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What is Fibromyalgia? Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal
pain, fatigue, and multiple tender points. "Tender points" refers to tenderness that occurs in precise, localized areas, particularly
in the neck, spine, shoulders, and hips. People with this syndrome may also experience sleep disturbances, morning stiffness,
irritable bowel syndrome, anxiety, and other symptoms.
How Many People Have Fibromyalgia?
According to the American College of Rheumatology, fibromyalgia affects 3 to 6 million Americans. It primarily occurs
in women of childbearing age, but children, the elderly, and men can also be affected.
What Causes Fibromyalgia?
Although the cause of fibromyalgia is unknown, researchers have several theories about causes or triggers of
the disorder. Some scientists believe that the syndrome may be caused by an injury or trauma. This injury may affect the central
nervous system. Fibromyalgia may be associated with changes in muscle metabolism, such as decreased blood flow, causing fatigue
and decreased strength. Others believe the syndrome may be triggered by an infectious agent such as a virus in susceptible
people, but no such agent has been identified. How is Fibromyalgia Diagnosed? Fibromyalgia
is difficult to diagnose because many of the symptoms mimic those of other disorders. The physician reviews the patient's
medical history and makes a diagnosis of fibromyalgia based on a history of chronic widespread pain that persists for more
than 3 months. The American College of Rheumatology (ACR) has developed criteria for fibromyalgia that physicians can use
in diagnosing the disorder. According to ACR criteria, a person is considered to have fibromyalgia if he or she has widespread
pain in combination with tenderness in at least 11 of 18 specific tender point sites. How is Fibromyalgia Treated?
Treatment of fibromyalgia requires a comprehensive approach. The physician, physical therapist, and patient may
all play an active role in the management of fibromyalgia. Studies have shown that aerobic exercise, such as swimming and
walking, improves muscle fitness and reduces muscle pain and tenderness. Heat and massage may also give short-term relief.
Antidepressant medications may help elevate mood, improve quality of sleep, and relax muscles. Patients with fibromyalgia
may benefit from a combination of exercise, medication, physical therapy, and relaxation. What Research
is Being Conducted on Fibromyalgia? The NIAMS (The National Institute of Arthritis and Musculoskeletal
and Skin Diseases) is sponsoring research that will increase understanding of the specific abnormalities that cause and accompany
fibromyalgia with the hope of developing better ways to diagnose, treat, and prevent this disorder. Recent NIAMS
studies show that abnormally low levels of the hormone cortisol may be associated with fibromyalgia. At Brigham and Women's
Hospital in Boston, Massachusetts, and at the University of Michigan Medical Center in Ann Arbor, researchers are studying
regulation of the function of the adrenal gland (which makes cortisol) in fibromyalgia. People whose bodies make inadequate
amounts of cortisol experience many of the same symptoms as people with fibromyalgia. It is hoped that these studies will
increase understanding about fibromyalgia and may suggest new ways to treat the disorder. NIAMS research studies
are looking at different aspects of the disorder. At the University of Alabama in Birmingham, researchers are concentrating
on how specific brain structures are involved in the painful symptoms of fibromyalgia. At George Washington University in
Washington, DC, scientists are investigating the causes of a post-Lyme disease syndrome as a model for fibromyalgia. Some
patients develop a fibromyalgia-like condition following Lyme disease, an infectious disorder associated with arthritis and
other symptoms. NIAMS-supported research on fibromyalgia also includes several projects at the Institute's Multipurpose
Arthritis and Musculoskeletal Diseases Centers. Researchers at these centers are studying individuals who do not seek medical
care, but who meet the criteria for fibromyalgia. (Potential subjects are located through advertisements in local newspapers
asking for volunteers with widespread pain or aching.) Other studies at the Centers are attempting to uncover better ways
to manage the pain associated with the disorder through behavioral interventions such as relaxation training. In
March 1998, NIAMS and several other NIH institutes and offices issued a Request for Proposals to promote research studies
of fibromyalgia. As a result of this request, NIAMS and its partners recently funded 15 new fibromyalgia projects totaling
more than $3.6 million. The NIAMS supports and encourages outstanding basic and clinical research that increases
the understanding of fibromyalgia. However, much more research needs to be done before fibromyalgia can be successfully treated
or prevented. The Federal Government, in collaboration with researchers, physicians, and private voluntary health
organizations, is committed to research efforts that are directed at significantly improving the health of all Americans afflicted
with fibromyalgia.
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