Fibromyalgia - a patient education video by Dr. Carlo Oller

What is fibromyalgia?

Fibromyalgia is one of a group of chronic pain disorders that affect connective tissues, including the muscles, ligaments (the tough bands of tissue that bind together the ends of bones), and tendons (which attach muscles to bones).

It is a chronic condition that causes widespread muscle pain (known as “myalgia”) and extreme tenderness in many areas of the body. Many patients also experience fatigue, sleep disturbances, headaches, and mood disturbances such as depression and anxiety. Despite ongoing research, the cause, diagnosis, and optimal treatment of fibromyalgia are not clear.

In the United States, fibromyalgia affects about 2 % of people by age 20, which increases to approximately 8% of people by age 70; it is the most common cause of generalized musculoskeletal pain in women between 20 and 55 years. It is more common in women than men.

FIBROMYALGIA CAUSES
— The cause of fibromyalgia is unknown. Various physical or emotional factors (such as infection, injury, or stress) may play a role in triggering symptoms, although many patients report a lifelong history of chronic pain.

In people with fibromyalgia, the muscles and tendons are excessively irritated by various painful stimuli. This is thought to be due to a heightened perception of pain, a phenomenon called “central sensitization.” Other conditions may also develop as a result of central sensitization, including irritable bowel syndrome (IBS); chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS); chronic headaches; chronic pelvic and bladder pain; and chronic jaw and facial pain.



There is no generally agreed-upon explanation for how or why central sensitization develops in some people. The most likely theory suggests that there is a genetic component, meaning that some people are predisposed to having a heightened perception of pain.

People with a parent or sibling with fibromyalgia have a higher chance of developing it themselves. In some cases, various stressors, including infection (eg, Lyme disease or viral illness), diseases that involve joint inflammation (eg, rheumatoid arthritis or systemic lupus erythematosus), physical or emotional trauma, or sleep disturbances appear to trigger the development of fibromyalgia.



Brain imaging studies in people with fibromyalgia and related chronic pain disorders shave shown changes in brain function and connections between different parts of the brain. As research continues, the factors that lead to chronic pain in fibromyalgia will be better understood, hopefully allowing for the development of better treatments.

Can fibromyalgia be cured? — Some people seem to get over fibromyalgia. But in most people it cannot be cured. Even so, people can learn to deal with the condition and lead fairly normal lives. Fibromyalgia does not get worse over time, and it is not life-threatening.

Does fibromyalgia cause symptoms besides muscle pain?

The primary symptom of fibromyalgia is widespread (or “diffuse”), chronic, and persistent pain. Although the pain is felt in muscles and soft tissues, there are no visible abnormalities in these areas. The pain may be described as a deep muscular aching, soreness, stiffness, burning, or throbbing. Patients may also feel numbness, tingling, or unusual “crawling” sensations in the arms and legs. Although some degree of muscle pain is always present, it varies in intensity and is aggravated by certain conditions, such as anxiety or stress, poor sleep, exertion, or exposure to cold or damp conditions. People often describe their muscle symptoms as feeling like they always have the flu.

The pain may be confined to specific areas, often the neck or shoulders, early in the course of the disease. Multiple regions are eventually involved, with most patients experiencing pain in the neck, middle and lower back, arms and legs, and chest wall. Areas called “tender points” can feel painful with even mild to moderate pressure. Many patients with fibromyalgia feel that their joints are swollen, although there is no visible inflammation of the joints (as would be found in forms of arthritis).

Other pain symptoms — Patients with fibromyalgia are often affected by other pain-related symptoms, including:

●Repeated headaches, including migraines

●Symptoms of irritable bowel syndrome (IBS), including frequent abdominal pain and episodes of diarrhea, constipation, or both

●Interstitial cystitis/painful bladder syndrome, in which bladder pain, urinary urgency, and frequency are typically present without an infection

●Temporomandibular joint (TMJ) syndrome, which can involve limited jaw movement; clicking, snapping, or popping sounds while opening or closing the mouth; pain within facial or jaw muscles in or around the ear; or headaches