Fibromyalgia is often characterised by muscle pain and can be linked to an increased sensitivity of the nerves. There is no definitive cause of fibromyalgia but it can be classified as a ‘multi-factorial’ disorder, meaning that many contributory factors have to come together in order to trigger the syndrome. In this page, our muscle and joint expert Earle Logan explains the possible causes and symptoms of fibromyalgia, and discusses how the condition can be diagnosed.
Fibromylagia is a health disorder characterised by widespread, chronic pain in the muscles and soft tissues in the body.
The term fibromyalgia arises from three Greek or Latin words:
‘fibra’ which means fibrous or connective tissue in the body – the soft bits such as muscles, tendons and ligaments
‘myo’ which means muscles
‘algos’ which means pain.
The term, literally meaning ‘muscle and connective tissue pain’, was first used by an American rheumatologist in 1981. However, symptoms which we now recognise as fibromylagia can be traced back to the 1800s or before. During these years, it was known variously as ‘muscular rheumatism’, ‘chronic rheumatism’, ‘spinal irritation’, ‘Charcot’s hysteria’, ‘hysterical paroxysm’ and having ‘a morbid affection’.
In the early 1900s, the term ‘fibrositis’ (inflammation of the fibrous tissue) was used and this term persisted through to the 1970s when it was replaced by ‘fibromyalgia’ because scientists and doctors could find no evidence of inflammation in the muscles.
Pain in muscles is the key and most common symptom of fibromyalgia. However, tests usually reveal that there is no inflammation in the muscle tissue. Hence, pain in muscles probably arises as a result of increased sensitivity of the nerves present associated with these tissues.
Although scientists do not understand the precise cause of this, research has shown that people suffering from fibromyalgia have an abnormality in the way their Central Nervous Systems (brain and spinal cord) work. Their nerves are more sensitive and perceive pain differently compared to other people.
Abnormalities can also be seen in the brain waves of those suffering from fibromyalgia during sleep and this could account for the poor sleep reported, as well as low mood, depression tiredness, fatigue, poor concentration and memory.
Although many theories exist, the cause of fibromyalgia is not known. What is clear is that it is unlikely that fibromyalgia has a single cause, but arises as a result of a number of coincident factors coming together – this is what doctors term a multi-factorial disorder.
Unfortunately, there is no single medical test (such as a blood test, X-ray or scan), that will help confirm the diagnosis of fibromyalgia. You may come across questionnaires or fibromyalgia tests, but these may not always give you an accurate assessment.
As fibromyalgia can mimic some other medical conditions, it is important that you see your doctor for a diagnosis, even if you feel sure that you have the condition. Many will consider this to be sound advice, even if some doctors may not fully understand the problem.
A doctor will consider the possibility of fibromyalgia based on the history of widespread muscle tenderness and pain, tiredness, sleep disturbances as well as other symptoms.
He or she will check to exclude other conditions such as rheumatism, rheumatoid arthritis or other autoimmune condition, thyroid problems, glandular fever or anaemia, and blood tests may be taken to exclude the possibility of these conditions. Normal results in these tests will help point towards a diagnosis of fibromyalgia.
Some doctors use a technique where they look for ‘greater than normal’ tenderness in 18 points in the body using criteria defined by the American College of Rheumatology in 1990. These points are at the neck and shoulders, elbows and knees, base of the spine and hips. Although helpful, this test is not always easy to carry out and is seldom definitive.
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