Fibromyalgia

Overview

Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. It is often associated with other symptoms such as sleep disorders, mood swings, and cognitive disturbances. The exact cause of fibromyalgia is unknown, but it is believed to involve a variety of genetic, environmental, and psychological factors. There is currently no cure for fibromyalgia, but a range of treatments can help to manage symptoms.

Photograph of a person holding their hand to their forehead, illustrating the discomfort and pain associated with fibromyalgia.

Etiology

The etiology of fibromyalgia is not fully understood. It is believed to be a result of a combination of genetic, environmental, and psychological factors. Some researchers believe that fibromyalgia is a disorder of central pain processing, with neuroendocrine/neurotransmitter dysregulation playing a key role. Others suggest that it may be related to a disorder of the immune system or an abnormality in the structure or function of the muscles.

Symptoms

The primary symptoms of fibromyalgia are widespread musculoskeletal pain and fatigue. The pain is often described as a constant dull ache, typically arising from muscles. For a diagnosis of fibromyalgia to be considered, this pain must occur on both sides of the body, and above and below the waist.

In addition to pain and fatigue, people with fibromyalgia may experience a variety of other symptoms including:

Cognitive disturbances, often referred to as "fibro fog", which can include problems with memory, concentration, and organization
Sleep disturbances, including insomnia, restless legs syndrome, and sleep apnea
Mood disorders, such as depression and anxiety
Other symptoms, such as headaches, irritable bowel syndrome, and temporomandibular joint disorders

Diagnosis

Diagnosing fibromyalgia can be difficult, as there is no specific laboratory test to confirm the diagnosis. Instead, the diagnosis is usually based on a person's symptoms and the exclusion of other conditions that could cause similar symptoms. The American College of Rheumatology has established two criteria for the diagnosis of fibromyalgia: widespread pain lasting for at least three months, and the presence of tender points at 11 or more of 18 specific sites on the body.

Treatment

There is currently no cure for fibromyalgia, but a variety of treatments can help to manage symptoms. These may include:

Medications, such as pain relievers, antidepressants, and anti-seizure drugs
Therapies, such as physical therapy, occupational therapy, and counseling
Lifestyle changes, such as regular exercise, a healthy diet, and adequate sleep

Prognosis

The prognosis for people with fibromyalgia varies. Some people may experience mild symptoms and continue to lead active, productive lives. Others may have severe symptoms that interfere with their daily activities and quality of life. Although fibromyalgia is a chronic condition, it is not progressive and it does not cause permanent damage to the muscles, joints, or internal organs.

Epidemiology

Fibromyalgia is estimated to affect 2-8% of the population, with a higher prevalence in women than in men. It is most commonly diagnosed in middle age, but can occur at any age.