Fibromyalgia
Publication Date: December 1999
Revised: June 2004
Questions and Answers about Fibromyalgia
Fibromyalgia
syndrome is a common and chronic disorder characterized by widespread
muscle pain, fatigue, and multiple tender points.
The
word fibromyalgia comes from the Latin term for fibrous tissue
(fibro) and the Greek ones for muscle (myo) and pain (algia).
Tender points are specific places on the body – on the neck,
shoulders, back, hips, and upper and lower extremities –
where people with fibromyalgia feel pain in response to slight
pressure.
Although
fibromyalgia is often considered an arthritis-related condition,
it is not truly a form of arthritis
(a disease of the joints) because it does not cause inflammation
or damage to the joints, muscles, or other tissues. Like arthritis,
however, fibromyalgia can cause significant pain and fatigue,
and it can interfere with a person’s ability to carry on
daily activities. Also like arthritis, fibromyalgia is considered
a rheumatic condition.
You
may wonder what exactly rheumatic means. Even physicians do not
always agree on whether a disease is considered rheumatic.
If you look up the word in the dictionary, you’ll find it
comes from the Greek word rheum, which means flux – not an
explanation that gives you a better understanding. In medicine,
however, the term rheumatic means a medical condition that impairs
the joints and/or soft tissues and causes chronic pain.
In
addition to pain and fatigue, people who have fibromyalgia may
experience:
*
sleep disturbances
* morning stiffness
* headaches
* irritable bowel syndrome
* painful menstrual periods
* numbness or tingling of the extremities
* restless legs syndrome
* temperature sensitivity
* cognitive and memory problems (sometimes referred to as “fibro
fog”)
* a variety of other symptoms.
Fibromyalgia
is a syndrome rather than a disease. Unlike
a disease, which is a medical condition with a specific cause
or causes and recognizable signs and symptoms, a syndrome is a
collection of signs, symptoms, and medical problems that tend
to occur together but are not related to a specific, identifiable
cause.
*
Who Gets Fibromyalgia?
* What Causes Fibromyalgia?
* How Is Fibromyalgia Diagnosed?
* How Is Fibromyalgia Treated?
* Will Fibromyalgia Get Better With Time
* What Can I Do To Try To Feel Better?
* What Are Researchers Learning About Fibromyalgia?
* Where Can I Get More Information About Fibromyalgia?
* Key Words
Who
Gets Fibromyalgia?
Scientists
estimate that fibromyalgia affects 5 million Americans age 18
or older. For unknown reasons, between 80 and 90 percent of those
diagnosed with fibromyalgia are women; however, men and children
also can be affected. Most people are diagnosed during middle
age, although the symptoms often become present earlier in life.
People
with certain rheumatic diseases, such as rheumatoid arthritis,
systemic lupus erythematosus (commonly called lupus), or ankylosing
spondylitis (spinal arthritis) may be more likely to have fibromyalgia,
too.
Several
studies indicate that women who have a family member with fibromyalgia
are more likely to have fibromyalgia themselves, but the exact
reason for this – whether it be hereditary or caused by environmental
factors or both – is unknown. One study supported by the
National Institute of Arthritis and Musculoskeletal and Skin Diseases
(NIAMS) is trying to identify whether certain genes predispose
some people to fibromyalgia. (See “What Are Researchers Learning
About Fibromyalgia?”)
What
Causes Fibromyalgia?
The
causes of fibromyalgia are unknown, but there are probably a number
of factors involved.
Many
people associate the development of fibromyalgia with a physically
or emotionally stressful or traumatic event, such as an automobile
accident. Some connect it to repetitive injuries. Others link
it to an illness. People with rheumatoid arthritis and other autoimmune
diseases, such as lupus, are particularly likely to develop fibromyalgia.
For others, fibromyalgia seems to occur spontaneously.
Many
researchers are examining other causes, including problems with
how the central nervous system (the brain and spinal cord) processes
pain.
Some
scientists speculate that a person’s genes may regulate the
way his or her body processes painful stimuli. According to this
theory, people with fibromyalgia may have a gene or genes that
cause them to react strongly to stimuli that most people would
not perceive as painful. However, those genes – if they,
in fact, exist – have not been identified.
