Definition, Symptoms, Diagnosis and Treatment.

DEFINITION:

Fibromyalgia is a musculo-skeletal, neuropathic pain syndrome affecting the whole body. It is common and observed in nine times more women than men and can be very isolating and debilitating causing suffering for many including family and carers. There is no cure for Fibromyalgia but management and treatment of symptoms can alleviate suffering, lifestyle changes are usually a must. FMS mimics many other illnesses such as ME and Lupus and therefore can be difficult to diagnose.

MAJOR SYMPTOMS:

Widespread muscular pain and stiffness
Specific tender points
Fatigue
Sleep disturbance
Disturbance to Central Nervous System
Cognitive dysfunction (memory loss, impairment,disorientation)
Numbness/Tingling
Anxiety
Headaches/Migraines
TMJ Dysfunction
Irritable Bowel Syndrome/Bladder dysfunction
Weight gain

DIAGNOSIS:

The American College of Rheumatology presented diagnostic criteria for fibromyalgia in 1990.

A history of widespread pain, present for at least 3 months. Pain is considered widespread when all the following are present: pain in both sides of the body and pain above and below the waist. In addition, axial skeletal pain (cervical spine, anterior chest, thoracic spine or low back pain) must be present.

'Low back' pain is considered lower segment pain.

Pain in 11 of 18 tender points. Digital palpation of the tender points should be performed with an approximate force of 4kg and should be classed as painful on palpitation.
Tender is not considered painful.

TREATMENT:
Appropriate medication as needed for sleep and pain combined with non-pharmacologic treatment such as specific paced exercise, instruction in relaxation techniques, attending support groups including participation in patient education programmes and cognitive-behavioural therapy. Treatment of symptoms is really the only option currently available through NHS services.