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What is fibromyalgia?

Fibromyalgia is a syndrome associated with chronic, widespread disabling pain. Those who have fibromyalgia have aching muscles and sore necks, shoulders, and backs. They sleep poorly and are often stiff when they wake up or when they move after sitting for long periods of time. The intensity and location of the pain and the degree of fatigue may vary from day to day and may become worse with excessive exercise and with stress.

Fibromyalgia is thought to affect 5 million Americans over the age of 18. Between 80% and 90% of the people affected by fibromyalgia are women, but men and children can also be affected. People with certain health conditions that affect muscles, bones, and joints (rheumatic diseases) like arthritis and lupus may also have a higher risk of fibromyalgia. For most rheumatologists, doctors who specialize in rheumatic diseases, it is the second or third most common condition diagnosed.

The pain, fatigue, and numerous other symptoms that are associated with fibromyalgia can frustrate both patient and physician. The condition often makes the affected individuals miserable but does not cause inflammation or visible damage to the affected tissues. While the pain and other symptoms come and go at random, they do not progress to a disease state or remit over time. While some depression is associated with fibromyalgia, it does not cause the condition; the prevalence of depression is about the same as it is with any chronic illness.

Healthcare practitioners familiar with the condition can make a diagnosis using the criteria established in 2010 by the American College of Rheumatology (ACR). (See the Tests section for more on this.) New research into understanding fibromyalgia centers mostly on how pain is processed in the brain and spinal cord rather than the pain receptors in the rest of the body. The change in perspective may lead to new means of diagnosing the disorder in the future.

Currently, there is no cure for fibromyalgia, but there are treatments available to manage the condition. People with the condition may need to be treated by a team of professionals that includes a general practitioner, a physical therapist, and possibly a rheumatologist. Such teams are typically available at pain clinics specializing in treatments for arthritis and other rheumatic diseases.

No single cause of fibromyalgia has been identified, but it is thought that there are both genetic and environmental components, that something acts as a trigger in people who are predisposed to the condition. Some families have a higher incidence of the disorder. Some cases appear to start with a physical trauma or a severe illness, while other cases arise without a discernible "event."

Some researchers think that the symptoms may be due to sleep disorders, while others believe that fibromyalgia may be due to a microorganism. Still others suspect altered skeletal muscle metabolism or chronic overreaction of the immune system to be the cause. Current research is focusing more on abnormalities in neural processes and pain processing pathways as the cause of fibromyalgia symptoms. While answers to what is causing the condition may be years away, healthcare practitioners can identify people with fibromyalgia and try to help them live relatively normal lives.

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