How Is Fibromyalgia Diagnosed?
Research
shows that people with fibromyalgia typically see many doctors
before receiving the diagnosis. One reason for this may be that
pain and fatigue, the main symptoms of fibromyalgia, overlap with
many other conditions. Therefore, doctors often have to rule out
other potential causes of these symptoms before making a diagnosis
of fibromyalgia. Another reason is that there are currently no
diagnostic laboratory tests for fibromyalgia; standard laboratory
tests fail to reveal a physiologic reason for pain. Because there
is no generally accepted, objective test for fibromyalgia, some
doctors unfortunately may conclude a patient’s pain is not
real, or they may tell the patient there is little they can do.
A
doctor familiar with fibromyalgia, however, can make a diagnosis
based on two criteria established by the American College of Rheumatology
(ACR): a history of widespread pain lasting more than 3 months
and the presence of tender points. Pain
is considered to be widespread when it affects all four quadrants
of the body; that is, you must have pain in both your right and
left sides as well as above and below the waist to be diagnosed
with fibromyalgia. ACR also has designated 18 sites on the body
as possible tender points. For a fibromyalgia diagnosis, a person
must have 11 or more tender points. One of these predesignated
sites is considered a true tender point only if the person feels
pain upon the application of 4 kilograms of pressure to the site.
People who have fibromyalgia certainly may feel pain at other
sites, too, but those 18 standard possible sites on the body are
the criteria used for classification.
How
Is Fibromyalgia Treated?
Fibromyalgia
can be difficult to treat. Not all doctors are familiar with fibromyalgia
and its treatment, so it is important to find a doctor who is.
Many family physicians, general internists, or rheumatologists
(doctors who specialize in arthritis and other conditions that
affect the joints or soft tissues) can treat fibromyalgia.
Fibromyalgia
treatment often requires a team approach, with your doctor, a
physical therapist, possibly other health professionals, and most
importantly, yourself, all playing an active role. It can be hard
to assemble this team, and you may struggle to find the right
professionals to treat you. When you do, however, the combined
expertise of these various professionals can help you improve
your quality of life.
You
may find several members of the treatment team you need at a clinic.
There are pain clinics that specialize in pain and rheumatology
clinics that specialize in arthritis and other rheumatic diseases,
including fibromyalgia.
In
June 2007, the U.S. Food and Drug Administration (FDA) approved
Lyrica* (pregabalin) as the first drug to treat fibromyalgia.
Doctors also treat fibromyalgia with a variety of medications
developed and approved for other purposes.
*
Brand names included in this booklet are provided as examples
only, and their inclusion does not mean that these products are
endorsed by the National Institutes of Health or any other Government
agency. Also, if a particular brand name is not mentioned, this
does not mean or imply that the product is unsatisfactory.
Following
are some of the most commonly used categories of drugs for fibromyalgia.
Analgesics
Analgesics
are painkillers. They range from over-the-counter acetaminophen
(Tylenol) to prescription medicines, such as tramadol (Ultram),
and even stronger narcotic preparations. For a subset of people
with fibromyalgia, narcotic medications are prescribed for severe
muscle pain. However, there is no solid evidence showing that
narcotics actually work to treat the chronic pain of fibromyalgia,
and most doctors hesitate to prescribe them for long-term use
because of the potential that the person taking them will become
physically or psychologically dependent on them.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
As
their name implies, nonsteroidal anti-inflammatory drugs, including
aspirin, ibuprofen (Advil, Motrin), and naproxen sodium (Anaprox,
Aleve), are used to treat inflammation. Although inflammation
is not a symptom of fibromyalgia, NSAIDs also relieve pain. The
drugs work by inhibiting substances in the body called prostaglandins,
which play a role in pain and inflammation. These medications,
some of which are available without a prescription, may help ease
the muscle aches of fibromyalgia. They may also relieve menstrual
cramps and the headaches often associated with fibromyalgia.
