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FIBROMYALGIA SYNDROME (FMS)
Fibromyalgia Syndrome (FMS) is a body wide musculoskeletal
pain disorder for which the cause is still unknown. Fibromyalgia means pain in the
muscles, ligaments and tendons--the fibrous tissues in the body. FMS was once called
Fibrositis, implying that inflammation in the muscles exists, but research has not proved
inflammation to be present.
Most patients with Fibromyalgia complain of aching all over. Muscles may feel like they
have been pulled or overworked and they may twitch and/or burn. FMS affects people of all
ages, but it is found more often in women.
While the severity of symptoms fluctuate from person to person, FMS may resemble a
post-viral flu state and this is why several experts in the field of FMS and CFS believe
that these two syndromes are one and the same.
SYMPTOMS
 | Pain - The pain of FMS is
tremendous. Described as deep muscular aching, burning, throbbing, shooting and stabbing.
Often, worse in the morning and accompanied by stiffness. Muscle groups that are used
repetitively may be more affected. |
| Fatigue -
This can range from mild to incapacitating. Patients often describe it as a "brain
fatigue" in which patients feel as though their arms and legs are extremely heavy,
they have difficulty concentrating, and totally drained of energy.
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| Sleep disorder - Most FMS patients have unrefreshed sleep. It has been described
by researchers as an associated sleep disorder called the alpha-EEG anomaly. This
condition is often diagnosed in a sleep lab with the aid of a machine which records the
brain waves of patients during sleep. FMS patients were found to be able to fall asleep
without much trouble, but their deep level (or stage 4) sleep was constantly interrupted
by bursts of awake-like brain activity. Thus, when they awaken in the morning, it is as
though they had slept very little. Some FMS patients have been found to have other sleep
disorders, such as sleep myoclonus or PLMS (nighttime jerking of the arms and legs),
restless leg syndrome and bruxism (teeth grinding). |
| Irritable Bowel Syndrome - FMS
patients have reported frequent constipation, diarrhea, frequent abdominal pain, abdominal
gas or nausea. |
| Chronic headaches - FMS
patients often report frequent migraine or tension-type headaches. |
| Temporomandibular Joint Dysfunction
Syndrome (TMJD )- The muscles and ligaments surrounding the jaw joints (but, not
necessarily the joint itself) can causes tremendous face and head pain. |
| Multiple Chemical Sensitivity
Syndrome - Sensitivities to odors, noise, bright lights, medications and various
foods is common in FMS. |
| Other common symptoms -
Painful menstrual periods (dysmenorrhea), chest pain, morning stiffness, cognitive or
memory impairment, numbness and tingling sensations, muscle twitching, irritable bladder,
the feeling of swollen extremities, skin sensitivities, dry eyes and mouth, frequent
changes in eye prescription, dizziness, and impaired coordination can occur.
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| Aggravating factors - Changes in weather, cold or drafty environments, hormonal
fluctuations (premenstrual and menopausal states), stress, depression, anxiety and
over-exertion can all contribute to symptom flare-ups.
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CAUSE
The cause of FMS is not known, but there are many triggering events thought to
precipitate its onset. An infection (viral or bacterial), an automobile accident or the
development of another disorder, such as rheumatoid arthritis, lupus, or hypothyroidism
may predate the onset of FMS.
These triggering events may not cause FMS, but they may awaken an underlying
pathophysiological weakness or abnormality that's already present. Some believe that a
person may have a genetic predisposition for FMS.
DIAGNOSIS
Routine laboratory tests often reveal nothing abnormal. However, upon physical
examination, the FMS patient will be sensitive to pressure in certain areas of the body
called tender points.
| To meet the diagnostic criteria for FMS,
patients must have:
 | Widespread pain in all four quadrants of their body for a
minimum of three months |
| At least 11 of the 18 specified tender points |
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These 18 tender point sites used for diagnosis cluster around the neck, shoulder, chest,
hip, knee and elbow regions. Over 75 other tender points have been found to exist, but are
not used for diagnostic purposes.
Although the above criteria focuses on tender point count, a consensus of 35 FMS experts
published a report in 1996 saying that a person does not need to have the required 11
tender points to be diagnosed and treated for FMS. This criteria was created for research
purposes and many people may still have FMS with less than 11 of the required tender
points as long as they have widespread pain and many of the common symptoms associated
with FMS.
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