Fibromyalgia is a complex, chronic, and debilitating condition characterized by widespread musculoskeletal stiffness and pain, in conjunction with specific tender (“trigger”) points, generalized fatigue, and sleep disturbance. People with this syndrome may also experience gastrointestinal disorders, headaches, trouble concentrating, or psychological symptoms, such as anxiety or depression .

Fibromyalgia Trigger Points

© 2009 Nucleus Medical Media, Inc.

Although fibromyalgia has only been classified as a syndrome within the last few decades, there are historical indications that a fibromyalgia-like condition was described by Hippocrates, thus making it one of the oldest medical mysteries.

It is estimated that approximately three to six million Americans have fibromyalgia. The majority of the people with fibromyalgia are women, but the condition can occur in men and children as well. Most cases occur between the ages of 20 to 40, although fibromyalgia can develop at any age.

Causes

The exact cause of fibromyalgia is unknown, and there has been significant controversy in the medical community about its origin.

Currently, there are several theories regarding possible causes of fibromyalgia, including the following:

Sleep Disorders —Sleep researchers have noted that fibromyalgia patients consistently show a disturbance during the stage IV (delta) cycle of sleep, which is considered the deepest and most restorative phase of sleep. Lack of restful sleep may be the cause of the overwhelming fatigue experienced by many fibromyalgia patients.

Infectious Trigger —Some researchers believe that there may be a viral or infectious agent that triggers the onset of fibromyalgia.

Preceding Incidence of Trauma —A high percentage of patients have reported traumatic emotional or physical events, such as an automobile accident or divorce, shortly before the onset of fibromyalgia symptoms. Although it is not believed that the events themselves cause fibromyalgia, they may serve as triggers in people who are genetically or otherwise susceptible to developing this syndrome.

Biochemical Abnormalities in the Nervous System —Studies have shown that people with fibromyalgia often have highly elevated levels of Substance P, a pain neurotransmitter, in their spinal fluid. Levels of other neurotransmitters, such as serotonin and norepinephrine, or hormones, such as cortisol and growth hormone, may play a role in fibromyalgia patients.

Researchers continue to explore these and other explanations for the possible causes of fibromyalgia. Currently there is no cure, but symptoms can be diminished by a combination of pharmacologic and nonpharmacologic treatments.

Overlapping syndromes

Physicians have noted that many people with fibromyalgia are also likely to have other syndromes, such as:

• Chronic fatigue syndrome
• Multiple chemical sensitivity syndrome
• Myofascial pain syndrome
• Temporomandibular disorder (TMD)
• Tension headaches or migraines
• Skin complaints
• Restless leg syndrome
• Irritable bowel syndrome
• Dysmenorrhea

There has been some speculation that fibromyalgia may not be a separate condition, but instead represents a constellations of symptoms that overlaps with other illnesses, all of which may have the same cause or causes, which are still unknown.

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