MEDICAL SURFARI: OH, MY ACHES AND PAINS!

Fibromyalgia Syndrome, first identified in the early 1900s, is characterized by generalized muscular pain and fatigue. The first symptoms of the syndrome may develop between ages 20 and 30 and may come and go in cycles. It is estimated that approximately 2 percent of the population, or 5 million people, suffer with this condition. Diffuse aches and pains may be caused by a variety of conditions, and that is what makes diagnosing fibromyalgia (sometimes referred to as fibrositis or myofacial pain syndrome) so difficult.

Fibromyalgia means pain in the muscles and fibrous ligaments and tendons. Fibromyalgia is not a true form of arthritis, even though at times it may feel like a joint disease. Instead, it is a form of soft tissue pain and stiffness.

Most people diagnosed with fibromyalgia have been to a variety of doctors before their signs and symptoms are identified as this condition. Pain is the most prominent symptom and although it may occur throughout the body, it is associated with dull aches and/or sharp stabbing pains that often appear in the neck, shoulder blades, lower back, thighs, and hips. The condition is commonly aggravated by emotional stress, illness, physical trauma, hormonal changes, insomnia, unaccustomed exertion, or dank weather. Generally, one's physical examination is normal except for focal, tender areas at specific locations.

Nearly 90 percent of people with fibromyalgia have associated fatigue and reduced exercise tolerance. In some patients, the fatigue is more a problem than the pain. Since fatigue is so common among people with this condition, some patients may carry a diagnosis of chronic fatigue syndrome as well.

It is also not unusual for patients with fibromyalgia to have difficulty sleeping or have a feeling of being unrefreshed or tired upon awakening. Other sleep disturbances, including sleep apnea, sleep myoclonus, and restless leg syndrome are also common among patients with this condition. Since changes in mood and "feeling down" are common, some researchers feel there may be a link between fibromyalgia and some forms of depression and chronic anxiety.

Fibromyalgia is diagnosed by exclusion of other conditions that may cause chronic pain and fatigue. There is no single laboratory or x-ray test that can reveal this condition. It is diagnosed by a physical examination that reveals wide-spread pain in combination with tenderness at very specific locations.

Fibromyalgia is treated with medications to relieve the discomfort and improve quality of sleep. Further, exercise programs that gently stretch muscles and improve aerobic fitness combined with relaxation techniques and other measures to ease muscle tension are thought to be effective for patients with fibromyalgia. Educational programs that improve the patient's understanding of the condition and the many different factors that, alone or in combination, may trigger the condition, are also thought to help teach patients how to manage their condition.

For further information regarding a seven week Fibromyalgia Self-Help Course or to sign up for a fibromyalgia support group, you can call the Regional Arthritis Center at Saint Francis Medical Center, (573)-339-6880 or 1-888-216-2393, or Southeast Missouri Hospital, (573)-334-4822.

World Wide Web Resources

Fibromyalgia: Ask Colorado HealthNet

http://www.coloradohealthnet.org/fibro/index_QnA.html

This site is arranged in an easy format of answers to questions about fibromyalgia.

USA Fibromyalgia Association

http;//www.w2.com/fibro1.html

Well known around the world, the USA Fibrositis Association is an national clearinghouse for hospitals, health care professionals or individuals looking for detailed information on Fibrositis.

Fibromyalgia Syndrome (FMS) Support Information

http://www.clark.net/pub/tbear/fms/

This web site will provide sources of information and support to those wanting additional knowledge about this syndrome including articles, pamphlets, guides, and support group information. It also provides links to additional world wide web links on Fibromyalgia.

Dr. Scott Gibbs is a neurosurgeon and editor-in-chief of Mosby's Medical Surfari. You may e-mail questions to him at drgibbs@semissourian.com or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardeau, Mo., 63701.