Fibromyalgia is a syndrome characterized by chronic pain, stiffness, and tenderness of muscles, tendons, and joints without detectable inflammation. It affects an estimated 3 to 6 million Americans. Fibromyalgia is the second most common disorder seen by rheumatologists. It predominantly affects women at a rate of 3.4%, and less commonly, men at 0.5%, children at 1.2% to 6.2%, and the elderly. Prevalence increases with age, and diagnosis is most common between ages 60 and 79, although symptoms are often present years prior to diagnosis. It can occur independently or can be associated with another rheumatic disease, such as systemic lupus or rheumatoid arthritis.
Although chronic, widespread body pain is the primary symptom of fibromyalgia, a variety of other symptoms are common. Approximately 90% experience trouble sleeping. Other symptoms include: problems with cognitive functioning, irritable bowel syndrome, headaches and migraines, anxiety and depression, and environmental sensitivities.
The 2010 American College of Rheumatology (ACR) fibromyalgia diagnostic criteria admits the importance of tender points, but reduces their role in diagnosis. Diagnosis now involves both a checklist of 19 potential areas of pain in the body (the widespread pain index, or WPI) and severity of symptoms (SS) in 4 categories unrelated to pain, including fatigue and cognitive problems. If for 3 months, either the WPI score has been greater than 7 (out of 19) and the SS score has been greater than 5, OR the WPI score has been between 3 and 6 and the SS score has been greater than 9, then fibromyalgia can be diagnosed. Other disorders that could otherwise explain the pain must also be ruled out to make a diagnosis.
Because symptoms vary among patients, treatment programs must be personalized. Treatment programs are most effective when they combine patient education, stress reduction, regular exercise, and drug therapy.
Alternative therapies, such as massage, myofascial release, acupuncture, chiropractic adjustment, herbal supplements, and yoga can be effective tools in managing fibromyalgia symptoms. Home remedies can also be effective in reducing pain; heat, especially moist heat, can ease pain and stiffness by boosting blood flow. Cold packs can also reduce deep muscle pain.
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Fibromyalgia is a syndrome characterized by chronic pain, stiffness, and tenderness of muscles, tendons, and joints without detectable inflammation. It affects an estimated 3 to 6 million Americans. View this slideshow to learn more about diagnosis and management of this challenging condition.