• Fibromyalgia

    (FM; Fibromyalgia Syndrome; FMS)

    Definition

    Fibromyalgia is a complex, chronic, and disabling disorder. It causes widespread pain. It also causes poor sleep and fatigue.
    Fibromyalgia Trigger Points
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    Causes

    The exact cause of fibromyalgia is unknown. It may be related to abnormal processing of pain.
    Conditions that are commonly associated with fibromyalgia include:

    Risk Factors

    Fibromyalgia is more common in women, and in people aged 20-60 years old. Physical or mental stress may also increase your chance of getting fibromyalgia.

    Symptoms

    Symptoms and severity of fibromyalgia are different for everyone.
    Fibromyalgia may cause:
      Generalized pain and tenderness that can:
      • Be moderate to severe
      • Feel stabbing, shooting, achy, or throbbing
      • Be widespread and chronic
      • Be associated with muscle twitching
    • Fatigue
    • Weakness
    • Poor sleep
    • Reduced physical endurance
    • Problems with concentration, thought, or memory
    • Sensitivity to noises, light, or odors
    Factors that may trigger or worsen symptoms include:
    • Physical injury
    • Weather changes, especially cold, damp weather
    • Stress or anxiety
    • Overexertion
    • Medical illness
    • Surgery

    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done. Diagnosis is usually based on reported symptoms and tenderness in specific areas of the body during the physical exam.
    Fibromyalgia is usually diagnosed when pain or tenderness is present in more than 7 locations and consistent for more than 3 months.

    Treatment

    The goal of treatment is to relieve or control the symptoms. Talk with your doctor about the best treatment plan for you. Options include:

    Therapy Programs

    Lifestyle Changes

    Your doctor may also recommend that you make lifestyle changes, such as:
    • Eat a healthy diet .
    • Learn to cope with physical and mental stress.
    • Maintain a regular sleep schedule.
    • Participate in a regular exercise program that includes aerobic activity, strength training, and flexibility exercises. Gentle exercises that may not strain painful areas include walking, biking, and swimming. Talk to your doctor to make sure it is safe for you to start exercising.

    Medications

    Your doctor may recommend the following to help manage symptoms:
    • Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs)
    • Antidepressants
    • Anticonvulsants
    • Sedatives
    • Muscle relaxants
    • Opioids—if not relieved by other treatments

    Prevention

    There are no current guidelines to prevent fibromyalgia.

    RESOURCES

    American College of Rheumatology http://www.rheumatology.org

    The American Fibromyalgia Syndrome Association http://www.afsafund.org

    CANADIAN RESOURCES

    The Arthritis Society http://www.arthritis.ca

    Fibromyalgia Information and Local Support http://fibromyalgia.ncf.ca

    References

    About fibromyalgia. National Fibromyalgia Association website. Available at: http://www.fmaware.org/about-fibromyalgia. Accessed May 6, 2016.

    Buckhardt CS, Goldenberg D, Crofford L, et al. Guideline for the management of fibromyalgia syndrome pain in adults and children. Glenview (IL): American Pain Society (APS); 2005. as summarized in National Guideline Clearinghouse 2005;19:7298.

    Carville SF, Arendt-Nielsen S, Bliddal H, et al. EULAR evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis. 2008;67:536-541.

    Fibromyalgia. American College of Rheumatology website. Available at: http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Fibromyalgia. Updated May 2015. Accessed May 6, 2016.

    Fibromyalgia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116339/Fibromyalgia. Updated September 18, 2016. Accessed September 28, 2016.

    Fibromyalgia. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Fibromyalgia/default.asp. Updated July 2014. Accessed May 6, 2016.

    Wierville L. Fibromyalgia: diagnosing and managing a complex syndrome. J Am Acad Nurse Pract. 2012;24(4):184-92.

    2/17/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116339/Fibromyalgia: Russell IJ, Perkins AT, Michalek JE; Oxybate SXB-26 Fibromyalgia Syndrome Study Group. Sodium oxybate relieves pain and improves function in fibromyalgia syndrome: a randomized, double-blind, placebo-controlled, multicenter clinical trial. Arthritis Rheum. 2009;60:299-309.

    4/14/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116339/Fibromyalgia: Munguía-Izquierdo D, Legaz-Arrese A. Assessment of the effects of aquatic therapy on global symptomatology in patients with fibromyalgia syndrome: a randomized controlled trial. Arch Phys Med Rehabil. 2008;89:2250-2257.

    4/22/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116339/Fibromyalgia: Sañudo B, Galiano D, Carrasco L, Blagojevic M, de Hoyo M, Saxton J. Aerobic exercise versus combined exercise therapy in women with fibromyalgia syndrome: a randomized controlled trial. Arch Phys Med Rehabil. 2010;91(12):1838-1843.

    4/22/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116339/Fibromyalgia: Carson JW, Carson KM, Jones KD, Bennett RM, Wright CL, Mist SD. A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia. Pain. 2010;151(2):530-539.

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