$Unique_ID{BRK03742} $Pretitle{} $Title{Fibromyalgia} $Subject{Fibromyalgia Fibromyositis Fibrositis Muscular Rheumatism Musculoskeletal Pain Syndrome Nonarticular Rheumatism Periarticular Fibrositis Rheumatoid Myositis Tension Myalgia Chronic Fatigue Syndrome Polymyalgia Rheumatica Polymyositis Rheumatoid Arthritis Sjogren Syndrome Temporomandibular Dysfunction} $Volume{} $Log{} Copyright (C) 1991 National Organization for Rare Disorders, Inc. 266: Fibromyalgia ** IMPORTANT ** It is possible that the main title of the article (Fibromyalgia) is not the name you expected. Please check the SYNONYMS listing to find the alternate name and disorder subdivisions covered by this article. Synonyms Fibromyositis Fibrositis Muscular Rheumatism Musculoskeletal Pain Syndrome Nonarticular Rheumatism Periarticular Fibrositis Rheumatoid Myositis Tension Myalgia Information on the following diseases can be found in the Related Disorders section of this report: Chronic Fatigue Syndrome Polymyalgia Rheumatica Polymyositis Rheumatoid Arthritis Sjogren Syndrome Temporomandibular Dysfunction General Discussion ** REMINDER ** The Information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Fibromyalgia is a chronic disorder characterized by pain throughout much of the body. The pain may begin gradually or have a sudden onset. Other symptoms are muscle spasms, fatigue, muscle tissue stiffness and non-restorative (unrefreshing) sleep. The exact cause of this disorder is unknown. The terms Fibrositis, Fibromyositis, Periarticular Fibrositis and Rheumatoid Myositis are still being used by many to describe this condition. The ending of "itis" on each of these terms is actually incorrect. "Itis" means inflammation, and there is no inflammation in Fibromyalgia. The term Fibromyalgia has now become the accepted term, but many people continue to be diagnosed with the other synonyms. Tension Myalgia is another synonym that is currently being used. Symptoms Patients with Fibromyalgia may have a gradual or sudden onset of symptoms. The major symptom of this disorder is muscular pain. Areas which are frequently affected may include muscles in the back of the neck and shoulders, in the low back, the sides of the breast bone, and the bony points of the elbows, hips and knees. In addition, small specific areas called tender points, which are painful when pressure is applied, will be found by an examining physician. Other symptoms found in most patients with Fibromyalgia are: muscle spasms, fatigue, muscle stiffness and non-restorative (unrefreshing) sleep. Some patients with fibromyalgia may have chest pain, painful menstrual periods, difficulty concentrating, headaches, painful and/or frequent urination, diarrhea, constipation, numbness, dryness in the eyes and mouth, dizziness, swelling of a tendon (tendinitis), swelling of the connective tissue structure surrounding a joint (bursitis), depression and/or anxiety. Causes The exact cause of Fibromyalgia is not known. Researchers are studying serotonin, a chemical in the brain (neurotransmitter), to see if there is a disturbance in the messages sent between various parts of the central nervous system in people with Fibromyalgia. An imbalance of serotonin could have a hand in the increase of pain, depression and unrefreshing sleep associated with Fibromyalgia. Muscle tissue, hormonal and immunological influences, as well as the possibility of a virus triggering the disorder are all being investigated by researchers. Affected Population Fibromyalgia is diagnosed more frequently in females than in males. The majority of patients with this disorder will develop symptoms between the ages of 20 and 50 years. Fibromyalgia may also develop in children and teenagers, often being misdiagnosed as "growing pains". Related Disorders Symptoms of the following disorders can be similar to those of Fibromyalgia. Comparisons may be useful for a differential diagnosis: Chronic Fatigue Syndrome is a controversial disorder that is characterized by extreme fatigue that occurs after the abrupt onset of a flu-like illness. Symptoms may include muscle aches, a low grade fever, sore throat or swollen glands. The fatigue must persist for at least six months and must significantly limit daily activity. (For more information on this disorder, choose "Chronic Fatigue" as your search term in the Rare Disease Database). Polymyalgia Rheumatica is a disorder characterized by pain and stiffness in certain muscle groups without causing permanent weakness or atrophy. The major symptoms