Antidepressants
Perhaps
the most useful medications for fibromyalgia are several in the
antidepressant class. Antidepressants elevate the levels of certain
chemicals in the brain, including serotonin and norepinephrine
(which was formerly called adrenaline). Low levels of these chemicals
are associated not only with depression, but also with pain and
fatigue. Increasing the levels of these chemicals can reduce pain
in people who have fibromyalgia. Doctors prescribe several types
of antidepressants for people with fibromyalgia, described below.
* Tricyclic antidepressants – When taken at bedtime in dosages
lower than those used to treat depression, tricyclic antidepressants
can help promote restorative sleep in people with fibromyalgia.
They also can relax painful muscles and heighten the effects of
the body’s natural pain-killing substances called endorphins.
Tricyclic antidepressants have been around for almost half a century.
Some examples of tricyclic medications used to treat fibromyalgia
include amitriptyline hydrochloride (Elavil, Endep), cyclobenzaprine
(Cycloflex, Flexeril, Flexiban), doxepin (Adapin, Sinequan), and
nortriptyline (Aventyl, Pamelor). Both amitriptyline and cyclobenzaprine
have been proven useful for the treatment of fibromyalgia.
* Selective serotonin reuptake inhibitors – If a tricyclic
antidepressant fails to bring relief, doctors sometimes prescribe
a newer type of antidepressant called a selective serotonin reuptake
inhibitor (SSRI). As with tricyclics, doctors usually prescribe
these for people with fibromyalgia in lower dosages than are used
to treat depression. By promoting the release of serotonin, these
drugs may reduce fatigue and some other symptoms associated with
fibromyalgia. The group of SSRIs includes fluoxetine (Prozac),
paroxetine (Paxil), and sertraline (Zoloft).
SSRIs may be prescribed along with a tricyclic antidepressant.
Doctors rarely prescribe SSRIs alone. Because they make people
feel more energetic, SSRIs also interfere with sleep, which often
is already a problem for people with fibromyalgia. Studies have
shown that a combination therapy of the tricyclic amitriptyline
and the SSRI fluoxetine resulted in greater improvements in the
study participants’ fibromyalgia symptoms than either drug
alone.
* Mixed reuptake inhibitors – Some newer antidepressants
raise levels of both serotonin and norepinephrine and are therefore
called mixed reuptake inhibitors. Examples of these medications
include venlafaxine (Effexor) and nefazodone (Serzone). Researchers
are actively studying the efficacy of these newer medications
in treating fibromyalgia.
Benzodiazepines
Benzodiazepines
help some people with fibromyalgia by relaxing tense, painful
muscles and stabilizing the erratic brain waves that can interfere
with deep sleep. Benzodiazepines also can relieve the symptoms
of restless legs syndrome, which is common among people with fibromyalgia.
Restless legs syndrome is characterized by unpleasant sensations
in the legs as well as twitching, particularly at night. Because
of the potential for addiction, doctors usually prescribe benzodiazepines
only for people who have not responded to other therapies. Benzodiazepines
include clonazepam (Klonopin) and diazepam (Valium).
Other Medications
In
addition to the previously described general categories of drugs,
doctors may prescribe others, depending on a person’s specific
symptoms or fibromyalgia-related conditions. For example, in recent
years, FDA has approved two medications – tegaserod (Zelnorm)
and alosetron (Lotronex) – for the treatment of irritable
bowel syndrome. Gabapentin (Neurontin) currently is being studied
as a treatment for fibromyalgia. (See “What Are Researchers
Learning About Fibromyalgia?”) Other symptom-specific medications
include sleep medications, muscle relaxants, and headache remedies.
People
with fibromyalgia also may benefit from a combination of physical
and occupational therapy, from learning pain management and coping
techniques, and from properly balancing rest and activity.
Complementary and Alternative Therapies
Many
people with fibromyalgia also report varying degrees of success
with complementary and alternative therapies, including massage,
movement therapies (such as Pilates and the Feldenkrais method),
chiropractic treatments, acupuncture, and various herbs and dietary
supplements for different fibromyalgia symptoms.
(For
more information on complementary and alternative therapies, contact
the National Center for Complementary and Alternative Medicine.
See “Where Can I Get More Information About Fibromyalgia?”)
Although
some of these supplements are being studied for fibromyalgia,
there is little, if any, scientific proof yet that they help.
