What is Fibromyalgia Fibromyalgia is a syndrome of multiple etiologies that affects the immune and central nervous systems as well

as many other organs. It is a syndrome of chronic fatigue, diffused muscle pain and stiffness with the presence of tender points on physical examination (Lippincott Manual of Practice, 2003). Fibromyalgia is seen in 3% to 6% of the general populationmostly women, and is most commonly diagnosed in individuals between the ages of 20 and 50 (Hurst, 2008). Although fibromyalgia only started drawing attentions of medical professionals and clinicians for a few decades by now, it has been around for a lot longer before it has been recognized. For several centuries, the condition has been contemplated with several names. It was believed that during biblical times, Job was speculated to have suffered from fibromyalgia in which pain was described in the book as though something were relentlessly gnawing to the bones. In 1660, symptoms were identified resembling fibromyalgia and were first given a name of muscular rheumatism. Dr. William Balfour of Edinburgh, Scotland gave the first full description of the condition in 1816 and was referred to as fibrosis, hysterical paroxysm and still, muscular rheumatism since it caused generalized burning sensation on soft tissues and in 1824, he became the first to describe sore points associated with fibromyalgia. In 1880, a psychiatrist in United States suggested heightened sensitivity to pain, psychological and psychiatric disturbances as one of the pathophysiological mechanisms of the illness which then, he called as neurasthenia. In 1904, British rheumatologist William Gowers establishd the term "fibrositis" ("fibro" means to fiber; "itis" means inflammation) into the medical lexicon to indicate the tender points found in patients with muscular rheumatism. Moreover, Dr. AJ Luff discussed factors related to fibrositis in the British Medical Journal in 1913. He observed that symptoms of the condition grew worse and poorer when the barometric pressure is low and when rain is approaching. Also, his article created the connection between growing pains in children and fibrositis as well as the temperature variations, fevers, infections and vehicular accidents in relation to the condition. In 1972, Dr. Hugh Smythe of the University of Toronto laid the foundation of fibromyalgia diagnosis and treatment by describing widespread pain and tender points. In addition, Dr. Harvey Moldofsky, a colleague of Smythes at the University of Toronto, performed the first sleep electroencephalogram study in 1975 and recognized the sleep disturbances and deprivation associated with fibromyalgia as manifested by short-term memory loss, word mix-ups and lack of concentration. Further studies were conducted and were found that signs of inflammation could not be evident, thus, physicians concluded that the term fibrositis was inappropriate. As a result, the term "fibromyalgia" ("my" means muscle; " algia" means pain) was introduced by Gower in 1976 to replace the misnomer "fibrositis". The first controlled clinical study with validation of signs and symptoms and tender points was published in 1981. The interconnection of the significant concepts of fibromyalgia and other similar condition was proposed in 1984. In 1986, Serotogenic and norepinephric drugs were first shown to be effective in treating the condition since these substances, which play important roles in sleep regulation and intensity of pain signals, were found to be in low levels in fibromyalgia patients. In 1987, the American Medical Association recognized it as a true illness that causes serious disabilities. Same year, Dr. Don L. Goldenberg, Chief of Rheumatology at NewtonWellesley Hospital in Massachusetts described the symptoms and treatments of his 118 patients

and recorded the diagnoses as fibromyalgia syndrome in an article in the Journal of American Medical Association (JAMA). In 1990, the American College of Rheumatology (ACR) released the first diagnostic criteria for fibromyalgia and neurohormonal mechanisms with central sensitization were developed afterwards. In 1997, the National Fibromyalgia Association (NFA) was established. Furthermore, the first treatment guidelines for fibromyalgia were developed by the American Pain Society in 2005. The Food and Drug Administration approved Lyrica (Pregabalin), Cymbalta (Duloxetine), and Savella (Milnacipran) as treatments of fibromyalgia in years 2007, 2008 and 2009, respectively. At present, many physicians lack knowledge and did not receive trainings on how to properly diagnose fibromyalgia, unfortunately. However, ACR continued in updating the diagnostic criteria for fibromyalgia. It is expected though that better understanding of fibromyalgia is impending and that health care providers will be able to make accurate diagnosis and appropriate interventions.

References
http://www.fibromyalgiadietandtreatment.com/the-history-of-fibromyalgia/ http://chronicfatigue.about.com/od/fibromyalgia/p/historyfm.htm http://www.ncbi.nlm.nih.gov/pubmed/15361321 http://www.livingwithfm.com/resources/The_History_of_Fibromyalgia.pdf http://www.livingwithfm.com/resources/The_History_of_Fibromyalgia.pdf http://legacy.lclark.edu/~sherrons/etiology.htm http://docs.google.com/viewer? a=v&q=cache:4LpuUKFs9JoJ:www.hcplive.com/media/pdf/098e2dabfd52029b32a85 2cf300f1719.pdf+dr.+luff %2Bfibromyalgia&hl=tl&gl=ph&pid=bl&srcid=ADGEEShN_Y-WnjqJKmQVprS0rlhfRbRe2oOpFV9ednm_bGY89IqWljsLpXFgf7LgVylXJdUuLR3rnY0wq3UWlrR5eia7Ff1l 4WW0YXXkoyHs9lTixVFYRz2txbRtnnNRKdkTj0mz_bz&sig=AHIEtbRigXCFTC5HAmke NBKDNsqH7Ewd6A&pli=1

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