Fibromyalgia
(FM; Fibromyalgia Syndrome; FMS)
Definition
| Fibromyalgia Trigger Points |
|
| Copyright © Nucleus Medical Media, Inc. |
Causes
- Depression and anxiety
- Muscle pain
- Chronic headache, such as tension headaches (frequently beginning with neck discomfort)
- Nocturnal myoclonus (moving legs involuntarily during sleep)
- Irritable bowel syndrome (IBS)
- Complex regional pain syndrome
- Substance abuse
- Premenstrual syndrome
- Female urethral syndrome (irritable bladder)
- Raynaud's disease
Risk Factors
- Sex: female
- Age: 20-60 years old
- Physical or mental stress
- Physical trauma (eg, accident, injury, or severe illness)
Symptoms
- Generalized fatigue or tiredness
- Reduced physical endurance
- Generalized aches and pains of muscles, tendons, and ligaments
- Muscle tightening or spasms
-
Pain in specific areas of the body, especially:
- Neck
- Shoulders
- Chest
- Back (upper and lower)
- Hips and thighs
- Insomnia or poor sleep
- Sensations of numbness or swelling (although swelling is not actually present)
- Chronic headaches, including migraines
- Morning stiffness
- Weather changes, especially cold, damp weather
- Stress or anxiety
- Overexertion
- Medical illness
- Surgery
Diagnosis
- Widespread pain lasting three months or longer
- Tenderness (on physical exam) in at least 11 of 18 specific areas of the body
Treatment
Therapy Programs
- Physical therapy (gradual aerobic exercise and stretching)
- Heated pool treatments—Aquatic training in warm water (eg, strength, aerobic, and relaxation exercises)
- Applying heat to painful areas
- Alternative treatments, such as massage, acupuncture, relaxation training, trigger point therapy, biofeedback, and yoga
- Cognitive behavioral therapy (CBT)
Lifestyle Changes
- Eating a healthy diet
- Learning to cope with physical and mental stress
- Maintaining a regular sleep schedule
- Participating in a regular exercise program that includes aerobic activity, strength training, and flexibility exercises. Gentle exercises that may not strain painful areas include walking, biking, and swimming. Talk to your doctor to make sure it is safe for you to start exercising.
Medications
- Antidepressants (eg, amitriptyline, fluoxetine, duloxetine, milnacipran, moclobemide)
- Medicines to relieve pain (eg, acetaminophen, pramipexole, pregabalin, tramadol)
- Sodium oxybate (eg, Xyrem), a central nervous system depressant
RESOURCES
American College of Rheumatology http://www.rheumatology.org/
The American Fibromyalgia Syndrome Association http://www.afsafund.org/
CANADIAN RESOURCES
The Arthritis Society http://www.arthritis.ca/
Fibromyalgia Information and Local Support http://fibromyalgia.ncf.ca/
References
Buckhardt CS, Goldenberg D, Crofford L, et al. Guideline for the management of fibromyalgia syndrome pain in adults and children. Glenview (IL): American Pain Society (APS); 2005. as summarized in National Guideline Clearinghouse 2005;19:7298.
Carville SF, Arendt-Nielsen S, Bliddal H, et al. EULAR evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis . 2008Íž67:536-541.
Fibromyalgia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 10, 2012. Accessed October 11, 2012.
Fibromyalgia. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Fibromyalgia/fibromyalgia%5Fff.asp. Updated July 2011. Accessed October 11, 2012.
Wierville L. Fibromyalgia: diagnosing and managing a complex syndrome. J Am Acad Nurse Pract. 2012;24(4):184-92.
2/17/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Russell IJ, Perkins AT, Michalek JE; Oxybate SXB-26 Fibromyalgia Syndrome Study Group. Sodium oxybate relieves pain and improves function in fibromyalgia syndrome: a randomized, double-blind, placebo-controlled, multicenter clinical trial. Arthritis Rheum. 2009;60:299-309.
4/14/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Munguía-Izquierdo D, Legaz-Arrese A. Assessment of the effects of aquatic therapy on global symptomatology in patients with fibromyalgia syndrome: a randomized controlled trial. Arch Phys Med Rehabil. 2008;89:2250-2257.
4/22/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Sañudo B, Galiano D, Carrasco L, Blagojevic M, de Hoyo M, Saxton J. Aerobic exercise versus combined exercise therapy in women with fibromyalgia syndrome: a randomized controlled trial. Arch Phys Med Rehabil. 2010;91(12):1838-1843.
4/22/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Carson JW, Carson KM, Jones KD, Bennett RM, Wright CL, Mist SD. A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia. Pain. 2010;151(2):530-539.