FDA does not regulate the sale of dietary supplements, so information
about side effects, proper dosage, and the amount of a preparation’s
active ingredient may not be well known. If you are using or would
like to try a complementary or alternative therapy, you should
first speak with your doctor, who may know more about the therapy’s
effectiveness, as well as whether it is safe to try in combination
with your medications.
Will
Fibromyalgia Get Better With Time?
Fibromyalgia
is a chronic condition, meaning it lasts a long time – possibly
a lifetime. However, it may comfort you to know that fibromyalgia
is not a progressive disease. It is never fatal, and it won’t
cause damage to your joints, muscles, or internal organs. In many
people, the condition does improve over time.
What
Can I Do To Try To Feel Better?
Besides
taking medicine prescribed by your doctor, there are many things
you can do to minimize the impact of fibromyalgia on your life.
These include:
*
Getting enough sleep –
Getting enough sleep and the right kind of sleep can help ease
the pain and fatigue of fibromyalgia. (See “Tips for Good
Sleep”.) Even so, many people with fibromyalgia have problems
such as pain, restless legs syndrome, or brainwave irregularities
that interfere with restful sleep.
*
Exercising –
Although pain and fatigue may make exercise and daily activities
difficult, it’s crucial to be as physically active as possible.
Research has repeatedly shown that regular exercise is one of
the most effective treatments for fibromyalgia. People who have
too much pain or fatigue to do vigorous exercise should begin
with walking or other gentle exercise and build their endurance
and intensity slowly. Although research has focused largely on
the benefits of aerobic and flexibility exercises, a new NIAMS-supported
study is examining the effects of adding strength training to
the traditionally prescribed aerobic and flexibility exercises.
*
Making changes at work –
Most people with fibromyalgia continue to work, but they may have
to make big changes to do so. For example, some people cut down
the number of hours they work, switch to a less demanding job,
or adapt a current job. If you face obstacles at work, such as
an uncomfortable desk chair that leaves your back aching or difficulty
lifting heavy boxes or files, your employer may make adaptations
that will enable you to keep your job. An occupational therapist
can help you design a more comfortable workstation or find more
efficient and less painful ways to lift.
If
you are unable to work at all due to a medical condition, you
may qualify for disability benefits through your employer or the
Federal Government. Social
Security Disability Insurance (SSDI) and Supplemental Security
Insurance (SSI) are the largest Federal programs providing financial
assistance to people with disabilities. Although the medical requirements
for eligibility are the same under the two programs, the way they
are funded is different. SSDI is paid by Social Security taxes,
and those who qualify for assistance receive benefits based on
how much they have paid into the system; SSI is funded by general
tax revenues, and those who qualify receive payments based on
financial need. For information about the SSDI and SSI programs,
contact the Social Security Administration. (See “Where Can
I Get More Information About Fibromyalgia?”)
*
Eating well –
Although some people with fibromyalgia report feeling better when
they eat or avoid certain foods, no specific diet has been proven
to influence fibromyalgia. Of course, it is important to have
a healthy, balanced diet. Not only will proper nutrition give
you more energy and make you generally feel better, it will also
help you avoid other health problems.
Tips
for Good Sleep
*
Keep regular sleep habits. Try to get to bed at the
same time and get up at the same time every day – even on
weekends and vacations.
*
Avoid caffeine and alcohol in the late afternoon and evening.
If consumed too close to bedtime, the caffeine
in coffee, soft drinks, chocolate, and some medications can keep
you from sleeping or sleeping soundly. Even though it can make
you feel sleepy, drinking alcohol around bedtime also can disturb
sleep.
*
Time your exercise. Regular daytime exercise can improve
nighttime sleep. But avoid exercising within 3 hours of bedtime,
which actually can be stimulating, keeping you awake.
*
Avoid daytime naps. Sleeping in the afternoon can interfere
with nighttime sleep. If you feel you can’t get by without
a nap, set an alarm for 1 hour. When it goes off, get up and start
moving.
*
Reserve your bed for sleeping. Watching the late news,
reading a suspense novel, or working on your laptop in bed can
stimulate you, making it hard to sleep.
