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$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).