Fibromyalgia syndrome (FS) is a chronic and complex condition of unknown etiology, which is characterized by widespread musculoskeletal pain with multiple tender points, which commonly co-exists with depression; sleep disturbance, and significant fatigue.
Patients suffering from fibromyalgia often report high disability level and poor quality of life. There is no specific laboratory test to diagnose it but the accepted method for diagnosis is the 1990 American College of Rheumatology (ACR) criteria. According to ACR patient should have widespread pain for longer than three months duration, with pain on palpation of at least 11 of 18 specific tender points on body.
Prevalence of fibromyalgia (all ages) is found to be 2% (females 3.4% and males 0.5%). Prevalence increases with age but females being more affected than males.
Classification: It is classified based on psychological and autonomic nervous system profiles
- “Extreme sensitivity to pain but no associated psychiatric conditions” (may respond to medications that block the 5-HT3 receptor)
- “Fibromyalgia and comorbid, pain-related depression” (may respond to antidepressants)
- “Depression with concomitant fibromyalgia syndrome” (may respond to antidepressants)
- “Fibromyalgia due to somatization” (may respond to psychotherapy)
What causes fibromyalgia?
There are many speculations about the causes of Fibromyalgia. Researchers suggest that being a complex syndrome it cannot be caused by a single event but from a combination of many physical and emotional stressors. Some researchers believe that it is caused by reduced level of serotonin (neurotransmitter) leads to reduced pain threshold and anxiety. Increased levels of substance P may cause increased pain sensitivity. Some studies link fibromyalgia to sudden brain and spinal cord injury.
1 :: Is stress and fibromyalgia related? Chronic stress may be an important precipitating factor as fibromyalgia is frequently seen in people with stress related disorders such as chronic fatigue syndrome, irritable bowel syndrome and depression.
2 :: Insomnia and fibromyalgia Many people suffering from fibromyalgia experience insomnia or non-restorable sleep which causes lower levels of serotonin, resulting in increased pain sensitivity.
3 :: Depression and fibromyalgia Some researchers used to believe that low-grade depression causes fibromyalgia but recent studies negate this thought. However continuous pain can cause anxiety and depression, which can worsen symptoms of fibromyalgia.
4 :: Genetics and fibromyalgia Some scientists theorize that people suffering from fibromyalgia may have gene or genes inherited from their parents, which cause adverse reaction to some stimuli. When these people are exposed to certain emotional or physical stressors there is a change in the body’s response to that stimulus. This causes higher sensitivity of entire body to pain.
5 :: Gluten sensitivity There is an association seen between fibromyalgia and gluten sensitivity. Also patients have seen improvements in their symptoms by eliminating gluten from their diet.