*
Keep your bedroom dark, quiet, and cool.
*
Avoid liquids and spicy meals before bed. Heartburn
and late-night trips to the bathroom are not conducive to good
sleep.
*
Wind down before bed. Avoid working right up to bedtime.
Do relaxing activities, such as listening to soft music or taking
a warm bath, that get you ready to sleep. (A warm bath also may
soothe aching muscles.)
What
Are Researchers Learning About Fibromyalgia?
NIAMS
sponsors research that will improve scientists’ understanding
of the specific problems that cause or accompany fibromyalgia,
in turn helping them develop better ways to diagnose, treat, and
prevent this syndrome.
The
research on fibromyalgia supported by NIAMS covers a broad spectrum,
ranging from basic laboratory research to studies of medications
and interventions designed to encourage behaviors that reduce
pain and change behaviors that worsen or perpetuate pain.
Following
are descriptions of some of the promising research now being conducted:
*
Understanding pain –
Research suggests that fibromyalgia is caused by a problem in
how the body processes pain – or more precisely, a hypersensitivity
to stimuli that normally are not painful. Therefore, several NIAMS-supported
researchers are focusing on ways the body processes pain to better
understand why people with fibromyalgia have increased pain sensitivity.
Previous research has shown that people with fibromyalgia have
reduced blood flow to parts of the brain that normally help the
body deal with pain. In one new NIAMS-funded study, researchers
will be using imaging technology called positron emission tomography
(PET) to compare blood flow in the brains of women who have fibromyalgia
with those who do not. In both groups, researchers will study
changes in blood flow that occur in response to painful stimuli.
Researchers
speculate that female reproductive hormones may be involved in
the increased sensitivity to pain characteristic of fibromyalgia.
New
research will examine the role of sex hormones in pain sensitivity,
in reaction to stress, and in symptom perception at various points
in the menstrual cycles of women with fibromyalgia and of women
without it. The results from studying these groups of women will
be compared with results from studies of the same factors in men
without fibromyalgia over an equivalent period of time.
Another line of NIAMS-funded research involves developing a rodent
model of fibromyalgia pain. Rodent models, which use mice or rats
that researchers cause to develop symptoms similar to fibromyalgia
in humans, could provide the basis for future research into this
complex condition.
*
Understanding stress –
Medical evidence suggests that a problem or problems in the way
the body responds to physical or emotional stress may trigger
or worsen the symptoms of any illness, including fibromyalgia.
Researchers funded by NIAMS are trying to uncover and understand
these problems by examining chemical interactions between the
nervous system and the endocrine (hormonal) system. Scientists
know that people whose bodies make inadequate amounts of the hormone
cortisol experience many of the same symptoms as people with fibromyalgia,
so they also are exploring whether there is a link between the
regulation of the adrenal glands, which produce cortisol, and
fibromyalgia.
Another NIAMS-funded study suggests that exercise improves the
body’s response to stress by enhancing the function of the
pituitary and adrenal glands. The hormones produced by these two
endocrine glands are essential to regulating sleep and emotions
as well as processing pain.
*
Improving sleep –
Researchers supported by NIAMS are investigating ways to improve
sleep for people with fibromyalgia whose sleep problems persist
despite treatment with medications. One team has observed that
fibromyalgia patients with persistent sleep problems share characteristics
with people who have insomnia, such as having erratic sleep and
wake schedules and spending too much time in bed. This team is
testing whether strategies developed to help insomnia patients
will also help people with fibromyalgia achieve deep sleep, which
eases pain and fatigue. Preliminary results show that sleep education,
which teaches good sleep habits, and cognitive behavioral therapy,
which includes sleep education and a regimen to correct poor habits
and improper sleep schedules, both reduce insomnia.
*
Looking for the family connection –
Because fibromyalgia appears to run in families, one group of
NIAMS-supported researchers is working to identify whether a gene
or genes predispose people to the condition.
Another team is trying to determine whether fibromyalgia is more
common in people with other conditions, such as serious mood disorders,
that tend to run in families. Specifically, the group is studying
the prevalence of psychiatric disorders and arthritis and related
disorders in people with fibromyalgia and their first-degree relatives
(parents, children, sisters, and brothers) as compared to people
with rheumatoid arthritis and their relatives. The group is exploring
whether clusters of conditions exist in families, which might
shed light on shared risk factors or disease processes.
