Fibromyalgia Symptoms, Diagnosis & Treatment

Fibromyalgia is often referred to as the “Invisible” illness or “Imaginary” disease. It was not until 1992 that it became recognized as a true medical problem by the World Health Organization. There are a few reasons for this. Some say it’s because it is often very hard to diagnose since Fibromyalgia’s symptoms often mimic those of other diseases and illnesses. Others say that it took so long for the medical community to recognize the syndrome because over 80% of the people affected have been women. For decades doctors have been telling patients with Fibromyalgia that they are just hypochondriacs.

What is Fibromyalgia?
Fibromyalgia syndrome is a common and chronic disorder characterized by widespread muscle pain, fatigue, and multiple tender points. The word fibromyalgia comes from the Latin term for fibrous tissue (fibro) and the Greek ones for muscle (myo) and pain (algia). Tender points are specific places on the body – on the neck, shoulders, back, hips, and upper and lower extremities – where people with fibromyalgia feel pain in response to slight pressure. Although fibromyalgia is often considered an arthritis-related condition, it is not truly a form of arthritis (a disease of the joints) because it does not cause inflammation or damage to the joints, muscles, or other tissues. Like arthritis, however, fibromyalgia can cause significant pain and fatigue, and it can interfere with a person’s ability to carry on daily activities. Also like arthritis, fibromyalgia is considered a rheumatic condition. You may wonder what exactly rheumatic means. Even physicians do not always agree on whether a disease is considered rheumatic. If you look up the word in the dictionary, you’ll find it comes from the Greek word rheum, which means flux – not an explanation that gives you a better understanding. In medicine, however, the term rheumatic means a medical condition that impairs the joints and/or soft tissues and causes chronic pain.

In addition to pain and fatigue, people who have fibromyalgia may experience:
•     sleep disturbances
•     morning stiffness
•     headaches
•     irritable bowel syndrome
•     painful menstrual periods
•     numbness or tingling of the extremities
•     restless legs syndrome
•     temperature sensitivity
•     cognitive    and memory problems (sometimes referred to as “fibro fog”)
•     a variety of other symptoms

Fibromyalgia is a syndrome rather than a disease. Unlike a disease, which is a medical condition with a specific cause or causes and recognizable signs and symptoms, a syndrome is a collection of signs, symptoms, and medical problems that tend to occur together but are not related to a specific, identifiable cause.

How Is Fibromyalgia Diagnosed?
Research shows that people with fibromyalgia typically see many doctors before receiving the diagnosis. One reason for this may be that pain and fatigue, the main symptoms of fibromyalgia, overlap with many other conditions. Therefore, doctors often have to rule out other potential causes of these symptoms before making a diagnosis of fibromyalgia.

Another reason is that there are currently no diagnostic laboratory tests for fibromyalgia; standard laboratory tests fail to reveal a physiologic reason for pain. Because there is no generally accepted, objective test for fibromyalgia, some doctors unfortunately may conclude a patient’s pain is not real, or they may tell the patient there is little they can do. A doctor familiar with fibromyalgia can make a diagnosis based on two criteria established by the American College of Rheumatology (ACR). The criteria include

1. A history of widespread pain lasting more than 3 months
2. The presence of tender points

Pain is considered to be widespread when it affects all four quadrants of the body; that is, you must have pain in both your right and left sides as well as above and below the waist to be diagnosed with fibromyalgia. ACR also has designated 18 sites on the body as possible tender points.

For a fibromyalgia diagnosis, a person must have 11 or more tender points. One of these predesignated sites is considered a true tender point only if the person feels pain upon the application of 4 kilograms of pressure to the site. People who have fibromyalgia certainly may feel pain at other sites, too, but those 18 standard possible sites on the body are the criteria used for classification.

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Information provided by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)