Jenny L. F. Andrus, MD
Fibromyalgia syndrome (FMS) is a chronic pain condition that causes pain all over the body. Often patients will say that they hurt from head to toe. Some of the areas may be more painful than others with patients often reporting higher levels of low back or neck pain. This “all over” pain is expressed as tenderness to touch or pressure. Other symptoms include fatigue, poor sleep or waking feeling unrefreshed and problems thinking clearly, known as “fibro fog”.
FMS is more of a descriptive diagnosis. This means that the diagnosis is based on how the patient feels as opposed to what is exactly causing the symptoms. The diagnosis is made based on your explanation of your symptoms and physical exam. There is no confirmation test; however, this is a diagnosis of exclusion. That means other causes of pain, such as rheumatoid disease, will need to be ruled out. Blood tests, diagnostic imaging, such as x-rays, and nerve testing may be done to rule out other problems.
The cause of FMS is unclear. Currently, it’s thought that this is most likely a dysfunctional central nervous system problem. This means that the central nervous system may be inappropriately sending a higher volume of pain sensation to the brain. There also may be a genetic predisposition. There are also indications that someone with a history of trauma and mood disorder may be more predisposed to developing FMS after some triggering event.
Patients with FMS often also have depression, anxiety, migraines, digestive problems like irritable bowel syndrome, overactive bladder, pelvic pain and TMJ. Because of the overlap in these problems, the treatments often overlap as well. Non-drug therapies are very important and include exercise and psychological therapy. Some medications may help ease symptoms or improve sleep.
Although distressing, FMS is not life threatening. It can be managed well with a combination of non- drug and pharmacological treatments. Lifestyle modifications are the best treatments and include stress reduction, establishing good sleep hygiene resulting in restful sleep and frequent gentle exercise.
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