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March 17, 2010
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Fibromyalgia
(Fibrositis)

Medical Author: William C. Shiel Jr., MD, FACP, FACR
Medical Editor: Melissa Conrad Stöppler, MD

Fibromyalgia: 3 Things Patients Can Do for Themselves

Medical Author: William C. Shiel Jr., MD, FACP, FACR
Medical Editor: Leslie J. Schoenfield, MD, PhD

William C. Shiel Jr., MD, FACP, FACR It is not unusual for a patient with fibromyalgia to ask the doctor: "What can I do to help relieve my symptoms? After all, I am not very interested in medications."

Some patients with fibromyalgia make this or similar statements to their doctors because they are often younger and many do not have underlying (additional ongoing) medical conditions (although some do). Therefore, they are not accustomed to taking medications regularly.

Are there really ways that patients can help themselves? Yes. Here are the big three...


What is fibromyalgia?

Fibromyalgia is a chronic condition causing pain, stiffness, and tenderness of the muscles, tendons, and joints. Fibromyalgia is also characterized by restless sleep, awakening feeling tired, fatigue, anxiety, depression, and disturbances in bowel function. Fibromyalgia was formerly known as fibrositis.

While fibromyalgia is one of the most common diseases affecting the muscles, its cause is currently unknown. The painful tissues involved are not accompanied by tissue inflammation. Therefore, despite potentially disabling body pain, patients with fibromyalgia do not develop body damage or deformity. Fibromyalgia also does not cause damage to internal body organs. In this sense, fibromyalgia is different from many other rheumatic conditions (such as rheumatoid arthritis, systemic lupus, and polymyositis). In those diseases, tissue inflammation is the major cause of pain, stiffness, and tenderness of the joints, tendons and muscles, and it can lead to joint deformity and damage to the internal organs or muscles.

What causes fibromyalgia?

The cause of fibromyalgia is not known. Those affected experience pain in response to stimuli that are normally not perceived as painful. Researchers have found elevated levels of a nerve chemical signal, called substance P, and nerve growth factor in the spinal fluid of fibromyalgia patients. Levels of the brain chemical serotonin are also relatively low in patients with fibromyalgia. Studies of pain in fibromyalgia have suggested that the central nervous system (brain) may be somehow supersensitive. Scientists note that there seems to be a diffuse disturbance of pain perception in patients with fibromyalgia.

Also, patients with fibromyalgia have an impaired non-Rapid-Eye-Movement, or non-REM, sleep phase (which likely, at least in part, explains the common feature of waking up fatigued and unrefreshed in these patients). The onset of fibromyalgia has been associated with psychological distress, trauma, and infection.

Who does fibromyalgia affect?

Fibromyalgia affects predominantly women (over 80% of those affected are women) between the ages of 35 and 55. Rarely, fibromyalgia can also affect men, children, and the elderly. It can occur independently or can be associated with another disease, such as systemic lupus or rheumatoid arthritis. The prevalence of fibromyalgia varies in different countries. In Sweden and Britain, 1% of the population is affected by fibromyalgia. In the United States, approximately 2% of the population has fibromyalgia.



Next: What are symptoms of fibromyalgia? »

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Fibromyalgia - Symptoms at Onset of Disease

The MedicineNet physician editors ask:

The symptoms of fibromyalgia can vary greatly from patient to patient. What were your symptoms at the onset of your disease?

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Fibromyalgia

Introduction to pain management

Pain management can be simple or complex, depending on the cause of the pain. An example of pain that is typically less complex would be nerve root irritation from a herniated disc with pain radiating down the leg. This condition can often be alleviated with an epidural steroid injection and physical therapy. Sometimes, however, the pain does not go away. This can require a wide variety of skills and techniques to treat the pain. These skills and techniques include:

  • Interventional procedures
  • Medication management
  • Physical therapy or chiropractic therapy
  • Psychological counseling and support
  • Acupuncture and other alternative therapies; and
  • Referral to other medical specialists

All of these skills and services are necessary because pain can involve many aspects of a person's daily life.

How is pain tre...

Read the Pain Management article »











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