Fibromyalgia is a common condition characterized by long-term, body-wide pain and tender points in joints, muscles, tendons, and other soft tissues. Fibromyalgia has also been linked to fatigue, morning stiffness, sleep problems, headaches, numbness in hands and feet, depression, and anxiety.

Fibromyalgia can develop on its own or along with other musculoskeletal conditions such as rheumatoid arthritis or lupus.

The cause of this disorder is unknown. Physical or emotional trauma may play a role in development of the syndrome. Some evidence suggests that fibromyalgia patients have abnormal pain transmission responses.

It has been suggested that sleep disturbances, which are common in fibromyalgia patients, may actually cause the condition. Another theory suggests that the disorder may be associated with changes in skeletal muscle metabolism, possibly caused by decreased blood flow, which could cause chronic fatigue and weakness.

Others have suggested that an infectious microbe, such as a virus, triggers the illness. At this point, no such virus or microbe has been identified.

Pilot studies have shown a possible inherited tendency toward the disease, though evidence is very preliminary.

The disorder has an increased frequency among women 20 to 50 years old. The prevalence of the disease has been estimated between 0.7% and 13% for women, and between 0.2% and 3.9% for men.

The overwhelming characteristic of fibromyalgia is long-standing, body-wide pain with defined tender points. Tender points are distinct from trigger points seen in other pain syndromes. Unlike tender points, trigger points can occur in isolation and represent a source of radiating pain, even in the absence of direct pressure.

Fibromyalgia pain can mimic the pain that occurs with various types of arthritis. However, the significant swelling, destruction, and deformity of joints seen in diseases such as rheumatoid arthritis does not occur with fibromyalgia syndrome alone.

The soft-tissue pain of fibromyalgia is described as deep-aching, radiating, gnawing, shooting or burning, and ranges from mild to severe. Fibromyalgia sufferers tend to wake up with body aches and stiffness.

For some patients, pain improves during the day and increases again during the evening, though many patients with fibromyalgia have day-long, unrelenting pain. Pain can increase with activity, cold or damp weather, anxiety, and stress.

Specific symptoms:

• Multiple tender areas (muscle and joint pain) on the back of the neck, shoulders, sternum, lower back, hips, shins, elbows, knees.
• Fatigue
• Sleep disturbances
• Body aches
• Reduced exercise tolerance
• Chronic facial muscle pain or aching

Diagnosis of fibromyalgia requires a history of a least three months of widespread pain, and pain and tenderness in at least 11 of 18 tender-point sites. These tender-point sites include fibrous tissue or muscles of the:

• Neck
• Shoulders
• Chest
• Rib cage
• Lower back
• Thighs
• Knees
• Arms (elbows)
• Buttocks

Sometimes, laboratory and x-ray tests are done to help confirm the diagnosis. The tests will also rule out other conditions that may have similar symptoms. The following conditions have been associated with fibromyalgia or mimic its symptoms:

• Cancer
• Cervical and low-back degenerative disease
• Chronic fatigue syndrome
• Depression
• HIV infection
• Hypothyroidism
• Irritable bowel syndrome
• Lyme disease
• Rheumatoid arthritis
  • Sleep disorders