Alternate Names: Fibromyositis; Fibrositis; Myofasical pain syndrome

Causes and Risks:

The cause of this disorder is unknown. Possible causes can include physical or emotional trauma. One hypothesis suggests that the disorder may be associated with changes in craniofacial and skeletal muscle metabolism, such as decreased blood flow, which could cause chronic fatigue and weakness. Another hypothesis is that an infectious microbe, such as a virus, triggers the illness. At this point, no virus or microbe has been identified.

Pilot studies have shown a possible inherited tendency toward the disease.

The disorder has an increased frequency among women 20 to 50 years old. The incidence is 9 out of 1,000 people.

Prevention:

There is no proven prevention for this disorder.

Symptoms:

• multiple tender areas (muscle and joint pain) on the back of the neck, shoulders, sternum, lower back, hip, shin, elbows, knees.
• fatigue
• sleep disturbances
• body aches
• reduced exercise tolerance
• chronic facial muscle pain or aching

Signs and Tests:

A number of tests may be done to rule out other disorders. An examination reveals multiple tender areas on the back of the neck, shoulders, sternum, lower back, hip, shin, elbows, or knees.

A dolorimeter, an instrument that distributes pressure over a specific area, is sometimes used to gain data about patients and their individual sites of pain.

Other underlying ailments, such as chronic fatigue syndrome, irritable bowel syndrome, and rheumatoid arthritis, can also be present. New patients should be checked for these underlying conditions as well as fibromyalgia.

Treatment:

In mild cases, symptoms may go away when stress is decreased. Treatment includes patient education, physical therapy, and counseling. Many fibromyalgia sufferers have found support groups helpful.

Low-dose tricyclic antidepressant medications or nonsteroidal anti-inflammatory drugs are sometimes prescribed. Studies show that antidepressants in low doses can decrease depression, relax craniofacial and skeletal muscles, improve sleep quality, and release pain-killing endorphins.

No special diets are recommended at this time, though some reports indicate that fish oil, magnesium/malic acid combinations, or vitamins may be effective. Reducing stress and improving coping skills may also help reduce painful symptoms.

Improved fitness through exercise is recommended. The best way to begin a fitness program is to start with low impact exercises like walking and swimming. Starting slowly helps stretch and mobilize tight, sore muscles. High-impact aerobics and weight lifting could cause increased discomfort. Gentle stretching and light massage may help relieve symptoms, as will electronic acupuncture and relaxation techniques.

Severe cases of fibromyalgia may require a referral to a pain clinic.

Prognosis:

Fibromyalgia isa chronic problem. The symptoms sometimes improve and at other times the symptoms may worsen and continue for months or years. The key is seeking professional help with a multi-faceted approach to the management and treatment of the disease.

Complications:

Conditions reported as associated with fibromyalgia or that mimic its symptoms include rheumatoid arthritis, hypothyroidism, cervical and low-back degenerative disease, Lyme disease, chronic fatigue syndrome, sleep disorders, depression, and HIV infection.

Call for an appointment with your health-care provider if symptoms of fibromyalgia develop.