Focusing on Fibromyalgia
A Puzzling and Painful Condition
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\n You\u2019ve probably heard of fibromyalgia, but you may not know what it is. Fibromyalgia is a long-term (chronic) pain condition that affects 5 million or more Americans ages 18 and older. For unknown reasons, most people diagnosed with fibromyalgia are women, although men and children also can be affected. People with certain disorders, such as rheumatoid arthritis or lupus, may also have fibromyalgia, which can affect their disease course and treatment.
\nFibromyalgia can take a powerful toll on health, well-being, and quality of life. \u201cPeople with fibromyalgia suffer from severe, daily pain that is widespread throughout the body,\u201d says Dr. Leslie J. Crofford, an NIH-supported researcher at Vanderbilt University. \u201cTheir pain is typically accompanied by debilitating fatigue, sleep that does not refresh them, and problems with thinking and memory.\u201d
\nPeople with fibromyalgia often see many doctors before finally receiving a diagnosis. The main symptoms\u2014pain and fatigue\u2014overlap with those of many other conditions, which can complicate the diagnosis.
\n\u201cTo make things more challenging, there are no blood tests or X-rays that are abnormal in people with the disorder,\u201d says Crofford. With no specific diagnostic test, some doctors may question whether a patient\u2019s pain is real. \u201cEven friends, family, and coworkers may have a difficult time understanding the person\u2019s symptoms,\u201d Crofford says.
\nA doctor familiar with fibromyalgia can make a diagnosis based on the criteria established by the American College of Rheumatology. Diagnostic symptoms include a history of widespread pain lasting more than 3 months and other symptoms such as fatigue. In making the diagnosis, doctors consider the number of areas throughout the body where the patient had pain in the past week, and they rule out other causes of disease.
\nWhat causes fibromyalgia isn`t fully understood. Many factors likely contribute. \u201cWe know that people with fibromyalgia have changes in the communication between the body and the brain,\u201d Crofford says. These changes may lead the brain to interpret certain sensations as painful that might not be bothersome to people without the disorder.
\nResearchers have found several genes that may affect a person\u2019s risk of developing fibromyalgia. Stressful life events may also play a role.
\nFibromyalgia isn\u2019t a progressive disease, so it doesn\u2019t get worse over time and may even improve. It\u2019s never fatal, and it won\u2019t harm the joints, muscles, or internal organs.
\nMedications may help relieve some\u2014but not all\u2014symptoms of fibromyalgia. \u201cDrug treatments by themselves don\u2019t result in remission or cure of fibromyalgia,\u201d says Crofford. \u201cWe\u2019ve learned that exercise may work as well as or better than medications. In addition, therapies such as tai chi, yoga, and cognitive behavior therapy can also help to reduce symptoms.\u201d
\nPeople with fibromyalgia often have the best results when treated with multiple therapies. \u201cIt\u2019s critically important for health care providers to help patients develop an understanding of fibromyalgia, and to provide realistic information about treatments, with an emphasis on using exercise and other physical therapies in conjunction with medications,\u201d Crofford says.
\nCrofford and her colleagues are exploring whether a treatment called TENS (transcutaneous electrical nerve stimulation) can help people with fibromyalgia exercise more comfortably and reduce pain. She and other NIH-funded teams are also seeking markers of fibromyalgia in the blood that might ultimately lead to more targeted and effective treatments.
\nIf you or someone you know has fibromyalgia, see the \u201cWise Choices\u201d box for tips on reducing its impact.
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References:
\nEffect of transcutaneous electrical nerve stimulation on pain, function, and quality of life in fibromyalgia: a double-blind randomized clinical trial. Noehren B, Dailey DL, Rakel BA, et al. Phys Ther. 2015 Jan;95(1):129-40. doi: 10.2522/ptj.20140218. Epub 2014 Sep 11. PMID: 25212518.
\nNew insights into the benefits of exercise for muscle health in patients with idiopathic inflammatory myositis. Alemo Munters L, Alexanderson H, Crofford LJ, Lundberg IE.Curr Rheumatol Rep. 2014 Jul;16(7):429. doi: 10.1007/s11926-014-0429-4. Review. PMID: 24879535.
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