What is Fibromyalgia Syndrome? by Hermanelli Torrevilas, MD

FMS (fibromyalgia syndrome) is a widespread musculoskeletal pain and fatigue disorder for which the cause is still unknown. Fibromyalgia means pain in the muscles, ligaments, and tendons — the soft fibrous tissues in the body.

Most patients with FMS say that they ache all over. Their muscles may feel like they have been pulled or overworked. Sometimes the muscles twitch and at other times they burn. More women than men are afflicted with FMS, and it shows up in people of all ages.

To help you relate to your condition, think of the last time you had a bad flu. Every muscle in your body shouted out in pain. You felt devoid of energy as though someone had unplugged your power supply. While the severity of symptoms differ from person to person, FMS may resemble a post-viral state. This similarity is the reason experts in the field of FMS and chronic fatigue syndrome (CFS) believe that these two syndromes may be one and the same. