Fibromyalgia is a generalized body pain disorder that lasts more than 6 months. It is characterized by the pressure sensitive tender spots, trigger points and accompanying systemic and neurological symptoms. It is seen twice as much in women and in 2-8% of the society.
Fibromyalgia pain may manifest as:
- Generalized body pain
- Head-neck pain
- Back, low back pain
- Joint pain
Complaints that can be seen alongside pain in patients with fibromyalgia are:
- Sleep disorders
- Waking tired in the morning
- Fatigue that does not improve with rest
- Brain fog (Fibro fog)
- Concentration loss, reduced attention span
- A deceleration of performance, inability to multitask
- Memory problems
- Migraines and headaches
- Dizziness
- Frequent urination, hyperactive bladder symptoms
- Painful menstruation, premenstrual syndrome
- Numbness of hands and feet
- Restless legs syndrome (RLS)
- Jaw pain, temporormandibular disorders, teeth grinding
- Augmented sensitivity
- Sensitivity to light and sound
- Sensitivity to cold
- Sensitivity to touch
- Allodynia (pain with non painful stimuli)
- Hyperalgesia (augmented pain with painful stimuli)
- Sensitivity to odours
- Multiple chemical and drug sensitivity
- Joint pain and morning stiffness
- Irritable bowel syndrome; Gastrointestinal symptoms (abdominal pain, diarrhea, constipation)
- Vertigo, light headedness
- Orthostatic intolerance
A physician can make a diagnosis of fibromyalgia by taking a detailed history and examining you. Tender points, tender areas and trigger points may be found during the examination.
Fibromyalgia is caused by a combination of genetic and environmental factors. There is augmented central sensitization, inflammation, neuro-inflammation, oxidative stress and problems of the serotonin and dopamin metabolisms. Fibromyalgia sometimes starts after physical trauma, surgery, a severe infection or major psychosocial stress; while in some patients it becomes evident over the years without any significant triggers.
Risk Factors for fibromyalgia are:
- Being a woman
- Smoking
- Obesity
- Lack of physical activity
- Working at a desk job
- Burnt out syndrome
- History of childhood trauma
- Western type diet
- Dysbiosis
- SIBO (small intestinal bacterial overgrowth)
- Non celiac gluten sensitivity
- Histamin intolerance
Disorders associated with fibromyalgia are:
- Chronic fatigue syndrome
- Sleep disorders
- Migraines
- Tension-type headache
- Interstitial cystitis (painful bladder syndrome)
- Obsessive compulsive disorder
- Depression, anxiety
- Post traumatic stress disorder
- Restless legs syndrome
- Rheumatic diseases
- Thyroid metabolism disorders
- Infections
The following diseases should be kept in mind for differential diagnosis:
- Rheumatic diseases
- Hypothyroidism
- Vitamin D deficiency
- Iron-deficiency anemia
