For years now, a good number of doctors and patients alike have held the belief that Fibromyalgia is a “wastebasket diagnosis,” a “catch-all,” or worst of all, “all in your head.”

Finally now there has been some scientific evidence that the condition we know as Fibromalgia is indeed real and based on differences in our biochemistry and brain function.

Fibromyalgia is a condition characterized by chronic widespread pain. It affects 2-5% of the US population. The majority of people with Fibromyalgia are women between the ages of 35 and 60 years of age, although it certainly can be seen in men and in other age groups as well.
 
People complain of pain in both muscles and joints. The pain can be described as aching, burning, or soreness and patients have multiple tender points on exam. In more than 75% of Fibromyalgia patients the pain is accompanied by other symptoms, including insomnia, fatigue, difficulty concentrating (fogginess) and mood disorders. Because some of these symptoms can be vague, and can be attributed to other things, the diagnosis is often delayed, which is frustrating to the patient and can serve to worsen the vicious cycle of pain, sleeplessness and fatigue.
 
Due to many physicians’ attitudes about Fibromyalgia, both doubting its existence, and attributing all the symptoms to depression, many patients are reluctant to pursue the diagnosis beyond these initial barriers.

It is not clear what causes Fibromyalgia, but it is thought there may be some genetic component associated with pain sensitivity. There are clearly some common triggers which either start the cycle or exacerbate it. These include physical trauma (such as surgery or a car accident), a prolonged illness (such as Lyme) or emotional trauma (stress).

There is now growing evidence that there is a biochemical basis for Fibromyalgia. The nerves of people with Fibromyalgia give off more excitatory chemicals than those of normals, which can at least partially explain the almost hyper-reactive tone of the nerves and muscles in these patients. In addition, special MRI scans that look at brain function have shown differences in the brains of Fibromyalgia patients when they were given a painful stimulus as compared to normals. These images are hard to ignore.

Recently, the first medication for Fibromyalgia was approved. Lyrica targets these excess chemicals at the nerve endings and, in studies, decreased pain and improved sleep and fatigue. There have been numerous other medications used over the years that have also had some success in Fibromyalgia but have NOT yet been approved for use in Fibromyalgia. These include muscle relaxants and antidepressants. Yet other medications are expected to be approved for Fibromyalgia in the near future. In addition to medication, physical therapy, as a reintroduction of the patient into some kind of regular exercise regimen is an essential component of treatment.

So, now is a great time to report your symptoms to your doctor and get the help you deserve. People with Fibromyalgia need to work as a team with their doctors to start treatment in a timely manner and with an eye toward all of the contributing symptoms as well as the potential side effects of treatment. If that is accomplished, the Fibromyalgia patient can live a normal, productive and happy life.

 
About the Author
Dr. Maryanne Wysell is a rheumatologist with Orthopedic Associates of Dutchess County.  She specializes in the treatment of all types of arthtitis and a board speectrum of autoimmune diseases.