Fibromyalgia (previously called fibrositis) is a common, but poorly understood disorder characterized by chronic, widespread pain and stiffness in various muscles, tendons, and ligaments. Profound fatigue frequently accompanies the pain, and both are made worse by seemingly trivial physical activity. Diagnostic tests show no abnormalities of the joints and no muscle damage.
Fibromyalgia is more common in women and increases in frequency with age. It often accompanies other illnesses, such as lupus or rheumatoid arthritis, but does not lead to joint or muscle damage. Treatment is aimed at the relief of symptoms.

Symptoms of Fibromyalgia

• Widespread muscle aches, pains, and stiffness. Physical activity may relieve stiffness but worsen pain. Stiffness is usually worse upon awakening in the morning, but may be present all day.
• Chronic fatigue and unrefreshing sleep.
• Symptoms of irritable bowel syndrome, dysmenorrhea, depression, migraine, or irritable bladder are sometimes present.

What Causes Fibromyalgia?

• The cause of fibromyalgia is unknown.
• Sleep disturbances or interruptions, especially of deep sleep (known as stage IV sleep), may provoke a flare-up of fibromyalgia.
• Underused muscles, poor fitness, and impaired blood circulation may contribute to fibromyalgia.
• Emotional stress and depression may worsen the illness.
• Sometimes an injury or infection will precede the onset of fibromyalgia; whether they cause the disease is unclear.

Prevention of Fibromyalgia

• There is no known way to prevent fibromyalgia.
• Eating a healthy, well-balanced diet and getting regular exercise may help decrease the risk.

Diagnosis of Fibromyalgia

Because symptoms of fibromyalgia are similar to those of many other disorders, it is difficult to diagnose. You may see several doctors before getting a correct diagnosis. No x-ray, biopsy, or blood test can identify fibromyalgia. However, the American College of Rheumatology has developed a set of criteria to diagnose fibromyalgia, including widespread pain, present for at least three months; pain located on both sides of the body, above and below the waist; and pain in at least 11 of 18 tender points.

How To Treat Fibromyalgia

• Over-the-counter pain relievers such as acetaminophen may be taken as necessary. Narcotic pain relievers should be avoided.
• A regular program of physical exercise may relieve pain and stiffness and improve circulation. Exercise may aggravate pain at first; therefore, in consultation with your doctor, start with low-impact activities such as walking, swimming, and bicycling, sustaining the activity for 20 to 30 minutes at a time. You may slowly work up to more vigorous exercises like jogging or aerobics.
• Medications such as amitriptyline, nortriptyline, doxepin, or cyclobenzaprine may be prescribed to promote restful sleep and decrease pain.
• A hot bath, heating pad, or massage may provide temporary relief from muscle pain.
• Practice good posture during the day. A firm mattress may help prevent muscle pain at night.
• Psychological counseling may be beneficial and help to ease emotional stress that may trigger painful flare-ups. Relaxation techniques such as meditation or biofeedback may help reduce muscle tension and stress.
• Although the pain of fibromyalgia may be difficult to control, the disease is never life-threatening and does not lead to damage of the body or progressive disability.

When To Call A Doctor

• Make an appointment with a doctor if you experience symptoms of fibromyalgia for more than 7 to 10 consecutive days, or if symptoms recur.

For more information on Fibromyalgia, click on this link -- Johns Hopkins Health Alerts: Arthritis