| The cause of fibromyalgia (FM) is unknown but | | | | patient with 11 of 18 tender trigger points fulfills a |
| theories pointing toward abnormal hypothalamic | | | | major diagnostic criterion for the diagnosis of |
| pituitary axis function or dysfunction of | | | | fibromyalgia. These trigger point tender areas are |
| neurotransmitter pathways in the brain are currently | | | | stereotypic meaning the same areas are tender in all |
| popular. | | | | patients with the diagnosis of FM.. |
| Several studies have demonstrated different | | | | Other symptoms include migraine headache, decrease |
| abnormalities in central nervous system functioning. | | | | in short term memory, cognitive dysfunction, blurred |
| Abnormal sleep studies showing alpha intrusion during | | | | or double vision, hypersensitivity to sound and smells, |
| delta (stage 4) sleep and a reduction of rapid eye | | | | shortness of breath, chest pains, palpitations, irritable |
| movement (REM) sleep have been seen. In addition, | | | | bowel, irritable bladder, painful menses, painful |
| abnormal SPECT scans have suggested lower blood | | | | urination, multiple drug allergies, multiple sensitivities to |
| flow to the thalamus and caudate nucleus in the | | | | chemicals. |
| brains of fibromyalgia patients. | | | | Laboratory testing will not be diagnostic. However, |
| Approximately 2 percent of the population has | | | | laboratory testing will help to exclude other conditions |
| fibromyalgia. About 80 percent of patients with | | | | such as polymyalgia rheumatica, hypothyroidism, |
| fibromyalgia are women. While fibromyalgia may | | | | rheumatoid arthritis, systemic lupus erythematosus, |
| occur as a primary condition, it is also a secondary | | | | etc., that might masquerade as fibromyalgia. FM is a |
| condition, occurring in as many as 30 percent of | | | | diagnosis of exclusion so it is imperative that other |
| patients with systemic lupus erythematosus and | | | | possible causes of aches and pains are ruled out. |
| rheumatoid arthritis. | | | | Imaging tests may also be helpful in establishing the |
| Patients with fibromyalgia complain of generalized pain | | | | presence or absence of FM. |
| affecting both sides of the body and both the upper | | | | Treatment must be individualized. Most patients will |
| as well as lower part of the body. | | | | respond to a combination of non impact aerobic |
| Pain tends to be aggravated by weather changes as | | | | exercise (swimming, stationary bike, elliptical trainer), |
| well as by stress. | | | | cognitive behavioral therapy, and medication. |
| While patients will complain of subjective joint | | | | Medications that have been found to be helpful |
| swelling, objective swelling is absent. | | | | include tricyclic antidepressants in low doses, muscle |
| Sleep disturbance occurs in almost all patients. | | | | relaxants such as cyclobenzaprine, also in low doses, |
| Complaints of chronic fatigue and non restorative | | | | and selective serotonin reuptake inhibitors (SSRIs). |
| sleep (feeling as if they haven't slept) are common. | | | | Other medicines such as gabapentin and tramadol |
| Sleep apnea may aggravate the situation. | | | | may also be helpful. |
| Tender trigger points are noted in all patients. A | | | | |