Fibromyalgia | |
---|---|
Other names | Fibromyalgia syndrome |
The nine possible pain sites of fibromyalgia according to the American Pain Society. | |
Pronunciation | |
Specialty | Rheumatology, neurology[2] |
Symptoms | Widespread pain, feeling tired, sleep problems[3][4] |
Usual onset | Early-Middle age[5] |
Duration | Long term[3] |
Causes | Unknown[4][5] |
Diagnostic method | Based on symptoms after ruling out other potential causes[4][5] |
Differential diagnosis | Anemia, autoimmune disorders (such as ankylosing spondylitis, polymyalgia rheumatica, rheumatoid arthritis, scleroderma, or multiple sclerosis), Lyme disease, osteoarthritis, thyroid disease[6][7] |
Treatment | Sufficient sleep and exercise[5] |
Medication | Duloxetine, milnacipran, pregabalin, gabapentin[5][8] |
Prognosis | Normal life expectancy[5] |
Frequency | 2%[4] |
Fibromyalgia is a medical syndrome that causes chronic widespread pain, accompanied by fatigue, awakening unrefreshed, and cognitive symptoms. Other symptoms can include headaches, lower abdominal pain or cramps, and depression.[9] People with fibromyalgia can also experience insomnia[10] and general hypersensitivity.[11][12] The cause of fibromyalgia is unknown, but is believed to involve a combination of genetic and environmental factors.[4] Environmental factors may include psychological stress, trauma, and some infections.[4] Since the pain appears to result from processes in the central nervous system, the condition is referred to as a "central sensitization syndrome".[4][13] Although a protocol using an algometer (algesiometer) for determining central sensitization has been proposed as an objective diagnostic test, fibromyalgia continues to be primarily diagnosed by exclusion.[14]
Fibromyalgia was first defined in 1990, with updated criteria in 2011,[4] 2016,[9] 2019.[12] The term 'fibromyalgia' is from Neo-Latin fibro-, meaning 'fibrous tissues', Greek μυο- myo-, 'muscle', and Greek άλγος algos, 'pain'; thus, the term literally means "'muscle and fibrous connective tissue pain'.[15] Fibromyalgia is estimated to affect 2 to 4% of the population.[16] Women are affected about twice as often as men.[4][16] Rates appear similar across areas of the world and among varied cultures.[4]
The treatment of fibromyalgia is symptomatic[17] and multidisciplinary.[18] The European Alliance of Associations for Rheumatology strongly recommends aerobic and strengthening exercise.[18] Weak recommendations are given to mindfulness, psychotherapy, acupuncture, hydrotherapy, and meditative exercise such as qigong, yoga, and tai chi.[18] The use of medication in the treatment of fibromyalgia is debated,[18][19] although antidepressants can improve quality of life.[20] Common helpful medications include other serotonin–norepinephrine reuptake inhibitors, nonsteroidal anti-inflammatory drugs, and muscle relaxants.[21] Q10 coenzyme and vitamin D supplements may reduce pain and improve quality of life.[22] While fibromyalgia is persistent in nearly all patients, it does not result in death or tissue damage.[19]
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