Fibromyalgia Syndrome

Fibromyalgia syndrome (FMS) is a common rheumatoid disorder of the muscles and bones that does not involve the joints.

FMS causes pain and fatigue, and people with FMS feel as if their muscles have been pulled or overworked. Sometimes the muscles twitch or burn.

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Symptoms

The signs of FMS include aches and pains in muscles, tendons and joints all over the body, but especially along the spine. Some people feel more pain when they try to relax and less when they are active, busy or exercising. 

Other symptoms include:

  • Disturbed sleep
  • Depression
  • Daytime tiredness
  • Headaches
  • Alternating diarrhea and constipation
  • Numbness and tingling in the hands and feet
  • Feelings of weakness
  • Memory difficulties
  • Dizziness

One characteristic of FMS is the presence of multiple tender points. This refers to specific points in the neck, spine, shoulders and hips that feel tender.

 

Causes and Risk Factors

The exact cause of fibromyalgia is not known. It is not associated with injuries to muscles, nerves or joints nor to any serious body damage or disease. FMS affects more women than men and occurs in people of all ages. In some people, FMS is associated with measurable changes in body chemistry and functioning, but it is not known whether these changes are causes or effects of FMS.

Stress and difficulty sleeping may contribute to FMS because lack of restful sleep can decrease the body's production of the chemicals needed to regulate pain. Other factors (such as illness, infection or anxiety) may also cause changes in body chemistry that lead to these symptoms.

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Diagnosis

A diagnosis of FMS will be based on:

  • A medical history and physical exam to rule out conditions (such as rheumatoid arthritis, muscle inflammation, bursitis or tendonitis) that can have similar symptoms
  • The presence or absence of widespread pain along with other symptoms of FMS that have lasted for three months or more
  • The presence or absence of tender spots that can be felt when light pressure is applied to specific locations on the body
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Treatments

FMS is usually treated with:

  • Drugs (such as low doses of anti-depressant drugs) taken before bed to improve sleep. Other kinds of sleeping pills have not proven effective for people with FMS. Non-steroidal anti-inflammatory drugs (such as aspirin and ibuprofen) may help decrease pain.
  • Lifestyle changes, such as stress reduction and using relaxation techniques. In particular, anxiety and depression need to be treated to reduce stress.
  • Exercise, including brisk walking, biking, swimming and water aerobics
  • Aerobic exercise for half an hour three times a week helps increase heart and lung function while stretching tight, sore muscles

Often if stressful situations are resolved, fibromyalgia may improve and medications may not be necessary. Even with treatment, however, many people with FMS will continue to have symptoms, especially if they have stressful lives. With treatment, there can be a significant reduction in symptoms. Those who are able to continue working and fulfilling their social obligations despite their pain do best.

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