Fibromyalgia is a chronic disorder characterized by widespread pain in the muscles and joints that is often associated with 18 "tender points" of the body. Common tender points include:
- both sides of the back of the head
- both sides of the neck
- shoulder blades
- top of each shoulder
- both sides of the upper chest
- outside of each elbow
- both sides of the hips
- inner knees
Many fibromyalgia symptoms overlap with other conditions. Other than pain in the tender points, symptoms also include profound fatigue, cognitive problems, sleep disturbances, and anxiety. Symptoms are thought to be triggered by emotional stress, physical trauma, or an illness. There may also be a genetic factor.
According to the National Fibromyalgia Association (NFA), the condition affects between 3 and 6 percent of the worldwide population and is usually diagnosed between the ages of 20 and 50. Women are much more likely to develop the disorder than men; the NFA states somewhere between 75 and 90 percent of fibromyalgia patients are women.
Fibromyalgia is often difficult to diagnose; there are no lab tests or imaging techniques for it, and there's a whole host of other conditions that may produce similar symptoms.
According to a 1990 report from the American College of Rheumatology (ACR), a fibromyalgia diagnosis was considered if both of the following were true:
- you experience constant pain in all four quadrants of the body (left and right sides, above and below the waist) for at least three consecutive months
- you have tenderness in at least 11 of the 18 tender points associated with fibromyalgia
New Diagnostic Criteria
In May 2010 the ACR published an update to the diagnostic criteria that decreased the significance of the tender point test and proposed a process involving a widespread pain index and a symptom severity score. The pain index involves a checklist of 19 areas of the body, and the severity score is calculated based on how the patient rates symptoms unrelated to pain (such as fatigue and cognitive problems) on a scale from 0 to 3. The scores a patient receives on those two tests are considered in diagnosing fibromyalgia.
There isn't a cure for fibromyalgia, but treatments help to decrease pain, improve muscle and joint function, and reduce other symptoms.
There are several drugs used to treat fibromyalgia, and making lifestyle changes can effectively reduce stress and improve sleep, both of which can help to relieve symptoms.
Other treatments include:
- Psychological counseling
- Physical and occupational therapy
- Tender point injections