WHAT IS FIBROMYALGIA?
Fibromyalgia Syndrome (FM) is a common and complex central nervous system (CNS) condition characterized by chronic diffuse musculoskeletal pain, increased pain sensitivity at multiple tender points, fatigue, abnormal pain processing, disturbed sleep and often, psychological stress. FM affects people not only physically, but mentally and socially as well. Severe symptoms can make FM extremely debilitating because it interferes with basic daily activities and affects quality of life. The National Pain Foundation estimates that 90% of FM patients have sleep problems, and it has been estimated that roughly one-quarter of people with fibromyalgia are work disabled.
FM is considered a syndrome rather than a disease because it is a collection of signs, symptoms, and medical problems that tend to occur together but are not related or attributable to a specific, identifiable cause with distinct signs or symptoms. Fibromyalgia is also referred to as fibromyalgia syndrome, fibromyositis and fibrositis.
HOW MANY PEOPLE HAVE IT AND IS THERE PREVALENCE AMONG ANY DEMOGRAPHIC GROUP?
According to the National Institutes of Health, scientists estimate that FM affects 5 million Americans age 18 or older. The National Fibromyalgia Association estimates that 3-6% of the world population has FM. FM is most prevalent in women -- 75-90 percent of those who have the condition are women – but it also occurs in men and children of all ethnic groups. FM is often seen in families, among siblings or mothers and their children. The diagnosis is usually made between the ages of 20 to 50 years, but the incidence of FM rises with age; by age 80, approximately 8% of adults meet the American College of Rheumatology classification of fibromyalgia.
HOW IS AN FM DIAGNOSIS DETERMINED?
Diagnosing FM presents a significant challenge for several reasons. The condition is not well understood by the medical community. Symptoms can include everything from widespread pain to fatigue, menstrual pain and sleep disturbances. Individual symptoms may often be mistaken for symptoms of other illnesses or diseases, and FM may co-exist with other conditions in the same patient. Chronic headaches, jaw pain, irritable bowel syndrome, and difficulty with memory and concentration are also common symptoms of FM.
A definite diagnosis of fibromyalgia syndrome should only be made when no other medical disease can explain the symptoms. The physician typically takes a proper history and physical exam coupled with blood work and/or x-rays to rule out a wide range of conditions including hormonal imbalance, anemia, infection, muscle disease, bone disease, nerve disease, joint disease, cancer, rheumatoid arthritis, and polymyalgia rheumatica. Checking thyroid-stimulating hormone levels routinely is also critical, since hypothyroidism and related thyroid deficiencies can mimic many FM symptoms. Compounding the difficulty in diagnosing FM is the fact that there is no specific test for FM. In most cases, standard medical laboratory tests appear normal.
WHAT MEDICAL CRITERIA MUST BE MET TO CONFIRM A DIAGNOSIS OF FM?
The generally accepted criteria for diagnosis of FM as defined by The American College of Rheumatology are widespread pain in all four quadrants of the body (left side, right side, above the waist, below the waist, at the neck, front of chest, mid-back or low back) persisting for a sustained period of at least three months, and sensitivity to pressure on at least 11 of the 18 specified tender points of fibromyalgia. These areas are painful on touch but without signs of redness, swelling or heat in surrounding joints or muscles. The physician may also conduct electrical nerve and muscle testing, known as electromyography (EMG) or nerve conduction velocity (NCV).
CAN FIBROMYALGIA BE CURED?
There is no cure for Fibromyalgia Syndrome. However, it is important to recognize that FM is not a fatal condition; it will not damage muscles, joints or organs, and can improve over time. It needs to be managed as a chronic condition, using both medical and non-drug treatments. Non-drug treatments may include exercise, acupuncture, nutritional and hormonal supplements, behavioral therapy, massage, and biofeedback.
ARE THERE EFFECTIVE MEDICATIONS THAT HELP RELIEVE THE SYMPTOMS?
Three drugs are currently approved by the U.S. Food and Drug Administration and marketed for the FM indication
All are daytime treatments; no bedtime medication has been approved for this indication. Muscle relaxants have also been used ‘off label’ to treat FM symptoms. TONIX Pharmaceuticals is developing the first medication from the “muscle relaxant” category to be submitted for approval in the FM indication.
WHAT KIND OF DOCTOR TREATS FM?
To effectively manage the multiple aspects of FM, many patients seek care from several different healthcare professionals including:
WHERE CAN I GET MORE INFORMATION AND HELP IN MANAGING FIBROMYALGIA?
American College of Rheumatology http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/fibromyalgia.asp
American Academy of Pain Management
American Fibromyalgia Syndrome Association
The Fibromylgia Network
The National Fibromyalgia Association
The National Fibromyalgia Research Association
The National Fibromyalgia and Chronic Pain Association
American Chronic Pain Association