Fibromyalgia (FMS) is a syndrome characterized by generalized pain of muscles and joints with debilitating fatigue. It affects 12 million Americans and is 10 times more likely to affect women than men. The cause of FMS is unknown, but it is thought that the symptoms may be caused by hormonal changes in the body or low levels of serotonin. It can lead to depression and may cause social isolation. FMS is often misunderstood and consequently can go undiagnosed for years. People with FMS take an average of five years to reach a diagnosis.
Persons with FMS often describe the feeling of aching all over accompanied by fatigue that does not go away with sleep or rest. They may experience stabbing pain or a burning sensation in muscles as though they have been strained from overwork, even when they have not exercised. Pain or aching in the neck and shoulder area with or without back and hip pain may cause difficulties with sleep. Other symptoms include lack of deep sleep, anxiety, headaches, lack of concentration and being overly sensitive to sounds, odors or temperatures (hot or cold). Those with FMS often complain that they are exhausted even after a full night's sleep, sometimes even claiming to be more tired than when they went to bed.
Many people mistakenly assume they have arthritis or bursitis because of the joint pain and stiffness upon rising in the morning or after remaining in a prolonged position, such as sitting or riding in a vehicle. Physicians may mistakenly treat the patient for arthritis or dismiss complaints of fatigue as psychosomatic.
Diagnosis is difficult and requires a thorough examination by a physician and may require blood tests to rule out other disorders. Tenderness or pain in pressure points on the body may distinguish FMS from other related disorders. Once other conditions have been ruled out, your doctor will evaluate your symptoms to determine if they meet the diagnostic criteria for FMS. According to the American College of Rheumatology, the criteria for a diagnosis of FMS require pain in all four quadrants of the body that has lasted for at least three months.
Undiagnosed FMS may contribute to social isolation as the patient is too exhausted to participate in outside activities. Patients may suffer from depression as a result of prolonged pain and the lack of adequate treatment. Once diagnosed and treated, patients are able to enjoy a normal lifestyle by altering their sleeping patterns, participating in appropriate forms of exercise and continuing routine medications.
The medications Lyrica and Cymbalta have both received approval from the FDA for use in treating FMS. Lyrica is used to treat nerve pain and is successful for some with FMS. Cymbalta is an antidepressant and functions as a serotonin and norepinephrine reuptake inhibitor. It is believed that a low level of serotonin may contribute to the symptoms of FMS. You may be prescribed other antidepressants to relieve associated depression, pain and sleep disorders. Nonsteroidal anti-inflammatory drugs may be prescribed for pain.