Fibromyalgia:  Myofascial Pain Syndrome and Fibromyositis

What Is Fibromyalgia?  
It is also known as myofascial pain syndrome and fibromyositis. This is a group of common disorders characterized by aches, pain, tenderness, and stiffness of muscles. Typically it does not involve the joints. Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and multiple tender points. "Tender points" refers to tenderness that occurs in precise, localized areas, particularly in the neck, spine, shoulders, and hips. People with this syndrome may also experience sleep disturbances, morning stiffness, irritable bowel syndrome, anxiety, and other symptoms.

How Many People Have Fibromyalgia?  
Fibromyalgia affects 3 to 6 million Americans. It primarily occurs in women of childbearing age, but children, the elderly, and men can also be affected. 

What Causes Fibromyalgia?
Although the cause of fibromyalgia is unknown, researchers have several theories about causes or triggers of the disease. Some scientists believe that the syndrome may be caused by an injury or trauma. This injury may affect the central nervous system. Fibromyalgia may be associated with changes in muscle metabolism, such as decreased blood flow, causing fatigue and decreased strength. The syndrome may be triggered by an infectious agent such as a virus, but no such agent has been identified.

How Is Fibromyalgia Diagnosed?  
Fibromyalgia is difficult to diagnose because many of the symptoms mimic those of other diseases. Dr.Rao reviews the patient's medical history and makes a diagnosis of fibromyalgia based on a history of chronic widespread pain that persists for more than 3 months. A person is considered to have fibromyalgia if he or she has widespread pain in combination with tenderness in at least 11 of 18 specific tender point sites.

How Is Fibromyalgia Treated?  
Treatment of fibromyalgia requires a comprehensive approach. The physician, physical therapist, and patient may all play an active role in the management of fibromyalgia. Studies have shown that aerobic exercise, such as swimming and walking, improves muscle fitness and reduces muscle pain and tenderness. Heat and massage may also give short-term relief. Antidepressant medications may help elevate mood, improve quality of sleep, and relax muscles. Fibromyalgia patients may benefit from a combination of exercise, medication, physical therapy, and relaxation.

Research on Fibromyalgia  
Recent studies show that abnormally low levels of the hormone cortisol may be associated with fibromyalgia. Researchers are studying regulation of the function of the adrenal gland (which makes cortisol) in fibromyalgia. People whose bodies make inadequate amounts of cortisol experience many of the same symptoms as people with fibromyalgia. It is hoped that these studies will increase understanding about fibromyalgia and may suggest new ways to treat the disorder.  

Other research studies are looking at different aspects of the disease. Researchers are concentrating on how specific brain structures are involved in the painful symptoms of fibromyalgia. MRI scans and Magnetic Resonance Spectroscopy are powerful tools that have been shown to be useful in evaluating muscle disorders and muscle performance. Some patients develop a fibromyalgia-like condition following Lyme disease, an infectious disorder associated with arthritis and other symptoms.