Fibromyalgia (previously called fibrositis) is a chronic condition involving:[1, 2]
Extreme fatigue
Pain in connective tissue, including the muscles, ligaments, and tendons
Multiple areas of tenderness of tissue called tender points (i.e., regions where pain results from even slight pressure)
Approximately 3 million to 6 million people in the United States have fibromyalgia.[2] An estimated 80% to 90% of the people with fibromyalgia are women. Although the onset of fibromyalgia is more common in young adults or in midlife, fibromyalgia can occur in children.
Scientists have theorized that the onset or a flare-up of fibromyalgia may be caused by various environmental, physical, and mental factors, including:[1-3]
Exposure to cold or dampness
Hereditary predisposition, although no specific gene has been identified
An overly acidic pH of the blood that can result from eating inflammatory types of foods, having chronic stress, and/or having other chronic conditions
Alterations in blood flow, substances affecting the activity of nerves that regulate muscle action, and/or metabolism inside muscle cells
Traumatic injury, especially in the upper portion of the spinal area, may have consequences on the function of the central nervous system
Physical stress
Insufficient sleep, including presence of sleep disorders (e.g., sleep apnea)
Abnormalities in the regulation of neurotransmitters, a type of chemical produced by the brain. Neurotransmitters (such as serotonin and substance P) can affect emotions, stress, the function of certain organs, and pain. Some people with fibromyalgia have lower levels of serotonin in their bodies.
Abnormal function of the parts of the nervous system that control involuntary functions of the body
Deficiency in or resistance to thyroid hormone
Leaky gut syndrome
Bacterial, mycoplasmal, yeast (Candida), or viral infections
A state of inflammation in the body, which can result in the immune system operating in an aberrant way.
Abnormal function of the immune system
Presence of rheumatic disease (e.g., autoimmune diseases such as rheumatoid arthritis or lupus)
Unresolved psychological issues that cause continued stress
Although the exact cause of fibromyalgia is not known, many scientists believe that fibromyalgia is a type of autoimmune disorder (i.e, a class of conditions in which the immune system attacks certain tissue or certain cells within the body), resulting in inflammation of connective tissue.[1, 3] For example, the levels of certain inflammatory molecules produced by the body may be increased in fibromyalgia patients. Some scientists think that fibromyalgia may be related in its causes and symptoms to another autoimmune disease, chronic fatigue syndrome (CFS).
Symptoms of fibromyalgia vary in individuals. The most common symptoms include: [1, 2]
Chronic, extreme fatigue and the presence of widespread flu-like symptoms (e.g., aching pain in the body) lasting at least 6 months. Mild to severe aching or burning pain occurs in muscles, ligaments, and tendons. Multiple tender points on the body are present. Pain worsens with physical activity and exhaustion.
Muscular stiffness that may appear upon awakening and worsens with remaining in one position for a prolonged period, physical activity, exhaustion, or changes in weather
Headaches and pain in the face, jaw (temporomandibular joint dysfunction; abbreviated TMJ dysfunction), neck, back of the head, and shoulders, which are some of the possible tender points
Pain in the muscles of the upper chest, one of the possible tender points
Pain in the limbs, including the following possible tender points: the elbows, hips, and knees. Some people experience muscle spasms (restless legs syndrome during waking hours and/or nighttime muscle spasms) in their legs.
Pain in the abdomen and gastrointestinal (GI) problems associated with irritable bowel syndrome (IBS), "leaky gut" syndrome, or insufficient production of enzymes by the pancreas. Symptoms include bloating, constipation, and diarrhea.
Disturbed sleep, including having a difficult time falling asleep, remaining asleep, and/or waking up refreshed (even if sufficient time was allowed for sleeping). These sleep disturbances may be caused by periodic peaks of brain wave activity.
Sensitivity to environmental conditions, such as chemicals, odors, mildew, noise, bright light, and weather
Furthermore, some individuals with fibromyalgia may experience the following symptoms:[1, 2]
Pain in the muscles of the lower chest
Sensations of numbness, tingling, prickling, or burning feeling in the hands and feet
Dryness of the eyes, mouth, and skin
Frequent urination and/or stronger urge to urinate in the absence of a bladder infection
Pelvic pain that can occur at any time, including during menstruation
Dizziness and nausea from problems with visually tracking objects, visual focusing, and visual confusion
Disorders in cognition (i.e., thinking processes), such as inability to concentrate, confusion in use of words, and loss of memory
Changes in mood
Depression and anxiety
Fibromyalgia is a multi-faceted disorder that, due to the pain of its symptoms, affects overall quality of life, can reduce the desire to eat, can diminish the ability to work, lessens the ability to exercise, can impair emotional state, and impact social life. Furthermore, as the immune systems of people with fibromyalgia are affected, other chronic diseases may develop if the underlying condition(s) is/are left untreated. Depending on how effectively it is diagnosed and managed, fibromyalgia has been responsible for permanent or temporary disability issues for many people.
Diagnosis involves physical examination, laboratory tests, and ruling out unrelated, underlying conditions of illness. Physicians who understand fibromyalgia will recognize the complexity of the condition and not attribute or dismiss the symptoms as reflecting "an extreme emotional state." According to the American College of Rheumatology, physicians should make a clinical diagnosis of fibromyalgia when the person has:[1,2]
Aching muscle pain that has occurred all over the body for a minimum of 3 months
Presence of 11 (out of 18 possible) tender points on the body
If you are experiencing widespread muscle pain and fatigue that seem unrelated to your activities, are long-lasting, or are preventing you from engaging in and enjoying your everyday life, consult your integrative medical physician, rheumatologist, or other healthcare professionals experienced in diagnosing and managing fibromyalgia in many people.
Do not accept labels for your condition, but rather, seek to change the causative factors that may have contributed to fibromyalgia. Although some mainstream medical literature may state that no specific "cure" for fibromyalgia has been found yet, many lifestyle practices and treatments for fibromyalgia are available to assist in reducing your symptoms and help you enjoy your life. For further information, see our Q&A on treatment of fibromyalgia.
REFERENCES
1. Life Extension Foundation. Fibromyalgia. In Disease Prevention and Treatment.
4th ed., 2003. Hollywood, FL: Life Extension Media.
2. Mayo Clinic. Fibromyalgia. 01/27/05. Accessed at www.mayoclinic.com.
3. Controlling chronic inflammation, culprit in cancer & chronic diseases. B, The Newsletter on Breast Health & Breast Cancer. 2005; 1(4):5-15.
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