Fibromyalgia (FM) is a chronic condition causing pain in muscles, tendons, and ligaments. In FM, specific places in the body where pain is felt are called tender points.
The cause is unknown, but it is not thought to be an infection or a hereditary problem. Possibilities include poor sleep, certain chemicals called serotonin and substance P, muscle abnormalities, and stress hormones.
FM can occur in both men and women but is most common in women aged between 20 and 50 and is also common in women older than 60.
Pain and fatigue are the main symptoms and can affect activities at work and home.
Pain is usually worse in the upper back and neck and the lower back and hips. Pain can occur near any tender point, however.
Fatigue can be severe. Headaches, numbness or tingling in the hands or feet, and forgetfulness are other symptoms.
A health care provider uses a medical history and an examination of joints and muscles for diagnosis. For a diagnosis of FM, the health care provider must find at least 11 of the 18 tender points.
Laboratory tests and x-rays may be done to rule out other diseases causing similar symptoms. Blood tests and x-rays are usually normal in fibromyalgia.
No cure exists for FM, but people with FM can feel better with treatment. Medicines, exercise, reducing stress, and improving sleep to reduce fatigue can help people feel better.
Medications can improve the amount and quality of sleep. Interrupted sleep prevents people from reaching the deepest sleep, but medicines can help them reach this deeper stage of sleep. As a result, pain decreases. The most common medicines include antidepressants (e.g., milnacipran, amitriptyline, duloxetine). Common side effects include grogginess, dry mouth, constipation, and weight gain.
Exercises help reduce pain. Stretching and posture exercises should be done daily for good body alignment and to prevent pain. Endurance exercises should be done three or four times a week; these include walking, biking, and water therapy. It is important to begin to exercise slowly and to increase gradually.
Often people with FM forget how to relax. A counselor can offer relaxation therapy as well as family counseling to see whether depression or family or financial problems are contributing to FM.
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