(FM; Fibromyalgia Syndrome; FMS)
Fibromyalgia is a complex, chronic, and disabling disorder. It causes widespread pain and stiffness in the muscles, tendons, and ligaments, along with poor sleep and fatigue.
Fibromyalgia Trigger Points
The exact cause is unknown.
The following conditions are commonly associated with fibromyalgia:
- Depression]]> and ]]>anxiety]]>
- Muscle pain
- Chronic headache, such as ]]>tension headaches]]> (frequently beginning with neck discomfort)
- Numbness and tingling
- Sensation of swollen hands and edema (swelling usually in the feet, ankles, and legs)
- Nocturnal myoclonus (moving legs involuntarily during sleep)
- ]]>Irritable bowel syndrome]]>
- Complex regional pain syndrome
- ]]>Substance abuse]]>
- ]]>Premenstrual syndrome]]>
- Female urethral syndrome (irritable bladder)
- ]]>Raynaud's disease]]>
A risk factor is something that increases your chance of getting fibromyalgia. Risk factors include:
- Sex: female
- Age: 20-60 years old
- Physical or mental stress
- Physical trauma]]> (eg, accident, injury, or severe illness)
Common symptoms include:
- Generalized fatigue or tiredness
- Reduced physical endurance
- Generalized aches and pains of muscles, tendons, and ligaments
- Muscle tightening or spasms
Pain in specific areas of the body, especially:
- Back (upper and lower)
- Hips and thighs
- Insomnia]]> or poor sleep
- Sensations of numbness or swelling (although swelling is not actually present)
- Chronic headaches, including ]]>migraines]]>
- Morning stiffness, worst on first arising
Factors that may trigger or worsen symptoms include:
- Weather changes, especially cold, damp weather
- Stress or ]]>anxiety]]>
- Medical illness
The doctor will ask about your symptoms and medical history, and perform a thorough physical exam. There are no specific tests for this condition.
The doctor will look for the following signs:
- Widespread pain lasting three months or longer
- Tenderness (on physical exam) in at least 11 of 18 specific areas of the body
The goal of treatment is to relieve or control the symptoms. Treatments include:
Physical and Behavioral Therapies
- Physical therapy (gradual aerobic exercise and stretching regimen)
- Heated pool treatments—Aquatic training in warm water (eg, strength, aerobic, and relaxation exercises) may help improve symptoms.
- Application of heat to painful areas
- Alternative treatments, such as massage]]> , ]]>acupuncture]]> , ]]>relaxation training]]> , trigger point therapy, biofeedback
- ]]>Cognitive behavioral therapy]]>
- ]]>Eating a healthful diet]]>
- ]]>Learning to cope]]> with physical and mental stress
regular, moderate, low-impact exercise with your doctor's approval
Try gentle exercise that does not strain painful areas, such as:
- Swimming, preferably in warmer water
- Try gentle exercise that does not strain painful areas, such as:
- Doing regular ]]>stretching exercises]]>
- Maintaining a regular sleep schedule
These medications may help to improve symptoms:
- Weak opioids (eg, ]]>tramadol]]> , paracetamol)
- Antidepressants (eg, ]]>amitriptyline]]> , ]]>fluoxetine]]> , ]]>duloxetine]]> , milnacipran, ]]>moclobemide]]> , pirlindole)
- Pain relievers (eg, tropisetron, ]]>pramipexole]]> , ]]>pregabalin]]> )
- ]]>Sodium oxybate]]> (eg, Xyrem), a central nervous system depressant
The American Fibromyalgia Syndrome Association
National Fibromyalgia Partnership, Inc.
The Arthritis Society
Fibromyalgia Information and Local Support
Berkow R. The Merck Manual of Medical Information . New York, NY: Pocket; 2000.
Carville SF, Arendt-Nielsen S, Bliddal H, et al. EULAR evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis . 2008;67:536-541.
Edema. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/disorders/edema/hic_edema.aspx . Updated November 2005. Accessed June 19, 2008.
Fibromyalgia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 2008. Accessed June 19, 2008.
Fibromyalgia. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Fibromyalgia/fibromyalgia_ff.asp . Updated August 2007. Accessed June 19, 2008.
Fibromyalgia update. Bandolier website. Available at: http://www.jr2.ox.ac.uk/bandolier/band149/b149-7.html .
Myofascial pain syndrome. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/myofascial-pain-syndrome/DS01042 . Updated May 2007. Accessed June 19, 2008.
Paresthesias. MedHelp website. Available at: http://www.medhelp.org/HealthTopics/Paresthesias.html . Accessed June 19, 2008.
Periodic limb movement disorder (PLMD) or nocturnal myoclonus. Eastern Virginia Medical School website. Available at: http://www.evms.edu/sleep/disorders-limb.html . Updated March 2006. Accessed June 19, 2008.
2/17/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Russell IJ, Perkins AT, Michalek JE; Oxybate SXB-26 Fibromyalgia Syndrome Study Group. Sodium oxybate relieves pain and improves function in fibromyalgia syndrome: a randomized, double-blind, placebo-controlled, multicenter clinical trial. Arthritis Rheum. 2009;60:299-309.
4/14/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Munguía-Izquierdo D, Legaz-Arrese A. Assessment of the effects of aquatic therapy on global symptomatology in patients with fibromyalgia syndrome: a randomized controlled trial. Arch Phys Med Rehabil. 2008;89:2250-2257.
Last reviewed October 2009 by ]]>Jill D. Landis, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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