Fibromyalgia: Fibromyalgia Defined

The most important information you need to improve your health

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• Publisher: Adams Media
• Year: 2012
• eBook ISBN: 9781440563652
• Topic: Medicine
• Subtopic: Diseases & Allergies

Looking for answers after your diagnosis of fibromyalgia? The Everything® Healthy Living Series is here to help. These concise, thoughtful guides offer the expert advice and the latest medical information you need to manage your pain and lead a healthy life.Inside you'll find information on this condition of chronic pain, including symptoms of the disorder, the overall effect it has on your body, and how it will affect your life. As you deal with the chronic pain and fatigue, the more you know about the disorder, the better you will be able to take charge of your condition.

Fibro Imitators

Sometimes, knowing what something isn’t can be as important as knowing what it is. That’s true with fibromyalgia. The symptoms of FMS overlap with so many other maladies that you could be misdiagnosed several times before learning you have fibromyalgia. Getting a better understanding of these other conditions can help you figure out whether you actually have fibromyalgia or something else.

Chronic Fatigue Immune Deficiency Syndrome (CFIDS)

Fatigue has become a part of the human condition. But chronic fatigue and immune deficiency syndrome (CFIDS), also called chronic fatigue syndrome (CFS), is more insidious than normal tiredness. With CFIDS, the fatigue is strong, persistent, and debilitating, typically making you too weak to perform everyday tasks. Often, you’re tired even when you have little to do or after a good night’s rest. Many people say that the fatigue of CFIDS is similar to the fatigue of the flu.

According to estimates by the U.S. Centers for Disease Control and Prevention, approximately 500,000 Americans suffer from CFIDS. Most people with CFIDS are women. In the 1980s, CFIDS was called the “yuppie flu” because most sufferers were well-educated, middle-to-upper-class women in their thirties and forties. But now we know that CFIDS can afflict anyone of any age, and that people of any race or socioeconomic level can be affected.

Today, the cause of CFIDS remains a mystery, though research suggests that a chronic, low-grade viral infection may be present. Usually, a diagnosis is made only after other medical conditions are ruled out. But like fibromyalgia, CFIDS can coexist with other disorders such as depression. It can also resemble other illnesses, such as hypothyroidism.

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Fact

A study done in England and published in the British Medical Journal found that a lack of exercise in childhood may be linked to a greater risk for developing CFIDS in adulthood. The study looked at 16,567 babies born in April of 1970 and followed them until they were thirty years old.

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Symptoms and Diagnosis

Getting a diagnosis of CFIDS can be difficult. There are no laboratory tests or clinical signs that characterize the condition, so doctors must rely on patient reports of specific symptoms. To make matters more challenging, some people are still skeptical that the condition even exists.

But a scientific panel of experts did come up with a set of criteria for CFIDS, which was first published in the Annals of Internal Medicine in March 1988 and revised in the same journal in December 1994. According to those criteria, you may be diagnosed with CFIDS if you have severe chronic fatigue that has lasted longer than six months without the presence of any other medical conditions. At the same time, you must have at least four or more of the following symptoms:

• Substantial impairment in short-term memory or concentration
• Sore throat
• Tender lymph nodes
• Muscle pain
• Joint pain in several joints without swelling or redness
• Headaches that seem different in severity, type, and pattern than those you’ve experienced in the past
• Unrefreshing sleep
• A feeling of malaise after exertion, lasting more than twenty-four hours

Other symptoms of CFIDS include fever, abdominal cramps, allergies, weight loss, rapid pulse, chest pain, night sweats, rash, and chest pain.

But your doctor won’t diagnose you with CFIDS if you have another documented illness that can cause chronic fatigue, such as cancer or hepatitis. Interestingly, fibromyalgia was specifically excluded from this rule, so it is possible to have both CFIDS and FMS.

Treating CFIDS

Unfortunately, there is no treatment for CFIDS at the current time. But certain lifestyle strategies can lessen the symptoms. Eating a balanced diet, getting enough sleep, and exercising regularly can all help. Studies show that even moderate amounts of exercise can reduce the symptoms in 75 percent of people with CFIDS. Strategies to minimize stress can help, too. Avoid doing too much, and practice strategies for managing stress, such as meditation or tai chi.

