Fibromyalgia and Chronic Fatigue Syndrome (CFS)

Fibromylagia is a chronic pain condition thought to

affect approximately 2% of the population (based on a

U.S. study).  It is probably the most common chronic pain

condition encountered by rheumatologists in the young and

middle aged, although it can also affect people in

childhood.  The vast majority of these individuals are

women although no hormonal or other reason can be found

to explain this gender imbalance.   It also occurs in

conditions such as osteoarthritis, rheumatoid arthritis,

lupus, ankylosing spondylitis, mechanical back pain and

Irritable Bowel Syndrome (IBS).

The main symptom of Fibromylagia is widepsread muscle

pain and tenderness to touch in a number of areas. This

pain is always there but can vary in intensity and many

sufferers say that their symptoms are worsened by stress.

However  Fibromyalgia is not just a pain condition as problems with

sleep and resulting fatigue are  major factors in the

condition. Tests show that Fibromyalgia patients lack the

non – REM phase of sleep which is the most restorative

phase.  This may also be linked to the hormone serotonin

which is very relevant to mood disorders and pain

processing in the body.  In fact many rheumatologists would consider Chronic Fatigue syndrome and Fibromyalgia as two sides of the same coin, with diagnosis based on the primary symptom reported by the patient.  The fatigue in both conditions is profound and not relieved by sleep.  Both CFS and Fibromyalgia sufferers experience many other problematic symptoms.

Many sufferers may also experience;

- disrupted sleep quality more than sleep quantity

 - memory and concentration problems – irritable bladder

-  pelvic pain

- headaches – temporomandibular disorder

- gastrointestinal reflux

- swelling of the abdomen

- recurrent cystitis

- pins and needles / numbness

- swollen fingers

- irritability / psychological distress / depression

The pain experienced in Fibrimyalgia is different to that

seen in arthritis in that it is located in fleshy

muscular areas and at bony points rather than at the

joints of the body.

There are no tests that can diagnose Fibromyalgia such as

x-rays, blood tests etc so it must be diagnosed by a

doctor according to the decriptions of the patient and

the symptoms they are experiencing.   However the doctor

(usually a rheumatologist) may order some lab tests in

order to rule out other diseases or causes of pain.

Current research suggests that Fibromylagia is caused

bythe body’s pain  system malfunctioning so that it

registers pain when there is no reason for it.  It hugely

decreases the threshold at which pain is felt so that

even small knocks and bumps can cause severe pain.

The reason for this may vary between people.  It is

thought that there are a number of genes that predispose

people to develop the condition when it occurs alongside

other factors such as trauma, arthritis, back problems,

physical and psychological stress.

Unfortunately there is no cure for Fibromyalgia.

Standard medical recommendations include a mixture of

pain medications and psychological support as well as a

suitable exercise programme.  Finding pain relief that

works is often done on a trial and error basis until the

right medication is found.  Anti-depressant medication

may also be prescribed even when the person does not

complain of depression because some of the main brain

chemicals involved in mood are also involved in how we

feel pain (such as serotonin mentioned above).

Don’t be offended if you are referred for psychological

support.  Remember that psychological treatment doesn’t

just “stay in your head” but instead alters the body’s

chemistry and “wiring”.  The body is one whole  system.  For

example, the hormone serotonin mentioned earlier is

hugely related to our mood and the amount we experience

pain and yet it is mainly produced in the gut.

In Fibromylagia there is no obvious inflammation, or

tissue damage to target and treat so a psychologist will

look at other parts of the condition to improve quality

of life, exercise levels, sleeping patterns mood and pain

severity. Through this many will find an escape from

their symptoms.