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Fibromyalgia

Q. What is fibromyalgia?

A. Fibromyalgia is a chronic pain syndrome. It has been recognized throughout this century by various names including firbrositis, fibromyositis and myofascial pain syndrome. It is not a disease discovered after the Gulf War. Fibromyalgia is estimated to effect approximately two to five percent of the population. Women between the ages of 20 and 50 are at an increased risk; however, the disease is found in both sexes and has been diagnosed in adolescents.

The American College of Rheumatology in 1990 developed specific clinical criteria for diagnosis. These criteria specify that a patient must have a history of widespread pain of at least three months duration and there must be pain in multiple sites. In addition, a patient must complain of pain when the examiner digitally applies 10 pounds. of pressure on at least 11 of 18 designated sites. These sites include the back of the neck, shoulder, rib, elbow, hip and knee areas.

Although pain is the primary symptom, patients usually complain of sleep disturbances, fatigue, and morning stiffness. Anxiety, depression, and the gastrointestinal complaints of diarrhea, excessive gas, and bloating are also common. These additional symptoms make the diagnosis of fibromyalgia often difficult to distinguish from Chronic Lyme Disease, Chronic Fatigue Syndrome and Multiple Chemical Sensitivity Syndrome.

Q. What causes fibromyalgia?

A. The cause of fibromyalgia is unknown. Diagnosis is based solely on patients' symptoms and the clinical finding of painful trigger points. There are no laboratory or radiological tests that will aid in diagnosis of this disease.

Treatment of fibromyalgia consists of treating the pain with analgesics most commonly acetaminophen (Tylenol) or nonsteroidal anti-inflammatories (Motrin). Antidepressants (most commonly Elavil) in low night doses to aid in sleep, moderate aerobic exercise, and patient education are also recommended.

Fibromyalgia is a chronic disease. Symptoms over time may disappear, but more commonly patients have recurrent episodes of pain that wax and wane in intensity and duration.

Q. Are there any research projects pertaining to fibromyalgia?

A. Current federally sponsored research projects pertaining to fibromyalgia are Dysregulation of the Stress Responses in the Persian Gulf Syndrome (DoD-31) (and Clinical and Neuroendocrine Aspects of Fibromyalgia (VA-6B) These studies have completion dates of 1999.

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