Fibromyalgia literally means “condition of pain in the muscle fibers.” Fibromyalgia is a syndrome, or group of symptoms that occur together, rather than a disease. Historically it has been a controversial and poorly understood diagnosis. The most prominent feature of Fibromyalgia is the presence of widespread muscle pain, often achy, gnawing or burning, either constant or recurrent, and varying in severity. Pain may wax and wane but is usually present all day and is made worse with increased activity, stress, and/or poor sleep. However, the muscle pain is often confusing to the patient and the health practitioner, because the pain can fade and intensify, or even change location within the body. Stiffness, soft tissue tenderness, general fatigue, and sleep disturbances, are also present. The most common sites of pain include the neck, back, shoulders, pelvic girdle, and hands, but any body part can be affected.
Population-based studies have demonstrated that Fibromyalgia affects approximately 2–7% of the population, with a very similar prevalence in at least 5 industrialized countries. This translates into approximately 6-21 million Americans who suffer with this condition. However, at any one time, 10–12% of the general population report chronic generalized musculoskeletal pain that cannot be traced to a specific structural or inflammatory cause. Such idiopathic widespread pain most often fits the classification criteria for Fibromyalgia. Women are generally affected by this disorder 8-10 times more commonly than men and the syndrome most often develops during the reproductive years. Children can also suffer from Fibromyalgia, however, in this age group, boys and girls are equally affected.
Individuals with Fibromyalgia show a number of abnormal patterns in muscle physiology.
- High basal levels of muscle tension, even at rest
- Asymmetries – higher levels of muscle tension in the same muscle on one side of the body than on the other
- Co-activations – muscles that are not designed to function during a movement are found to tense during the activity
- Failure to recover after exertion – muscles do not return to relaxation following use
- Long-term atrophy of muscle tissue, with shortening of muscle fibers and increased sensitivity
Many of these abnormalities make sense, in terms of the patient’s body reaction to the presence of pain. When human beings experience pain, they tense. A common example of this finding is the twisting of body posture defensively around a painful site in order to splint or brace the painful region. This causes the tensed torso and musculature to lose flexibility. Additionally, those in severe pain tend to avoid activity in an attempt to minimize pain. This results in a muscle disuse syndrome consisting of atrophy of muscle tissue, muscle deconditioning, and the loss of flexibility and strength
100 Questions & Answers About Fibromyalgia
Jones & Bartlett, Publishers, LLC (20010)