Fibromyalgia Syndrome (FMS) is a painful, chronic illness primarily involving widespread muscle pain (often described as burning, throbbing, shooting or stabbing), and stiffness. The pain and stiffness are often worse of the morning and can vary from mild to debilitating. It is one of the most common illnesses affecting the muscles and generates between 20 to 30 million physician visits a year in the U.S. alone.

What Causes Fibromyalgia?

Research studies indicate that a genetic predisposition makes some people more susceptible to developing Fibromyalgia. However, based on studies of identical twins, other research indicates that genetic predisposition is not the only factor. Other important issues are lifestyle and the total accumulated load of microbes and toxins in the body. (Most of us are exposed to toxins in the food we eat, the water we drink, the air we breathe, and the products we use on a daily basis.)

Fibromyalgia often surfaces when a trauma throws the body's system off track. This could be physical (i.e., a severe bacterial or viral infection, accident or chemical exposure), or emotional (i.e., a divorce or death in the family). Patients often report a history of illness or injury within the year before their symptoms started. Others report their symptoms came on gradually. They have often lived with on-going stress for years.

How is Fibromyalgia Diagnosed?

In the May 2010 issue of Arthritis Care & Research (ACR) The American College of Rheumatology published a new set of diagnostic criteria they are proposing for fibromyalgia. The new criteria include common symptoms such as fatigue, sleep disturbances, and cognitive problems, as well as pain.

The original diagnostic criteria, established by the ACR in 1990, required the patient to have:

1. A history of widespread pain in all four quadrants of the body for a minimum duration of three months, and
2. Pain in at least 11 of 18 designated tender points when four kilograms (about 10 pounds) of pressure are applied.

The new method offers an easier way to diagnose fibromyalgia, using questions that put more emphasis on cognitive problems and other symptoms common in those with fibromyalgia. It doesn't require doctors to perform a physical or administer a tender point exam. The new set of questions is expected to result in more fibromyalgia diagnoses because the tender point exam, used for the last 20 years, may have missed a lot of people with fibromyalgia including many men, since men tend to be less sensitive to the pain than women. The American College of Rheumatology, which had previously endorsed the tender point exam, has preliminarily accepted the new method as a diagnostic tool for fibromyalgia pending further research.

Proposed New Diagnostic Criteria

The new diagnostic criteria, as proposed, will still require the first part of the old criteria – a history of widespread pain in all four quadrants of the body for a minimum duration of three months – but will replace the second part, the tender point exam, with:

• A widespread pain index score which will be determined by counting the number of areas on the body where the patient has felt pain in the last week. The checklist includes 19 specified areas.
• A symptom severity score which will be determined by rating on a scale of zero to three (three being the most pervasive), the severity of three common symptoms: fatigue, waking unrefreshed and cognitive symptoms. An additional three points can be added to account for the extent of additional symptoms such as numbness, dizziness, nausea, irritable bowel syndrome or depression. The final score is between 0 and 12.

To meet the criteria for a diagnosis of fibromyalgia a patient would have:

• Seven or more pain areas and a symptom severity score of five or more, or
• Three to six pain areas and a symptom severity score of nine or more.

Do you think you may have fibromyalgia?

These questions can help you find out. Keep in mind that fibromyalgia must be diagnosed by a doctor, so even if you think you have symptoms see a medical professional to be sure.

1. Do you have widespread pain located in seven or more of the following areas: shoulders, upper arms, lower arms, hips, upper legs, lower legs, jaw, chest, neck, or abdomen? (Please note that if you have pain on both sides of the body—say, in both your left and right upper arms—each arm would count separately.)
2. Do you experience any other fibromyalgia symptoms, such as irritable bowel syndrome, fatigue, problems thinking or remembering, muscle weakness, abdominal pain or cramping, numbness or tingling, dizziness, insomnia, depression, constipation, nausea, nervousness, chest pain, fever, dry mouth, itching, frequent or painful urination, or wheezing?
3. Have your symptoms been present for at least three months?
4. Do you have another medical disorder that may otherwise explain the pain?

If you answer yes to the first three questions and no to the last one, you may have fibromyalgia. Follow up with your doctor for a full assessment.

Common Symptoms of Fibromyalgia

In addition to pain and tender points, symptoms of FMS vary widely in number and intensity and can develop over time or suddenly.

• Anxiety, depression, mood swings
• Bloating, constipation and/or diarrhea, abdominal pain, nausea
• Chemical sensitivities including medications
• Cold hands and feet
• Dizziness
• Dry mouth and/or eyes
• Fatigue and/or lethargy
• Food allergies (often hidden)
• Hair loss
• Headaches
• Heart palpitations
• Itchy scalp
• Memory lapse, difficulty concentrating, transposing numbers and words
• Numbness and tingling in hands, arms, feet, legs and/or face
• Sensitivity to light, sound, odors, and/or temperature
• Sleep disturbances
• Vision changes and/or floaters

Fibromyalgia is often associated with other illnesses, especially Chronic Fatigue Syndrome and Multiple Chemical Sensitivities.

Other Conditions/Illnesses Often Associated with Fibromyalgia

• Cancer
• Carpel tunnel syndrome
• Diabetes or hypoglycemia
• Gulf War syndrome
• HIV/AIDS
• Heavy metal toxicity
• Hidden food allergies
• Hypothyroidism or (occasionally) Hyperthyroidism
• Irritable bladder or Irritable bowel syndrome
• Lyme disease
• Menstrual cramps and PMS
• Mouth lesions/Canker sores
• Multiple Sclerosis
• Myofascial Pain Syndrome
• Osteoarthritis or Rheumatoid arthritis
• Raynaud’s phenomenon
• Seasonal affective disorderSystemic lupuS
• Temperomandibular jaw pain (TMJ)
• Yeast, parasites and/or other intestinal infections

An individual holistic approach, along with avoiding exposure to substances that trigger reactions (foods, fumes, toxic chemicals, etc.) has been the most effective treatment to date. If you think you have FMS, see a natural-minded doctor who understands root causes.

Who is at Risk for Fibromyalgia?

Fibromyalgia is seen in all age groups from young children to the elderly, although in most patients symptoms appear between 25-50 years of age. It affects more women than men (about 65 percent to 35 percent respectively).

NOTE: These statements are meant for educational purposes only and should not be interpreted as a substitute for appropriate medical advice or treatment. FCI offers support as an adjunct to, but not a substitute for, professional health care. Any attempt to diagnose or treat illness should come under the direction of a healthcare professional.