Rule In, Rule Out

After years of study and calling it by a number of different names, researchers are now able to put a “face” on this chronic pain syndrome. Fibromyalgia is challenging to diagnose because symptoms mimic other problems. They also do not materialize together, but rather accumulate over time with no particular trigger events.

The pain can indicate muscle strain, low back pain (sciatica), migraine headache, anxiety/panic attacks, restless legs, depression, sleep apnea and pms. Bruising may also be present. Depression or anxiety are not symptoms, but may co-exist because of frustration of dealing with this widely misunderstood condition. Women are more likely to experience fibromyalgia syndrome than men.

No blood test or x-ray series exists to identify this condition. There is also no cure. A variety of medicine is available to control pain. Eighteen “tender points” occur in pairs starting at the back of the head, continuing symmetrically down front and back, ending with a pair of tender points on the inner knee.


Symptoms of Fibromyalgia

Most patients report a dull annoying ache at (or near) a muscle. A doctor of rheumatology is the specialist who confirms or denies the presence of fibromyalgia. The patient may be unaware that the same pain exists in a matching muscle on the other side of the body. 

To be widespread, pain must occur above and below waist level as well as both sides of the body. Confirmation of fibromyalgia pain comes when pressure causes additional pain making the patient extremely uncomfortable. Firm pressure on several tender points will confirm the diagnosis:

1. Back of the head
2. Between the shoulder blades
3. Top edge of the shoulders
4. Front sides of the neck
5. Upper chest just under the shoulder blades
6. Outer elbows
7. Upper hips below the waist
8. Sides of hips at upper thighs
9. Inner knees at side of the joint


Risk and Causes

Fibromyalgia is not the forerunner of other illnesses. This is a chronic illness because there is no known cure. It can become disabling when the pain signals make it hard for a patient to sleep. The combination of pain and sleep deprivation can interfere with the ability to function at home or work. These are three risk factors for fibromyalgia:

1. Your sex: Females are more susceptible and their hormones may be the culprit for how they experience the intensity of pain signals.

2. Family history: You are more likely to develop fibromyalgia if someone else in your biological family has it.

3. Rheumatic disease: If you already have rheumatoid arthritis or lupus, you are most likely to develop fibromyalgia.

The cause of this chronic illness is elusive, but one or more of the following could be a contributing factor:

1. Genetics: the design of mutations on a chromosome can make you more susceptible to the development of fibromyalgia.

2. Infections: certain illnesses, flu and Epstein-Barr are two that doctors suspect, may trigger or aggravate fibromyalgia.

3. Trauma: physical, emotional or mentally intensive experiences including post traumatic stress disorder or brain injury.