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Chronic Fatigue and Fibro Living
How is it diagnosed?
Causes of FMS
Fibromyalgia is not well understood by the medical community. Fibromyalgia is a syndrome characterized by long-lasting widespread
pain and tenderness at specific points on the body. The term “fibromyalgia” means pain in the muscles, ligaments and tendons. Other
integral symptoms are sleep disturbances and fatigue.
Fibromyalgia is referred to as a syndrome because it’s a set of signs and symptoms that occur together with no known cause or
FMS is a confusing and misunderstood condition. Because FMS symptoms are quite common and laboratory tests results generally
appear normal, people are often told this condition is “in their head.” Additionally, fibromyalgia has often been a great imitator of other
diseases because so many of its symptoms mimic those of other disorders. As a result, it can often be difficult to properly diagnosis
fibromyalgia. However, there are subtle differences between many of the illnesses and FMS.
Other Mistaken Conditions of FMS
Fibromyalgia is often mistaken, occur concurrently, or simulate the following diseases:
Lyme disease, Lupus, Osteoarthritis, Rheumatoid arthritis, Cushing’s syndrome, Hypothyroidism, Polymyalgia Rheumatica, Reflex
sympathetic dystrophy syndrome, Reflex sympathetic dystrophy syndrome, Cervical spinal stenos, Sleep apnea, Medications such as
lipid-lowering drugs or antiviral agents, Autoimmune disorders, such as rheumatoid arthritis and lupus, early stages Addison’s disease,
Cushing syndrome, and Hyperparathyroidism
How is it diagnosed? [back to the top]
Current medical studies confirms its existence and estimates the syndrome affects two to four percent of the population. People with
fibromyalgia often look healthy and have no outward signs of pain or fatigue. Many refer to it as the “invisible illness”. The difficulty
diagnosing fibromyalgia is that there is no clear-cut test to determine fibromyalgia. No evidence of it appears on X-rays or in laboratory
test results. There is no diagnostic marker in the blood.
Instead, fibromyalgia is diagnosed by the identification of symptoms and the exclusion of other conditions. In 1990, the American
College of Rheumatology, the official body of doctors who treat arthritis and related conditions, developed criteria for the diagnosis of
fibromyalgia. It is diagnosed when the patient displays the following symptoms:
A history of widespread pain (pain on both sides of the body and above and below the waist) that is present for at least three months.
Pain in at least 11 of 18 tender-point sites. These points are considered positive when pain is felt upon the application of 4 kilograms of
pressure – the approximate amount of pressure required to blanch the examiners’ fingernail.
At least half of the individuals who have the clinical diagnosis of fibromyalgia will not fulfill this definition. Your doctor will listen to
you explain all of your symptoms, will order laboratory tests to rule out other conditions with similar symptoms
Related Conditions [back to the top]
People with fibromyalgia are also at risk for developing other disorders, many of which can exacerbate your current fibromyalgia
symptoms or are linked to certain conditions that may lead to fertility problems.
Irritable Bowel Syndrome
Carpal Tunnel Sydrome
Chronic Fatigue Syndrome
Seasonal Affective Disorder
Low Cytokine Levels
FMS can affect your libido. Fibro and Fatigue Fighters find out how to improve sexual intimacy in your relationship.
Other Body Functions Affected
FMS can also affect the way your body functions. It affects the following systems:
FMS Symptoms [back to the top]
Symptoms of Fibromyalgia include:
Pain and tenderness
Musculoskeletal pain in all sections of the body is the most common symptom of fibromyalgia. The pain may begin in one region of the
body, but eventually every section becomes affected. For some people, the pain waxes and wanes, and seems to travel throughout the
body. In addition to this generalized feeling of aching all over, people with fibromyalgia experience tenderness to the touch. When
pressure is applied to different points on the body, a person with fibromyalgia will feel pain whereas a person without fibromyalgia would
feel only a bit of pressure. These spots on the body are called tender points. Studies now show, however, that people with fibromyalgia
display increased sensitivity to pain throughout the body. The pain and stiffness are worse in the morning and you may hurt more in
muscle groups that are used repetitively.
Fatigue and sleep disturbances
People with fibromyalgia experience chronic fatigue and tire quickly after only mild exertion. In fact, about half of individuals who meet
diagnostic criteria for fibromyalgia also meet the diagnostic criteria for chronic fatigue syndrome the fatigue can be more debilitating than
the pain. People with fibromyalgia often have trouble getting a good night’s sleep. Whether the fatigue is a symptom of the condition or a
symptom of the lack of sleep is not known at this time. It is known that people with fibromyalgia usually can fall asleep without problem
but their sleep is light and easily disturbed. They wake up in the morning feeling exhausted and unrefreshed. Sleep laboratory tests have
shown that patients’ deep sleep (stages 3 and 4) gets interrupted frequently. Sufferers of FMS best sleep comes in the hour or two before
awakening in the morning. This disordered pattern of sleep does not allow the person’s body to rejuvenate itself.
Other Common Symptoms
Frequent headaches: tension and migraine – Recurrent migraine or tension-type headaches are seen in about 70% of fibromyalgia
Cognitive difficulties: poor attention span, trouble with short-term memory, inability to think clearly; often called “fibro fog,” possibly
related to lack of sleep
Irritable bowel syndrome: – Constipation, diarrhea, frequent abdominal pain, abdominal gas, and nausea are symptoms frequently found.
Acid reflux or gastroesophageal reflux disease (GERD) also occurs frequently in FMS patients.
Dry eyes and mouth
“Allergic” symptoms: multiple chemical sensitivity, nasal congestion, rhinitis (inflammation of the nasal passages). The reactions are not
actually allergic because the defining immunologic responses are not present, but the symptoms felt are similar.
Restless leg syndrome: numbness, tingling and crawling sensations that necessitate constantly moving the legs; contributes to poor sleep.
Premenstrual syndrome and painful periods, chest pain, morning stiffness, cognitive or memory impairment, numbness and tingling
sensations, muscle twitching, irritable bladder, feeling of swollen extremities, skin sensitivities, the dry eyes and mouth, dizziness, and
impaired coordination can occur. Fibromyalgia patients are often sensitive to odors, loud noises, and bright lights, and have heat and/or
Causes of FMS [back to the top]
Although no one knows what causes fibromyalgia, a theory is that an individual may be genetically predisposed to the syndrome exposed
to an environmental trigger, symptoms develop. Patients attributed an onset of fibromyalgia to an illness with a fever, surgery attributed,
or a long –term psychological stress (trauma).
Researchers have made some progress in determining what is happening in the body that might cause some of the symptoms people
experience. Most agree that the central nervous system in people with fibromyalgia is not functioning properly and that components of the
body’s stress response are responsible for symptoms.
Sensory Processing: Disturbances are probably general and not pain-specific. People with fibromyalgia often experience great sensitivity
not just to pain but to loud noises, bright lights, odors, drugs, temperament changes and chemicals.
Substance P: People with fibromyalgia have approximately threefold higher concentrations in their spinal fluid of this chemical that
amplifies pain signals than healthy controls.
Serotonin: This brain chemical is believed to modulate pain signals and has been found to be low or processed poorly in people with
HPA Axis: Several abnormalities in the hypothalamic-pituitary adrenal axis (the brain - and hormone interactions that regulate virtually
all physiologic activities, including the stress response) have been noted.
Psychological and behavioral factors: Psychological disorders are no longer believed to cause fibromyalgia. However, the anxiety and
depression brought about by chronic pain and fatigue can make fibromyalgia symptoms worse, creating a cycle of pain, fatigue, anxiety ,
maladaptive behaviors leading to more pain.