An Overview of Fibromyalgia

Fibromyalgia is a relatively new diagnosis to many people. In fact it is a relatively new diagnosis to many doctors as well, although the symptoms of this condition have been known for centuries. In essence it is defined as any atypical chronic pain combined with a condition known an allodynia, which occurs when pressure or touch causes intensive pain and discomfort.

There is still some limited controversy in the medical community as to a diagnosis of fibromyalgia. This is largely due to the way in which the condition is diagnosed. It cannot be diagnosed by medical tests or specific indicators, rather it is diagnosed by ruling out other conditions that do have specific tests and cause the same types of symptoms. If these specific medical conditions are not found a general diagnosis of fibromyalgia is often made.

This is known as a diagnosis of exclusion, and therefore some medical professionals continue to question if it is truly a diagnosis. New research at the neurological level has begun to shed light on specific indicators that may be used to conclusively diagnose the condition.  An effort is currently underway by the American College of Rheumatology to develop a standardized test and symptom severity measure for fibromyalgia.

Syndrome Versus Disease

The variations in the symptoms of fibromyalgia between individuals and the lack of a specific medical test that confirms a diagnosis puts this medical condition into the category of a syndrome instead of a disease. A disease, by definition, has a clearly defined origin or cause combined with specific symptoms and indicators that have to be present for a diagnosis to be made.

A syndrome, on the other hand, is a collection of symptoms that may occur as a complete set or as one or two factors in an individual. Instead of there being a definite cause or origin of the symptoms noted, a syndrome may have several etiologies or origins as well as unknown factors that trigger the presence of the symptoms. Often syndromes, once researched and studied, will become recognized diseases.

A clear example of that is AIDS, first identified as a group of symptoms that was triggered by changes in the immune system. From this early grouping of symptoms more advanced research lead to the understanding that it was linked to the human immunodeficiency syndrome or HIV. Other syndromes include Asperger’s Syndrome, Down Syndrome and Chronic Fatigue Syndrome and, like fibromyalgia syndrome, they have multiple etiologies that may or may not be discoverable.

Symptoms Of Fibromyalgia

The symptoms of fibromyalgia can and will vary from person to person and may become more pronounced during times of physical or medical stress, major life changes or increased level of emotional stress. The most commonly reported symptom includes a chronic pain that spreads across the entire body. The pain can be dull and throbbing, or it can be sharp and shooting. It can impact the joints or the large muscles, or it can seem to be everywhere. Periods of high activity or low activity can make the pain more pronounced and, for most people, the pain is most pronounced after waking up in the morning and decreases or localizes during the day. Fibromyalgia tends to be much more commonly found in women than men and is not often diagnosed in children or teens.

Other symptoms commonly reported with the chronic pain include:

– Sleep problems – this prevents patients from getting the deep REM sleep needed to rejuvenate and heal the body.
– Fatigue and exhaustion – partially a combination of lack of restorative sleep and chronic pain, the fatigue experienced by those with fibromyalgia is debilitating and may cause difficulties in working and maintaining an active lifestyle.
– Headaches and migraines – this is most problematic in women
– Anxiety and depression – often a concurrent diagnosis with fibromyalgia
– Skin rashes and irritations
– Cognitive dysfunction and fog
– Restless leg syndrome
– Bowel and urinary problems
– Myofascial pain
– Vision problems
– Impaired coordination
– Raynaud’s Syndrome –  also known as Raynaud’s phenomenon, it is a discoloration of the skin and coldness of the fingers and toes due to constriction of the blood vessels

Not all individuals experience all symptoms, and in some people symptoms may come and go based on stress levels and triggering factors. The symptoms often develop over time and may become progressively more debilitating, or they may remain at a constant level without progression.  Individuals that have significant allodynia, the sensitivity to touch, have very similar symptoms as those with diabetic neuropathy. Approximately 20-35% of patients with these conditions report the same sensory phenomena, posing a possible link to the neurological causes of both conditions.

Causes of Fibromyalgia

Research into the specific causes of fibromyalgia is ongoing. Most researchers indicate that there is some type of genetic predisposition to the condition as it is more common in some families. Other factors that may trigger or enhance the risk of developing fibromyalgia include high stress levels, which can include being depressed, having a diagnosis of posttraumatic stress disorder (PTSD), irritable bowel syndrome or chronic fatigue syndrome.

Dopamine dysfunction, known as hypodopaminergia, is a condition where the body doesn’t produce enough dopamine so pain receptors and analgesia responses in the body are distorted. There is also evidence linking abnormal serotonin metabolism to the development of fibromyalgia. Serotonin is also responsible for pain and sleep regulation as well as balancing moods, in allowing concentration and in pleasure sensations in the brain.

Research into depression has shown links, particularly in patients with Major Depressive Disorder or MDD because of brain chemistry patterns that are similar in both diagnoses. They are not the same condition, but may share similar etiologies or triggering factors. Sleep problems and depression can concurrently exist and recent research has also linked sleep irregularities to an increased risk of developing fibromyalgia.

Treatment Of Fibromyalgia

Just as there is controversy with the specific diagnosis of fibromyalgia, there is also considerable debate as to the best possible treatment. Most treatment through conventional medicine focuses on managing the symptoms including the pain and related health issues. Depression, sleep problems and mental health concurrent conditions are typically also addressed through conventional treatments. Patient education and the importance of exercise in treatment are also seen as essential.
New understanding of the syndrome has lead to increased options for patients. These can include alternative treatments such as physical therapy, exercise routines, massage and acupuncture, yoga, aromatherapy, biofeedback techniques, chiropractic treatments, nutritional supplements and cognitive therapy.

This article was originally published on July 11, 2012 and last revision and update of it was 9/7/2015