FIBROMYALGIA

Jenifer Bassett, MD
Pediatrics & Internal Medicine
Southside Medical Clinic
Eau Claire

If you do an internet search for Fibromyalgia, over 2 million entries come up. It is a popular topic for several reasons. First, the cause is unknown and there is limited medical or scientific information about the disorder. This leaves lots of room for speculation and personal opinion. Second, sufferers of the disorder are eager for answers and, where science fails to provide them, advertisers and well-intentioned fellow sufferers are happy to fill the void, sharing their own stories and promoting their own cure-all products.

What is Fibromyalgia?

Fibromyalgia is a syndrome, a group of signs and symptoms which occur together in the same individual. Its cause is unknown. A disorder characterized by muscle pain and fatigue has been described as far back as the 1800s. In the 1970s, the term fibromyalgia came into use, “fibro-“ deriving from the Latin word for filament and “myalgia“ from the Greek words for muscle and pain. In 1990, the American College of Rheumatology (ACR) issued guidelines for the diagnosis of fibromyalgia. (This is an organization that provides programs of education, research and advocacy in the care of people with rheumatic and musculoskeletal diseases, such as arthritis.) According to the ACR, diagnosis requires that widespread pain be present for 3 months or more, with pain distributed on both sides of the body, both above and below the waist. In addition, pain must be present in 11 or more of 18 specified tender points (see diagrams).

One symptom of fibromyalgia is on-going pain in 11 or more tender points on the body

People with fibromyalgia will frequently experience one or more of the following symptoms:

• Fatigue
• Irritable Bowel Syndrome
• Difficulty sleeping
• Depression
• Anxiety
• Headaches
• Jaw pain/temporomandibular joint dysfunction
• Cognitive or memory impairment
• Morning stiffness
• Painful menstrual periods
• Numbness or tingling of the arms and legs
• Dizziness or lightheadedness
• Skin sensitivity to soaps and chemicals

A history of viral infection or Lyme Disease is common in fibromyalgia sufferers. However, a direct cause-and-effect relationship has not been established.

There is no test for fibromyalgia. Blood tests may be used to rule out other causes of pain and fatigue.  It is estimated that around 2% of the United States population meets criteria for fibromyalgia, though not all seek treatment. Approximately 80% of fibromyalgia sufferers are women.

Is there treatment?

When a disease is well understood, treatments can be developed based on the cause. With a syndrome such as fibromyalgia, for which the cause is unclear, effective treatments are identified through trial and error. Often, drugs used to treat other disorders are found to be helpful in reducing the symptoms of fibromyalgia. This is true of antidepressants, especially a family of medications called tricyclic antidepressants, several of which have proven effective for fibromyalgia symptoms. Another family of antidepressants, called selective serotonin reuptake inhibitors, also have benefits. A muscle relaxant called cyclobenzaprine, chemically related to the tricyclic antidepressants, has been helpful, as well. Other muscle relaxants have produced no benefit when compared to a sugar pill. Tramadol, a pain reliever, effectively suppresses symptoms in some sufferers. Other pain medicines, including hydrocodone (found in Vicodin) and oxycodone (Percocet, OxyContin) have been less helpful. Nonsteroidal anti-inflammatory medications such as ibuprofen (Motrin, Advil) and naprosyn (Aleve) have not been very effective for pain associated with fibromyalgia.

The most consistently effective treatment for fibromyalgia identified thus far is exercise. Exercise may be painful for some sufferers, but generally produces an improvement in the individual’s level of energy and ability to function.  Less traditional therapies, such as acupuncture, are helpful for some people.

Of those people who meet criteria for fibromyalgia, it is estimated that about one half of all children and one fifth to one third of adults will recover completely. The remainder will experience waxing and waning symptoms.

If you are concerned that you or someone you know may be suffering with fibromyalgia, see your health care provider to determine if there may be other causes for your symptoms, and to help guide your treatment.

For more information or to schedule an appointment with Dr. Bassett, Southside Medical Clinic, Eau Claire, call 715.830.9990 or visit www.southsidemedicalclinic.com