* Studying and targeting treatments – NIAMS recently funded
its first study of a drug treatment for fibromyalgia. The study
will measure the effectiveness of gabapentin, an anticonvulsant
medication, in reducing symptoms of fibromyalgia. Gabapentin has
been found to relieve chronic pain caused by nervous system disorders,
and it was recently approved by FDA for the treatment of persistent,
severe pain that can follow an episode of shingles.
Scientists
recognize that people with fibromyalgia often fall into distinct
subgroups that adapt to and cope with their symptoms differently.
They also realize that these subgroups may respond to treatments
differently. One
NIAMS-funded team of researchers has divided people with fibromyalgia
into three groups based on how they cope with the condition. Relative
to other chronic pain patients, those in the first group have
higher levels of pain and report more interference in their life
due to pain. They also have higher levels of emotional distress,
feel less control over their lives, and are less active. The second
group reports receiving less support from others, higher levels
of negative responses from significant others, and lower levels
of supportive responses from significant others. Those in the
third group are considered adaptive copers; they have less pain,
report less interference in their lives due to pain, and have
less emotional distress. Members of this last group feel more
control over their lives and are more active. On the premise that
the better you understand the subgroups, the better you can tailor
treatments to fit them, the researchers now are trying to design
and test different programs for each group, combining physical
therapy, interpersonal skills training, and supportive counseling.
Where
Can I Get More Information About Fibromyalgia?
National Institute of Arthritis and Musculoskeletal and Skin
Diseases (NIAMS)
Information Clearinghouse
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Phone: 301-495-4484
Toll Free: 877-22-NIAMS (226-4267)
TTY: 301–565–2966
Fax: 301-718-6366
Email: NIAMSinfo@mail.nih.gov
Website: http://www.niams.nih.gov
National Center for Complementary and Alternative Medicine
National Institutes of Health
P.O. Box 7923
Gaithersburg, MD 20898
Phone: 301-519-3153
Toll Free: 888-644-6226
TTY: 866-464-3615
Fax: 866-464-3616
Email: info@nccam.nih.gov
Website: http://nccam.nih.gov
Social Security Administration
6401 Security Boulevard
Baltimore, MD 21235
Toll Free: 800-772-1213
TTY: 800-325-0778
Website: http://www.ssa.gov/disability
American College of Rheumatology (ACR)
1800 Century Place, Suite 250
Atlanta, GA 30345-4300
Phone: 404-633-3777
Fax: 404-633-1870
Website: http://www.rheumatology.org
Advocates for Fibromyalgia Funding, Treatment, Education, and
Research
P.O. Box 768
Libertyville, IL 60048-0766
Phone: 847-362-7807
Fax: 847-680-3922
Email: info@affter.org
Website: http://www.affter.org
Fibromyalgia Network
P.O. Box 31750
Tucson, AZ 85751-1750
Toll Free: 800-853-2929
Website: http://www.fmnetnews.com
National Fibromyalgia Association
2121 S. Towne Centre Place, Suite 300
Anaheim, CA 92806
Phone: 714-921-0150
Fax: 714-921-6920
Email: nfa@fmaware.org
Website: http://www.fmaware.org
National Fibromyalgia Partnership, Inc.
P.O. Box 160
Linden, VA 22642–0160
Toll Free: 866–725–4404
TTY: 866–666–2727 (free of charge) or 540–622–2998
Email: mail@fmpartnership.org
Website: http://www.fmpartnership.org
Arthritis Foundation
P.O. Box 7669
Atlanta, GA 30357-0669
Phone: 404-872-7100
Toll Free: 800-283-7800
Website: http://www.arthritis.org
Key
Words
Adrenal glands – A pair
of endocrine glands located on the surface of the kidneys. The
adrenal glands produce orticosteroid hormones such as cortisol,
aldosterone, and the reproductive hormones.
Analgesic – A medication
or treatment that relieves pain.
