What is FMS?
Fibromyalgia syndrome is a widespread musculoskeletal pain and fatigue disorder. The name refers to pain in the fibrous tissues of the body and the muscles, tendons and ligaments. It affects people of all ages, but is more common in women. Most patients report aching all over, muscles that feel pulled or overworked, and may experience twitching, burning or tingling sensations. Specific symptoms and their severity fluctuate from person to person.
How is FMS Diagnosed?
Routine lab tests usually reveal nothing. However, a physical exam reveals sensitivity to certain areas of the body referred to as tender points. To meet the diagnostic criteria established in 1990 (see the February 1990 issue of Arthritis and Rheumatism) patients must have widespread pain in all four quadrants of their body for at least three months and at least 11 of the 18 specified tender points. Roughly 75% of CFIDS patients meet the criteria for FMS.
Symptoms and Associated Syndromes
Symptoms include pain (often worse in the morning and in muscle groups that are used repetitively); fatigue (mild in some and incapacitating in others, includes cognitive fatigue/dysfunction); and sleep disorder (usually an alpha-EEG anomaly in which deep level sleep is disrupted). Many fibromyalgia patients also experience sleep apnea, sleep myoclonus, restless leg syndrome, irritable bowel syndrome, chronic headaches, and temporomandibular joint dysfunction. Other symptoms may include PMS, chest pain, morning stiffness, memory impairment, irritable bladder, dry eyes and mouth, eye trouble, dizziness, and impaired coordination.
What causes FMS?
The cause is unknown, but there are many possible triggering events, such as infection (viral or bacterial), an automobile accident, or the development of another disorder like rheumatoid arthritis, lupus or hypothroidism. These triggering events probably don't cause fibromyalgia, but they may awaken an underlying physiological abnormality that's already present.
How is FMS treated?
Traditional treatments are geared toward improving the quality of sleep and reducing pain. Since deep level sleep is critical for many body functions, the sleep disorder is thought to be a major contributing factor to the symptoms of this condition. Medicines that raise your body's level of serotonin and norepinephrine and transmitters that modualte sleep, pain and immune function and are commonly prescribed. Examples of such drugs include Elavil, Flexeril, Sinequan, Paxil, Xanax, and Klonopin. Most patients have drug sensitivities, so starting with a very low dose, then increasing, is important. Nonsteriodal, anti-inflammatory drugs (NSAIDS) like ibuprofen may be helpful. Other treatments have proven beneficial. These include trigger point injections with lidocaine, physical therapy, acupuncture, acupressure, osteopathic manipulation, chiropractic care, therapeutic massage, or a gentle exercise program.
What is the Prognosis?
Long term follow-up studies have shown that it is chronic, that the symptoms wax and wane. The impact of the illness on one's life differs greatly among patients. Overall, studies have shown that FM can be a disabling as rheumatoid arthritis.
This information is based on the brochure "Fibromyalgia Syndrome", published by the Fibromyalgia Network. The brochure is included in our new member packet.