What is Fibromyalgia?
Written by Kimberly Vaughn, MD   
Thursday, 15 October 2009
Fibromyalgia is a poorly understood condition that causes multiple tender points, called trigger points, in the muscles and soft tissues of the body.
What is going on in the body?

People who have fibromyalgia have chronic, widespread pain and stiffness in the muscles. Fatigue is a key factor in fibromyalgia. Some healthcare professionals believe that fatigue may occur because the person doesn't get enough deep, restful sleep. Others believe that the sleep disturbance may actually be a cause of the fibromyalgia.

Recent research has shown that people who have fibromyalgia have a decrease in blood flow to the parts of the brain involved with pain perception. They also have two times the normal level of a brain chemical known as substance P. This substance is involved in the transmission of pain messages from nerve cells to the brain.

Fibromyalgia may occur alone, or together with other disorders such as Lyme disease or rheumatoid arthritis.
What are the causes and risks of the condition?

No one knows for sure what causes fibromyalgia, but there are several theories. Some possible causes of fibromyalgia include the following:
- autoimmune disorders, or a condition in which the body creates antibodies against its own tissues
- endocrine abnormalities, which are problems with various glands in the body
- biochemical abnormalities in the central nervous system, such as the elevated level of substance P in the brain
- impaired blood flow to the brain
- stress
- mechanical stresses to the cervical and lumbar spine
- history of abuse as a child

New research findings suggest that autoimmune disorders may be triggered by a transfer of cells between the fetus and the mother during pregnancy. The study involved women with scleroderma, an autoimmune disorder involving the skin. These women have more fetal cells in their blood decades after a pregnancy than women who don't have scleroderma. While further research is needed to substantiate these findings, the study does offer an explanation for the much higher incidence of autoimmune disorders in women than in men.

Women account for 75% of those who have the disease. It is most common in women of childbearing age.

What are the treatments for the condition?

There is no cure for fibromyalgia. However, there are some treatments that can improve the symptoms and quality of life for someone with the condition. People with fibromyalgia have reported improvement from the following:
- acupuncture
- aerobic exercises, such as bicycling or jogging
- antidepressant medications, such as amitriptyline and cyclobenzaprine, to improve sleep and relax muscles
- biofeedback
- chiropractic treatments
- heat or cold treatments
- hypnosis
- injections of local anesthesia medications or corticosteroids into tender points
- massage therapy
- occupational therapy, which can teach individuals how to continue functioning in spite of pain
- stretching and range of motion exercises, which involve moving joints through their normal movements

Some individuals may find one or more of these treatments helpful, while others may find that a particular treatment worsens symptoms.
If a treatment is helping and the side effects are tolerable, the treatment should be continued.
What are the side effects of the treatments?

Side effects of antidepressants include dry mouth, sexual dysfunction, and constipation. Injecting local anesthetic medications can make the chronic pain worse in some cases and can cause an allergic reaction.
What happens after treatment for the condition?

The course of fibromyalgia is unpredictable and highly individualized. Treatment is lifelong.