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Fibromyalgia strikes people down with a chronic, body-wide pain and tenderness that is unrelenting. The pain is poorly localized, severe, and has a significant impact on daily living.
Many sufferers also have other symptoms such as fatigue, anxiety, depression, trouble sleeping, and difficulties with remembering and thinking. Stress may exacerbate the condition. It occurs most commonly in women, with a ratio of 9:1, and is more common in young to middle-aged women. However, fibromyalgia can occur in any sex and at any age.
The cause of fibromyalgia is unknown. Researchers believe it may be due to abnormalities with central pain processing. The difficulty with recognizing fibromyalgia is that it is a diagnosis of exclusion — meaning it is only diagnosed once other causes of chronic pain and fatigue have been ruled out.
Understanding the Signs and Symptoms
Fibromyalgia occurs in about two to five percent of the general population. However, it occurs in 20 percent or more of patients with degenerative or inflammatory rheumatic conditions — those involving generalized pain of the muscles, tendons, joints, bones or nerves. In addition, fibromyalgia occurs in about 50 percent of patients with the autoimmune condition systemic lupus erythematosus (SLE, or simply, lupus).
It is thought that an illness or trauma may trigger the onset of fibromyalgia. The illness may act as the initial or ongoing source of pain that precipitates malfunction of the central pain pathways.
Other conditions that commonly occur together with fibromyalgia are musculoskeletal, infectious, metabolic and psychiatric conditions. The symptoms of these concurrent diseases can cause symptoms that mimic fibromyalgia, which can make fibromyalgia difficult to recognize.
The primary symptom of fibromyalgia is chronic, widespread pain and tenderness that won’t go away. The pain is not localized to one area. Doctors use a number of criteria to diagnose fibromyalgia:
- Persistent widespread pain and tenderness that occurs for most of the day
- The pain has been present for more than three months
- The pain occurs on both sides of the body, above and below the waist, and over the spine
- The pain gets worse when the area is pressed or touched by hot or cold objects
- 19 different areas of the body are pressed to assess for the presence of pain and severity: Shoulder, shoulder girdle, hip, jaw, upper and lower arms, upper and lower legs, upper and lower back, chest, neck, and abdomen (all areas are tested on both sides of the body)
Other symptoms often occur and may be present to varying degrees and not in every patient. Such symptoms include:
- Pain, stiffness or fatigue that worsens with exercise or unaccustomed activity
- Sensitive legs and bruising
- Muscle spasms, headaches and abdominal pain
- Sleep problems — difficulty with falling or staying asleep, waking too early, or waking feeling unrefreshed
- Thinking problems — slow thinking, problems with concentration, short-term memory loss
All symptoms affect quality of life. To classify as fibromyalgia, there must generally be at least seven areas of the body that have moderate pain on touching or three to six areas with severe pain. The presence of other symptoms, such as fatigue, thinking impairment, depression and unrefreshed sleep are also taken into account.
Fibromyalgia is a difficult disease to recognize. It is diagnosed based on symptoms and after excluding other diseases that might explain the symptoms.
For this reason, your doctor may want to conduct blood tests. They might be aimed at ruling out inflammatory or autoimmune diseases, hypothyroidism (underactive thyroid) or low vitamin D, vitamin B12, iron, and magnesium levels. All these conditions can cause varying degrees of diffuse muscle pain and fatigue.
It can be a challenge; once other diseases have been ruled out or treated, you may be left with the debilitating condition that is fibromyalgia. For those that are suffering, management is focused is on improving quality of life and day-to-day functioning rather than in completely eliminating the pain.