Overview, Causes, & Risk Factors
Fibromyalgia is a poorly understood condition that causes multiple tender
points, called trigger points, in the muscles and soft tissues of the body.
What is going on in the body?
People who have fibromyalgia have chronic, widespread pain and stiffness in the
muscles. Fatigue is a key factor in fibromyalgia. Some healthcare professionals
believe that fatigue may occur because the person doesn't get enough deep,
restful sleep. Others believe that the sleep disturbance may actually be a
cause of the fibromyalgia.
Recent research has shown that people who have fibromyalgia
have a decrease in blood flow to the parts of the brain involved with pain
perception. They also have two times the normal level of a brain chemical
known as substance P. This substance is involved in the transmission of pain
messages from nerve cells to the brain.
Fibromyalgia may occur alone, or together with other disorders such as
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What are the causes and risks of the condition?
No one knows for sure what causes fibromyalgia, but there are several theories.
Some possible causes of fibromyalgia include the following:
autoimmune disorders, or a condition in which the
body creates antibodies against its own tissues
endocrine abnormalities, which are problems with various glands in the
biochemical abnormalities in the central nervous system, such as the
elevated level of substance P in the brain
impaired blood flow to the brain
mechanical stresses to the cervical and lumbar spine
history of abuse as a
New research findings suggest that autoimmune disorders may be triggered by a transfer of cells between the fetus and the mother during pregnancy. The study involved women with scleroderma, an autoimmune disorder involving the skin. These women have more fetal cells in their blood decades after a pregnancy than women who don't have scleroderma. While further research is needed to substantiate these findings, the study does offer an explanation for the much higher incidence of autoimmune disorders in women than in men.
Women account for 75% of those who have the disease. It is most common
in women of childbearing age.
Symptoms & Signs
What are the signs and symptoms of the condition?
Symptoms of fibromyalgia include prolonged pain and multiple trigger points in
the muscles and soft tissues. These trigger points tend to be located in the
shoulders, neck, upper and lower back, and hips.
People with fibromyalgia experience muscle pain and stiffness, especially in
the morning. The pain is worse in the morning and worsens again at night.
Other symptoms are as follows:
with constipation or
fatigue, which is
probably caused by disrupted sleep
tingling of the skin that involves numbness or burning
Diagnosis & Tests
How is the condition diagnosed?
Diagnosis of fibromyalgia begins with a medical history and physical examination. There
are no laboratory tests such as biopsies or X-rays for this disease. These tests
are sometimes used to rule out other medical illnesses.
The American College of Rheumatology recommends the following guidelines for a
widespread pain for more than three months
pain involving any or all areas of the spine
tenderness at 11 or more of the 18 tender points identified in people
depressed mood or clinical
Prevention & Expectations
What can be done to prevent the condition?
There is no known way to prevent fibromyalgia.
What are the long-term effects of the condition?
The chronic pain of fibromyalgia may lead to clinical depression. Some individuals with fibromyalgia have
because of the chronic pain. The ability to work may be lost. Fibromyalgia is
not thought to be a progressive disease, and it does not cause deformities.
What are the risks to others?
Fibromyalgia is not contagious and poses no risk to others.
Treatment & Monitoring
What are the treatments for the condition?
There is no cure for fibromyalgia. However, there are some treatments that can
improve the symptoms and quality of life for someone with the condition. People
with fibromyalgia have reported improvement from the following:
aerobic exercises, such as bicycling or jogging
antidepressant medications, such as amitriptyline and cyclobenzaprine, to
improve sleep and relax muscles
heat or cold treatments
injections of local anesthesia medications or corticosteroids into tender
occupational therapy, which can teach individuals how to continue functioning in spite of pain
stretching and range of motion exercises, which involve moving joints
through their normal movements
Some individuals may find one or more of these treatments helpful, while others may
find that a particular treatment worsens symptoms. If a treatment
is helping and the side effects are tolerable, the treatment should be
What are the side effects of the treatments?
Side effects of antidepressants include dry mouth, sexual dysfunction, and
local anesthetic medications
can make the chronic pain worse in some cases and can cause an allergic reaction.
What happens after treatment for the condition?
The course of fibromyalgia is unpredictable and highly individualized.
Treatment is lifelong.
How is the condition monitored?
Self-monitoring of symptoms is important. People can document the severity of
pain, fatigue, stiffness, and mood in a daily log. This information can help in
treatment plans. Any new or worsening symptoms should be reported to the