Some people find relief from CFIDS by taking antidepressants. Low-dose tricyclic antidepressants such as Elavil or selective serotonin reuptake inhibitors (SSRIs) such as Prozac have been shown to provide relief by improving the quality of sleep and decreasing the fatigue, not necessarily by relieving depression.

How CFIDS Differs from FMS

Even doctors can’t always separate CFIDS from FMS. Patients with CFIDS often experience some pain, while those with FMS are frequently fatigued. As a result, a person diagnosed with fibromyalgia by one doctor may be told he has CFIDS by another, which can be very confusing.

But subtle differences do exist. Fibromyalgia is often linked to an injury or trauma. CFIDS typically starts off like flu. People who have CFIDS typically don’t have tender points. And in research, CFIDS sufferers are less likely to have abnormal levels of substance P or serotonin the way fibro sufferers do.

Chronic Myofascial Pain (CMP)

People who have fibromyalgia often have symptoms of chronic myofascial pain (CMP) too. But CMP, like CFIDS, is a syndrome unto itself. Experts believe that CMP originates with a muscle lesion or strain on a particular muscle, ligament, or tendon, which in turn creates a small spastic knot called a trigger point. Trigger points cause local pain and often send pain to other parts of the body — called referred pain — sometimes quite a ways from the location of the trigger point. CMP may also come on as a result of fatigue, repetitive motion, a medical condition, or lack of activity.

To better understand CMP, consider the word myofascial. “Myo” means muscle and “fascia” means connective tissue. So myofascial pain stems from problems in muscles and connective tissue. This makes it different from FMS, which is the result of oversensitivity in the parts of your nervous system responsible for sensing and processing pain.

It appears that irritation or damage to muscles can, in some cases, cause a change in the nerves responsible for telling the muscle to contract. As a result, instead of just telling the muscle to work when you want it to, the nerve starts constantly releasing chemicals that activate the muscle. This causes that local area of muscle to go into a tight, spastic knot that actually reduces blood flow. As a result of the decrease in blood flow, the area doesn’t get the oxygen it needs, and lactic acid (among other things) starts to build up. This activates nerves in the area, causing pain.

The trigger point causes pain when you try to move, and you lose range of motion. As you become increasingly resistant to moving, other muscles are summoned to compensate for the weakness. Once these other muscles are overworked, they too become vulnerable to the development of trigger points. The resulting pain is typically steady, dull, deep, and can be anything from mild to excruciating.

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Alert

Holding a muscle in an awkward position can lead to the development of a trigger point. Sitting in a chair with poor back support, using your shoulder to hold a phone to your ear, and prolonged bending over a desk can all create trigger points. Other perpetuating factors include emotional stress, sports injuries, and poor posture.

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Symptoms and Diagnosis

People who have CMP complain about regional pain that is persistent and restricts motion. Often, the neck, shoulder, low back, and pelvic muscles are affected. You may experience tension headaches, tinnitus (a ringing of the ears), temporomandibular joint disorder, joint pain, vision problems, and torticollis (wry neck). CMP does not cause systemic problems such as joint swelling.

The key to diagnosing CMP is identifying trigger points in muscles that reproduce pain when pressed. There are actually four different kinds of trigger points, which can all be felt by palpation. Palpation is the application of pressure — usually by the diagnosing physician — on a suspected trigger point, which causes tremendous pain.

Active Trigger Points

Active trigger points spontaneously hurt, are extremely sensitive to touch, and can cause both local and referred pain. When pressed, active trigger points can sometimes produce severe pain.

Latent Trigger Points

Latent trigger points don’t hurt unless someone is pressing on them. But they still cause muscle tension, restrict movement, and weaken the muscle. They can become ...

Table of contents

• Cover
• Title Page
• Contents
• Introduction
• Fibromyalgia Defined
• Signs and Symptoms
• Fibro Imitators
• Also Available
• Copyright Page