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Questions About Fibromyalgia
Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain,
fatigue, and multiple tender points. "Tender points" refers to tenderness that
occurs in precise, localized areas, particularly in the neck, spine, shoulders, and hips.
People with this syndrome may also experience sleep disturbances, morning stiffness,
irritable bowel syndrome, anxiety, and other symptoms.
According to the American College of Rheumatology, fibromyalgia affects 3 to 6 million
Americans. It primarily occurs in women of childbearing age, but children, the elderly,
and men can also be affected.
Although the cause of fibromyalgia is unknown, researchers have several theories about
causes or triggers of the disorder. Some scientists believe that the syndrome may be
caused by an injury or trauma. This injury may affect the central nervous system.
Fibromyalgia may be associated with changes in muscle metabolism, such as decreased blood
flow, causing fatigue and decreased strength. Others believe the syndrome may be triggered
by an infectious agent such as a virus in susceptible people, but no such agent has been
identified.
Top
Fibromyalgia is difficult to diagnose because many of the symptoms mimic those of other
disorders. The physician reviews the patient's medical history and makes a diagnosis of
fibromyalgia based on a history of chronic widespread pain that persists for more than 3
months. The American College of Rheumatology (ACR) has developed criteria for fibromyalgia
that physicians can use in diagnosing the disorder. According to ACR criteria, a person is
considered to have fibromyalgia if he or she has widespread pain in combination with
tenderness in at least 11 of 18 specific tender point sites.
Treatment of fibromyalgia requires a comprehensive approach. The physician, physical
therapist, and patient may all play an active role in the management of fibromyalgia.
Studies have shown that aerobic exercise, such as swimming and walking, improves muscle
fitness and reduces muscle pain and tenderness. Heat and massage may also give short-term
relief. Antidepressant medications may help elevate mood, improve quality of sleep, and
relax muscles. Patients with fibromyalgia may benefit from a combination of exercise,
medication, physical therapy, and relaxation.
The NIAMS is sponsoring research that will increase understanding of the
specific abnormalities that cause and accompany fibromyalgia with the hope of developing
better ways to diagnose, treat, and prevent this disorder.
Recent NIAMS studies show that abnormally low levels of the hormone
cortisol may be associated with fibromyalgia. At Brigham and Women's Hospital in Boston,
Massachusetts, and at the University of Michigan Medical Center in Ann Arbor, researchers
are studying regulation of the function of the adrenal gland (which makes cortisol) in
fibromyalgia. People whose bodies make inadequate amounts of cortisol experience many of
the same symptoms as people with fibromyalgia. It is hoped that these studies will
increase understanding about fibromyalgia and may suggest new ways to treat the disorder.
NIAMS research studies are looking at different aspects of the disorder.
At the University of Alabama in Birmingham, researchers are concentrating on how specific
brain structures are involved in the painful symptoms of fibromyalgia. At George
Washington University in Washington, DC, scientists are investigating the causes of a
post-Lyme disease syndrome as a model for fibromyalgia. Some patients develop a
fibromyalgia-like condition following Lyme disease, an infectious disorder associated with
arthritis and other symptoms.
NIAMS-supported research on fibromyalgia also includes several projects at
the Institute's Multipurpose Arthritis and Musculoskeletal Diseases Centers. Researchers
at these centers are studying individuals who do not seek medical care, but who meet the
criteria for fibromyalgia. (Potential subjects are located through advertisements in local
newspapers asking for volunteers with widespread pain or aching.) Other studies at the
Centers are attempting to uncover better ways to manage the pain associated with the
disorder through behavioral interventions such as relaxation training.
In March 1998, NIAMS and several other NIH institutes and offices issued a
Request for Proposals to promote research studies of fibromyalgia. As a result of this
request, NIAMS and its partners recently funded 15 new fibromyalgia projects totaling more
than $3.6 million.
The NIAMS supports and encourages outstanding basic and clinical research
that increases the understanding of fibromyalgia. However, much more research needs to be
done before fibromyalgia can be successfully treated or prevented.
The Federal Government, in collaboration with researchers, physicians, and
private voluntary health organizations, is committed to research efforts that are directed
at significantly improving the health of all Americans afflicted with fibromyalgia.
NIAMS-supported research on fibromyalgia also includes several projects in the
Institute's Multipurpose Arthritis and Musculoskeletal Diseases Centers. Researchers at
these centers are studying individuals who do not seek medical care, but who meet the
criteria for fibromyalgia. (Potential subjects are located through advertisements in local
newspapers asking for volunteers with widespread pain or aching.) Other studies at the
Centers are attempting to uncover better ways to manage the pain associated with the
disease through behavioral interventions such as relaxation training.
The NIAMS supports and encourages outstanding basic and clinical research that
increases the understanding of fibromyalgia. However, much more research needs to be done
before fibromyalgia can be successfully treated or prevented.
The Federal Government, in collaboration with researchers, physicians, and private
voluntary health organizations, is committed to research efforts that are directed to
significantly improving the health of all Americans afflicted with fibromyalgia.
Where Can People
Get More Information About Fibromyalgia?
This is the main voluntary organization devoted to all forms of arthritis.
The Foundation publishes a pamphlet on fibrositis. Single copies are free with a
self-addressed stamped envelope. The Foundation also can provide physician referrals.
Fibromyalgia Network
P.O. Box 31750
Tucson, AZ 85751-1750
800/853-2929
Contact: Ms. Kristin Thorson
Fibromyalgia Partnership (formerly Fibromyalgia Association of Greater
Washington)
140 Zinn Way
Linden, VA 22642-5609
(toll free) 866/725-4404
Fax: 540-622-2998
World Wide Web address: http://www.fmpartnership.org
National Fibromyalgia Awareness Campaign (NFAC)
2415 N. River Trail Road, Suite 200
Orange, CA 92865
714/921-0150
Fax: 714/921-8139
These are the main organizations devoted to fibromyalgia. They publish
newsletters and provide pamphlets on the disease.
The mission of the National Institute of Arthritis and Musculoskeletal and
Skin Diseases (NIAMS), a part of the National Institutes of Health (NIH), is to support
research into the causes, treatment, and prevention of arthritis and musculoskeletal and
skin diseases, the training of basic and clinical scientists to carry out this research,
and the dissemination of information on research progress in these diseases. The National
Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse is
a public service sponsored by the NIAMS that provides health information and information
sources. Additional information can be found on the NIAMS Web site at http://www.niams.nih.gov/.
Reprinted with the permission of:
National Institute of Arthritis and Musculoskeletal and Skin Diseases
NIAMS/National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Publication Date December, 1999
The National Arthritis and
Musculoskeletal and Skin Diseases Information Clearinghouse (NAMSIC) is a public service
sponsored by the NIAMS that provides health information and information sources. The
NIAMS, a part of the National Institutes of Health (NIH), leads the Federal medical
research effort in arthritis and musculoskeletal and skin diseases. The NIAMS sponsors
research and research training throughout the United States as well as on the NIH campus
in Bethesda, MD, and disseminates health and research information. |
