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There are few illnesses that evoke the mind/body connection like fibromyalgia. The brain, nervous system, and the rest of the body work in tandem to express the symptoms of this pain syndrome. For a long time, people with fibromyalgia, or fibro, were thought to be malingerers or mentally ill. But fibro is a real pain syndrome that causes real disability, and the diagnostic criteria have just been revised, so it is a good time to revisit just what fibromyalgia is.
The National Fibromyalgia Association states:
“Fibromyalgia (pronounced fy-bro-my-AL-ja) is a common and complex chronic pain disorder that affects people physically, mentally and socially. Fibromyalgia is a syndrome rather than a disease. Unlike a disease, which is a medical condition with a specific cause or causes and recognizable signs and symptoms, a syndrome is a collection of signs, symptoms, and medical problems that tend to occur together but are not related to a specific, identifiable cause.
Fibromyalgia, which has also been referred to as fibromyalgia syndrome, fibromyositis and fibrositis, is characterized by chronic widespread pain, multiple tender points, abnormal pain processing, sleep disturbances, fatigue and often psychological distress. For those with severe symptoms, fibromyalgia can be extremely debilitating and interfere with basic daily activities.”
Diagnosis of fibro has in the past been made primarily on the basis of specific tender points spread throughout the body. However, fibro sufferers often have other symptoms as well, including widespread pain, extreme fatigue, non-restorative sleep, and cognitive issues commonly referred to as “fibro fog”.
The American College of Rheumatology has revised the diagnostic criteria to include some of these other symptoms, which is likely to extend the diagnosis to more patients. It is a little controversial because the new criteria may cause some overlap with other diagnoses, such as chronic fatigue syndrome. The previous diagnostic criteria were developed 20 years ago. Many felt the previous criteria left too many patients behind and not properly diagnosed.
People with fibromyalgia often complain of feeling like they always have the flu and of widespread pain. These symptoms are often accompanied by bowel and bladder dysfunction, sleep and mood disturbances, and fatigue. Diagnosis is made using the ACR criteria, as there is no diagnostic test yet that points to fibro. It is a diagnosis of history and exclusion.
Fibromyalgia can be diagnosed by primary health care providers, but is often diagnosed and managed in partnership with a rheumatologist, sometimes along with a pain specialist. It can take a long time to get diagnosed because symptoms often seem vague. Hopefully the new criteria will help lead to faster diagnosis and treatment.
Sources:
Medline Plus: Fibromyalgia
http://www.nlm.nih.gov/medlineplus/ency/article/000427.htm
National Fibromyalgia Association
http://www.fmaware.org/site/PageServer?pagename=fibromyalgia
Pain Medicine News, Issue: August, 2010, Volume: 8:08 : Will New ACR Fibromyalgia Criteria Improve or Confuse Diagnosis?
http://www.painmedicinenews.com/index.asp?section_id=82&show=dept&ses=ogst&issue_id=654&article_id=15596
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