test looking at brain waves called an electroencephalogram (EEG) can detect these changes.

People can develop fibromyalgia if their sleep is disturbed repeatedly. Thus, anything that causes sleep problems may eventually lead to it, eg people with arthritis may develop fibromyalgia because the pain and stress of that original condition may have disturbed their sleep pattern (this is called secondary fibromyalgia).

Emotional upsets and depression may also bring about fibromyalgia.

In some patients the onset of fibromyalgia can be traced to a recent trauma or accident. This is called reactive fibromyalgia.

The problem with fibromyalgia is that once the complaints start, the continuing sleep disturbance can result in a vicious cycle of pain and distress. This can lead on to depression.

Research indicates that fibromyalgia may be linked to a lack of growth hormone production by the brain or to a lack of exercise.

Who is at risk?

As many as 3 per cent of the population have fibromyalgia, with 10 times more women affected than men.

Fibromyalgia has some similarities with chronic fatigue (post viral) syndrome or ME (myalgic encephalomyelitis). However, unlike fibromyalgia sufferers, those with ME may have had a preceding viral infection.

ME patients feel less pain but are more tired and lethargic.

What are the symptoms of fibromyalgia?

The aching can affect almost all of the body and sometimes be bad enough to affect your personal life. The sore points over the body are noticeable in specific areas, such as on the outer side of the elbows, top of the shoulders, upper part of the front of the chest, inner side of the knees, etc.

For a definitive diagnosis to be made many experts say there should be at least eight tender sites present on the body.

People suffering from fibromyalgia may look well despite feeling miserable. Patients often feel worse when they wake up, as if they have slept poorly, but may not improve as the day goes on.

Tiredness can also fluctuate. Patients may lack stamina making it difficult for some to do a full day's work, household chores or even shopping.

Other symptoms include a sensation of poor circulation or an apparent feeling of swelling of the hands and feet - although this does not actually happen.

Tingling and numbness in the fingers and toes with a feeling of restlessness in the legs, particularly at night, can also occur.

Patients often feel irritable, down or even weepy. They may suffer from headaches, poor concentration or lack of memory and irritable bowels or bladder. This means they need to urinate frequently. Women can also suffer painful periods.

How can fibromyalgia be diagnosed?

. There is no single test, such as a blood test or X-rays to help in the diagnosis. The doctor may suspect the condition from the symptoms in the absence of any structural damage, inflammation or swelling of the joints.

The presence of sore areas on the body along with a history of undue tiredness and sleep disturbance can help the doctor to make the diagnosis.

Those bordering on chronic fatigue syndrome or ME may occasionally show evidence of recent or past infection from blood tests, such as glandular fever or some other viral infection. Doctors usually ask for several blood tests or even X-rays to rule out other likely causes that can sometimes look like fibromyalgia.

What else could it be?

The following conditions sometimes cause fibromyalgia-like complaints and need to be excluded by X-ray, physical examination and laboratory tests:

- underactive thyroid gland.
- polymyalgia, an inflammatory condition affecting mainly those over 55. These patients, unlike fibromyalgia patients, have an elevated ESR (erythrocyte sedimentation rate) on blood tests.
- patients with an immune disorder called Sjogren's syndrome are frequently tired with widespread aches and pains and may therefore be confused with fibromyalgia. But these patients also suffer from dry, gritty eyes or dry mouth and glandular swelling. Blood tests will help confirm Sjogren's syndrome in these individuals.
- like Sjogren's syndrome, other conditions such as rheumatoid arthritis or lupus may initially look like fibromyalgia. But after some months the true cause becomes more obvious and tests can then help diagnosis and rule out fibromyalgia.

How does it progress?

Occasionally, the condition settles down after months or even years, but it usually continues long term. People with fibromyalgia can be reassured that it will not cause any permanent joint or bone damage or lasting physical disability. They are at no greater risk of developing any form of arthritis later in life.

The documents contained in this web site are presented for information purposes only. The material is in no way intended to replace professional medical care or attention by a qualified practitioner. The materials in this web site cannot and should not be used as a basis for diagnosis or choice of treatment. Conditions for use

© Copyright 1998 - 2009 NetDoctor.co.uk - All rights reserved