Most patients with fibromyalgia say that they ache all over. Their muscles may feel like they have been pulled or overworked. Sometimes the muscles twitch and at other times they burn. More women than men are afflicted with fibromyalgia, but it shows up in people of all ages. Fibromyalgia is not associated with muscle, nerve or joint injury; inadequate muscle repair; or any serious bodily damage or disease. Also, people who have fibromyalgia are not at greater risk for any other musculoskeletal disease.

Think back to the last time you had a bad case of the flu. Every muscle in your body probably shouted out in pain. In addition, you may have felt devoid of energy as though someone had unplugged your power supply. While the severity of symptoms fluctuate from person to person, FMS may resemble a post-viral state and this is why several experts in the field of FMS and CFS (Chronic Fatigue Syndrome) believe that these two syndromes are one and the same.

What are the symptoms of fibromyalgia?
 
The pain of fibromyalgia usually seems worse when a person is trying to relax and is less noticeable during busy activities or exercise.

Other symptoms are often associated with the pain, including the following:

• Sleep disturbance
• Depression
• Daytime tiredness
• Headaches
• Alternating diarrhea and constipation
• Numbness and tingling in the hands and feet
• Feelings of weakness
• Memory difficulties
• Dizziness

What causes fibromyalgia?
 
The exact cause of fibromyalgia is unknown. There are, however, many theories about why people get fibromyalgia. One theory suggests that stress contributes to the onset
of fibromyalgia. Other possible causes are:

• Distress (stress related to finances, work, marriage or recent loss such as the death of a close family member)
• Conscious or subconscious tension, disordered sleep
• Abnormal production of pain-related chemicals in the nervous system
• Lower pain threshold, heightened perception of pain
• Tenderness in certain areas, such as the upper back and forearms

Symptoms of fibromyalgia

When fibromyalgia begins, stresses in a person's life are prominent. Stress often results
in disturbed sleep patterns and a lack of restful sleep. When you don't get enough sleep, your body does not produce the chemicals necessary to control or regulate pain. A lack of these pain-regulating chemicals results in tenderness in the upper back and forearms, leading to the symptoms of fibromyalgia.

Physical and emotional factors may also contribute to the onset of fibromyalgia. For example, a physical illness (such as an infection) could cause changes in your body chemistry that lead to pain and sleeplessness.

Women tend to have fibromyalgia more often than men. In Europe, some studies suggest that as many as 14 percent of women may have fibromyalgia symptoms. In the United States, the fibromyalgia estimate is much lower - 2 to 4 percent of women and men.

How is fibromyalgia diagnosed?
 
The diagnosis of fibromyalgia is based on a combination of factors, including the following:

• Complete medical history and physical exam (to exclude other illnesses that may have similar symptoms such as rheumatoid arthritis, muscle inflammation, bursitis or tendonitis).
• Presence of widespread pain together with some of the other symptoms of fibromyalgia.
• Presence of very tender areas ("tender points") at specific locations. People who have fibromyalgia experience abnormal sensitivity when light pressure is applied to many of the locations shown here.

How is fibromyalgia treated?
 
People with fibromyalgia receive individual treatment based on several factors, including their overall health, medical history, number of tender points, severity of pain and presence of other symptoms. Treatment for fibromyalgia includes the following:

• Medications that decrease pain and improve sleep
• Lifestyle changes, including stress reduction
• Exercise to improve cardiovascular (heart and lung) health
• Relaxation techniques to relieve muscle tension

Medications

Medications that increase restful sleep may help, such as low doses of antidepressant medication taken before bedtime. Other kinds of sleeping pills are not very helpful for people who have fibromyalgia.

Nonsteroidal anti-inflammatory drugs including aspirin and ibuprofen (such as Motrin) may help decrease pain, but should be used sparingly. These drugs have many side effects such as stomach upset and fluid retention. They may also interact unfavorably with other drugs, such as medications for high blood pressure. Anti-inflammatory medications (such as cortisone derivatives) used to treat other rheumatic conditions have been tested in people with fibromyalgia and did not improve symptoms in tests.

Exercise

Brisk walking, biking, swimming and water aerobics are good activities to choose when starting your exercise program. Participating in aerobic exercise for 30 minutes three times each week is an important step to improve fibromyalgia symptoms. Exercise increases heart and lung function and stretches tight, sore muscles.

Coping with Stress
 
Certain stress factors in life (financial burdens, or difficulties with a boss, coworkers or your spouse) may not be easily eliminated. Evaluating the causes of stress and learning new ways to handle or cope may improve fibromyalgia. Relaxation techniques can help relieve muscle tension and reduce stress.

What is the long-term outlook for people with fibromyalgia?

Often, if the situations that caused the initial stress are resolved, fibromyalgia may spontaneously improve and medications may not be necessary.

Long term follow-up studies on fibromyalgia syndrome have shown that it is chronic but the symptoms may wax and wane. Many people with fibromyalgia will continue to have symptoms despite treatment, especially when life is stressful. However, medications that can alter the balance of pain-producing chemicals, such as anti-depressant drugs, should improve symptoms by 30 percent.

Aerobic exercise is an inexpensive, effective treatment for fibromyalgia. Women, the elderly, and those with rheumatoid arthritis or lupus are at the highest risk for this condition. Those who are able to continue working and fulfilling their social obligations - despite their pain - do best.