| What
Is 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.
How
Many People Have Fibromyalgia?
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.
What
Causes Fibromyalgia?
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.
How
Is Fibromyalgia Diagnosed?
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.
How
Is Fibromyalgia Treated?
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.
What
Research Is Being Conducted on Fibromyalgia?
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.
|