of this disorder are pain and stiffness in the neck, shoulders, upper arms, lower back, hips and thighs. The symptoms often appear suddenly and the stiffness is most severe in the morning. The pain of PMR is felt on both sides of the body. Fever, lack of appetite, fatigue, weight loss and depression may also be present. (For more information on this disorder, choose "Polymyalgia" as your search term in the Rare Disease Database). Polymyositis is a systemic connective tissue disorder characterized by inflammatory and degenerative changes in the muscles, leading to weakness and some degree of muscle atrophy. The areas principally affected are the hip, shoulders, arms, pharynx and neck. Other symptoms of Polymyositis may include fever, weight loss and occasional pain or tenderness in muscles or joints. The exact cause of this disorder is not known. (For more information on this disorder, choose "Polymyositis" as your search term in the Rare Disease Database). Rheumatoid Arthritis is an inflammatory autoimmune disease in which the body's natural defenses against foreign agents (antibodies & lymphocytes) attack healthy joints. This disorder is characterized by a lack of appetite, fatigue, painful and deformed joints, early morning stiffness chiefly in the hands, knees, feet, jaw and spine. (For more information on this disorder, choose "Arthritis" as your search term in the Rare Disease Database). Sjogren Syndrome is a degeneration of the mucous secreting glands, particularly the tear and saliva glands. It is sometimes associated with arthritis. There is often a gritty, burning sensation in the eyes due to the loss of lubrication. When the mouth becomes dry, chewing and swallowing food is difficult. The lack of saliva causes particles of food to stick to the cheeks, gums and throat. Other symptoms of Sjogren Syndrome include a weak voice, dental decay, sensitivity of the eyes to the light, swelling of the salivary glands, and dryness of the nose, skin and vagina. Fibromyalgia may occur in conjunction with Sjogren's Syndrome. (For more information on this disorder choose "Sjogren" as your search term in the Rare Disease Database). Temporomandibular Joint Dysfunction (TMJ) is a painful disorder of the jaw joint which is made worse during or after eating or yawning. This disorder may cause limited jaw movement and clicks and pops during chewing. In severe cases pain may radiate into the neck, shoulders and back, mimicking the pain of Fibromyalgia. (For more information on this disorder choose "Temporomandibular Joint Dysfunction" as your search term in the Rare Disease Database). Therapies: Standard Fibromyalgia may be treated with low doses of tricyclic antidepressant medications. Amitriptyline (Elavil) and Cyclobenzaprine (Flexeril), which are prescribed as muscle relaxants, may be helpful. They may also help patients who suffer from unrefreshing (non-restorative) sleep. The tricyclic antidepressant amitriptyline (Elavil) can also be used to help patients with this disorder who have depression. When Elavil is used for this reason it is given at higher dosages. Some patients receive temporary help with such things as stretching exercises, deep heat treatments, warm showers and baths, whirlpool baths and hot tubs, heating pads, massages, ice packs, acupuncture, biofeedback and/or aerobic exercise. Therapies: Investigational The antidepressant fluoxetine (Prozac) is currently being studied as a treatment for patients with Fibromyalgia. Prozac does not cause drowsiness like other antidepressants. More research is needed to determine long-term safety and effectiveness of Prozac for this disorder. This disease entry is based upon medical information available through October 1991. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on Fibromyalgia, please contact: National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 Fibromyalgia Association of Central Ohio Riverside Methodist Hospitals North Medical Bldg., Suite 8 3545 Olentangy River Road Columbus, Ohio 43214 (614) 262-2000 Arthritis Foundation 1413 Spring Street, N.W. Atlanta, GA 30309 (404) 872-7100 The National Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse Box AMS Bethesda, MD 20892 (301) 495-4484 Ontario Fibromyalgia Assoc. 250 Bloor St., East, Suite 901 Toronto, Ontario, M4W 3P2 References CECIL TEXTBOOK OF MEDICINE, 19th Ed.: James B. Wyngaarden, and Lloyd H. Smith, Jr., Editors; W.B. Saunders Co., 1990. P. 2048. Fibromyalgia: Mary Anne Saathoff BSN, Fibromyalgia Association of Central Ohio (1991).