Fibromyalgia

Fibromyalgia is a common rheumatic syndrome affecting 3-10% of the general population. It has an increased frequency in females age 20-50. There is no lab test to diagnose this syndrome.

The cause is unknown but sleep disorders such as sleep apnea (multiple episodes of not breathing while asleep), depression and infections have been proposed.

The symptoms include chronic aching pain and stiffness with musculoskeletal pain in the neck, shoulders, low back and hips. Cold and damp weather can aggrevate the symptoms. Mild exertion can aggrevate the pain and increases fatigue.

The physical exam for fibromyalgia can be normal. Occasionally trigger points for pain can be found at the inside knee, outerside of the elbow or trapezius muscle in the neck.

Other diseases can yield some of fibromyalgia symptoms but can be diagnosed by lab tests. These include rheumatoid arthritis and lupus. If you have hypothyroid disease (slow functioning thyroid) you can have fibromyalgia symptoms. A blood test determines what your thyroid is doing.

Once fibromyalgia is diagnosed, and it may take some time, patient education is important. Presently amitriptyline (an antidepresent) is used. An exercise program is initiated. NSAIDS ( motrin, advil, nuprin,aleve) can be tried but do not offer a lot of relief.

This can be a very frustrating disease for patient and doctor. At least the disease does not progress to a more severe state. Treatment options are few and must be taylored to each patient. Perhaps in the future this will change with research.