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Fibromyalgia
Definition
You hurt all over, and you frequently feel exhausted. Even after numerous tests, your doctorcan't find anything specifically wrong with you. If this sounds familiar, you may havefibromyalgia.Fibromyalgia is a chronic condition characterized by widespread pain in your muscles,ligaments and tendons, as well as fatigue and multiple tender points — places on your bodywhere slight pressure causes pain.Fibromyalgia occurs in about 2 percent of the population in the United States. Women aremuch more likely to develop the disorder than are men, and the risk of fibromyalgia increaseswith age. Fibromyalgia symptoms often begin after a physical or emotional trauma, but inmany cases there appears to be no triggering event.
Tender points
The 18 tender points associated with fibromyalgia occur in symmetrical pairs from the back of your head to your inner knees.
 
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Symptoms
Signs and symptoms of fibromyalgia can vary, depending on the weather, stress, physicalactivity or even the time of day.
Widespread pain and tender points
The pain associated with fibromyalgia is described as a constant dull ache, typically arisingfrom muscles. To be considered widespread, the pain must occur on both sides of your bodyand above and below your waist.Fibromyalgia is characterized by additional pain when firm pressure is applied to specific areasof your body, called tender points. Tender point locations include:
 
Back of the head
 
Between shoulder blades
 
Top of shoulders
 
 
Front sides of neck
 
Upper chest
 
Outer elbows
 
Upper hips
 
Sides of hips
 
 
Inner knees
Fatigue and sleep disturbances
People with fibromyalgia often awaken tired, even though they seem to get plenty of sleep.Experts believe that these people rarely reach the deep restorative stage of sleep. Sleepdisorders that have been linked to fibromyalgia include restless legs syndrome and sleepapnea.
Co-existing conditions
Many people who have fibromyalgia also may have:
 
Chronic fatigue syndrome
 
 
Depression
 
Endometriosis
 
Headaches
 
Irritable bowel syndrome (IBS)
 
Lupus
 
Osteoarthritis
 
Post-traumatic stress disorder
 
Restless legs syndrome
 
 
Rheumatoid arthritis
Causes
Doctors don't know what causes fibromyalgia, but it most likely involves a variety of factorsworking together. These may include:
 
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Genetics.
Because fibromyalgia tends to run in families, there may be certain geneticmutations that may make you more susceptible to developing the disorder.
 
 
Infections.
Some illnesses appear to trigger or aggravate fibromyalgia.
 
Physical or emotional trauma.
Post-traumatic stress disorder has been linked tofibromyalgia.
Why does it hurt?
Current thinking centers around a theory called central sensitization. This theory states thatpeople with fibromyalgia have a lower threshold for pain because of increased sensitivity in thebrain to pain signals.Researchers believe repeated nerve stimulation causes the brains of people with fibromyalgiato change. This change involves an abnormal increase in levels of certain chemicals in thebrain that signal pain (neurotransmitters). In addition, the brain's pain receptors seem todevelop a sort of memory of the pain and become more sensitive, meaning they can overreactto pain signals.
Risk factors
Risk factors for fibromyalgia include:
 
Your sex.
Fibromyalgia occurs more often in women than in men.
 
Age.
Fibromyalgia tends to develop during early and middle adulthood. But it can alsooccur in children and older adults.
 
Disturbed sleep patterns.
It's unclear whether sleeping difficulties are a cause or a
 
result of fibromyalgia. But people with sleep disorders — such as nighttime muscle
 
spasms in the legs, restless legs syndrome or sleep apnea — often havefibromyalgia.
 
Family history.
You may be more likely to develop fibromyalgia if a relative also has
 
the condition.
 
Rheumatic disease.
If you have a rheumatic disease, such as rheumatoid arthritis orlupus, you may be more likely to develop fibromyalgia.
Complications
Fibromyalgia isn't progressive and generally doesn't lead to other conditions or diseases. Itcan, however, lead to pain, depression and lack of sleep. These problems can then interferewith your ability to function at home or on the job, or maintain close family or personalrelationships. The frustration of dealing with an often-misunderstood condition also can be acomplication of the condition.
Preparing for your appointment
Because many of the signs and symptoms of fibromyalgia are similar to various otherdisorders, you may see several doctors before receiving a diagnosis. Your family physicianmay refer you to a rheumatologist, a doctor who specializes in the treatment of arthritis andother inflammatory conditions.
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