Arthritis – Literally
means joint inflammation, but is often used to indicate a group
of more than 100 rheumatic diseases. These diseases affect not
only the joints but also other connective tissues of the body,
including important supporting structures, such as muscles, tendons,
and ligaments, as well as the protective covering of internal
organs.
Chronic disease – An
illness that lasts for a long time, often a lifetime.
Connective tissue –
The supporting framework of the body and its internal organs.
Cortisol – A hormone
produced by the adrenal cortex, important for normal carbohydrate
metabolism and for a healthy response to stress.
Fibromyalgia – A chronic
syndrome that causes pain and stiffness throughout the connective
tissues that support and move the bones and joints. Pain and localized
tender points occur in the muscles, particularly those that support
the neck, spine, shoulders, and hips. The disorder includes widespread
pain, fatigue, and sleep disturbances.
Fibrous capsule – A
tough wrapping of tendons and ligaments that surrounds the joint.
Inflammation – A characteristic
reaction of tissues to injury or disease. It is marked by four
signs: swelling, redness, heat, and pain. Inflammation is not
a symptom of fibromyalgia.
Joint – A junction where
two bones meet. Most joints are composed of cartilage, joint space,
fibrous capsule, synovium, and ligaments.
Ligaments – Bands of
cordlike tissue that connect bone to bone.
Muscle – A structure
composed of bundles of specialized cells that, when stimulated
by nerve impulses, contract and produce movement.
Nonsteroidal anti-inflammatory drugs
(NSAIDs) – A group of drugs, such as aspirin and
aspirin-like drugs, used to reduce inflammation that causes joint
pain, stiffness, and swelling.
Pituitary gland – A
pea-sized gland attached beneath the hypothalamus at the base
of the skull that secretes many hormones essential to bodily functioning.
The secretion of pituitary hormones is regulated by chemicals
produced in the hypothalamus.
Sleep disorder – A disorder
in which a person has difficulty achieving restful, restorative
sleep. In addition to other symptoms, people with fibromyalgia
usually have a sleep disorder.
Tender points
– Specific places on the body where a person with
fibromyalgia feels pain in response to slight pressure.
Tendons – Fibrous cords
that connect muscle to bone.
Acknowledgments
NIAMS
gratefully acknowledges the assistance of Deborah Ader, Ph.D.,
NIAMS, NIH; Karen Amour and Lynne Matallana, National Fibromyalgia
Association, Orange, CA; Michele L. Boutaugh, M.P.H., Arthritis
Foundation, Atlanta, GA; Daniel Clauw, M.D., and Leslie Crofford,
M.D., University of Michigan, Ann Arbor; and Tamara Liller, National
Fibromyalgia Partnership, Linden, VA, in the preparation of this
booklet.
The
mission of the National Institute of Arthritis and Musculoskeletal
and Skin Diseases (NIAMS), a part of the U.S. Department of Health
and Human Services’ National Institutes of Health (NIH),
is to support research into the causes, treatment, and prevention
of arthritis and musculoskeletal and skin diseases; the training
of basic and clinical scientists to carry out this research; and
the dissemination of information on research progress in these
diseases. The NIAMS Information Clearinghouse is a public
service sponsored by the Institute that provides health information
and information sources. Additional information can be found on
the NIAMS Web site at www.niams.nih.gov.
For Your Information
This
publication contains information about medications used to treat
the health condition discussed in this booklet. When this booklet
was printed, we included the most up-to-date (accurate) information
available. Occasionally, new information on medication is released.
For
updates and for any questions about any medications you are taking,
please contact
U.S. Food and Drug Administration
Toll Free: 888-INFO-FDA (888-463-6332)
Website: http://www.fda.gov/
For
updates and questions about statistics, please contact
Centers for Disease Control and Prevention’s National Center
for Health Statistics
Toll Free: 800–232–4636
Website: http://www.cdc.gov/nchs
This
booklet is not copyrighted. Readers are encouraged to duplicate
and distribute as many copies as needed.
Additional
copies of this booklet are available from
National Institute of Arthritis and Musculoskeletal and Skin Diseases
(NIAMS)
Information Clearinghouse
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Phone: 301-495-4484
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NIH
Publication No. 04-5326
