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About FM
The word Fibromyalgia (FM) 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, neck, shoulders, back, hips, and
upper and lower extremities where people with FM feel pain in response to slight
pressure. The image to your right indicated the 18 tender point locations on the body.
Although FM 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, FM can cause
significant pain and fatigue, and it can interfere with a person's ability to carry on
daily activities. Also like arthritis, FM is considered a rheumatic condition.
What Exactly Does Rheumatic Mean?
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.
While FM is one of the most common diseases affecting the muscles, its cause is
currently unknown. The painful tissues involved are not accompanied by tissue
inflammation. Therefore, despite potentially disabling body pain, patients with FM do
not develop body damage or deformity. FM also does not cause damage to internal body
organs. Therefore, FM is different from many other rheumatic conditions (such as
rheumatoid arthritis, systemic lupus, and polymyositis). In those diseases,
tissue inflammation is the major cause of pain, stiffness and tenderness of the
joints, tendons and muscles, and it can lead to joint deformity and damage to the
internal organs or muscles.
In addition to pain and fatigue, people who have FM experience:
- Widespread Musculoskeletal Pain
- Non restorative Sleep
- Fatigue
- Psychological Distress
- Specific Regions of Localized Tenderness
People with FM may also have other symptoms such as:
- Morning stiffness
- Tingling or numbness in hands and feet
- Headaches, including migraines
- Irritable bowel syndrome
- Problems with thinking and memory (sometimes called "fibro fog")
- Painful menstrual periods and other pain syndromes
Onset
FM as defined by the ACR criteria is more common in females than in males, with
a female-to-male ratio of approximately 9:1. Males with FM tend to have lower
health perception and more physical limitations than females. Females with FM have
greater pain sensitivity and may exhibit greater life interference
due to pain.
Some of the mechanisms that may contribute to increased pain sensitivity in women
include:
1. Differences in primary afferent input to the CNS, with developmental and
menstrual cycle–dependent enhancement.
2. Developmental and phasic gonadal-hormonal modulation of pain regulatory
systems, stress-induced analgesia, and opioid receptors.
3. Higher levels of trait and state anxiety.
4. Increased prevalence of depression.
5. Use of maladaptive coping strategies.
6. Increased behavioral activity in response to pain.
Although usually considered a disorder of women aged 20-50 years, FM is observed
in pediatric populations, especially in adolescents, and in older persons. FM in
children responds to a combination of psychotherapy, exercise, relaxation techniques,
and education. Pharmacotherapy is generally not indicated.
Frequency
United States
Chronic pain and fatigue are extremely prevalent in the general population,
especially among women and persons of lower socioeconomic status. The
prevalence of regional pain is 20%; widespread pain, 11%; FM according to
the American College of Rheumatology (ACR) criteria,27 3-5% in females
and 0.5-1.6% in males; and chronic fatigue, approximately 20%. Because the ACR criteria
are relatively insensitive, the actual prevalence of FM is higher.
FM experts estimate that about 10 million Americans and approximately 3-6% of the
population worldwide suffer with FM. While it is most common in women, the illness
strikes men, women, and children of all ages and ethnic backgrounds. For those with
severe symptoms, FM can be extremely debilitating and interfere with even routine
daily activities.
mortality
FM is a chronic relapsing condition. In academic medical centers,
long-term follow-up care of patients with FM reportedly averages 10 outpatient visits
per year and 1 hospitalization every 3 years. Chronic pain and fatigue in FM increases
the risk for metabolic syndrome.
A subset of patients with FM consider themselves to be more ill and more
impaired, reporting markedly abnormal scores for pain, functional disability,
fatigue, sleep disturbance, and psychologic status. They have significantly higher
levels of comorbid illness and healthcare utilization and costs than matched controls.
The annual economic burden of FM in 2005 was $10,199 (US dollars) per patient per
year, nearly double that of matched controls.
Years Spent Searching For Help
If you've been from one doctor to another looking for a correct diagnosis, you're not
alone. It takes
many years for most FM patients to receive an accurate diagnosis. Many times this
is because FM mimics other illnesses. Often times it's because many physicians
don't understand FM, or don't believe it to be a real illness.
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