Fibromyalgia is a common condition of unknown cause. The name means “muscle-fiber pain,” and symptoms certainly include pain in muscles, tendons, and bursa, but nowadays it’s not thought to have anything happening in the actual fibers. It’s considered a disorder of pain perception (all of which happens in the brain), similar to several other conditions noted below.
In most people, Fibromyalgia began between 20 and 50 years old. It’s more common among women than men. There’s no test to diagnose it. First we rule out other conditions (see topic Body Aches). Then, if a patient has had widespread body pain for at least 3 months, we obtain a history of 3 components (click link for a formal Fibromyalgia Scoring System):
- Pain in at least 7 of 19 areas, usually with tenderness to firm pushing
- History of significant a) Fatigue, b) Waking from Sleep Unrefreshed, c) Mental Symptoms (poor concentration, forgetfulness, can’t multitask)
- A variety of other conditions like depression, headache, dizziness, abdominal pains, urinary problems, blurry vision, anxiety, chest pains, nausea, poor appetite, numbness or tingling, etc.
There are many treatment possibilities for Fibromyalgia. On the one hand, that’s good news, since one treatment may work for one person, and another for another. But whenever we have many possible treatments to try, it usually means we don’t understand what’s going on, or which is best. It’s not unusual for patients with Fibromyalgia to suffer from similar conditions that are common but poorly understood. These include Irritable Bowel, Chronic Fatigue Syndrome, Migraines, Temporomandibular joint Disorder (“TMJ”), Interstitial Cystitis, and chronic Pelvic Pain. None of these conditions can be diagnosed by specific tests. All are thought to be due to abnormal tolerance to and perceptions of pain, for reasons unknown.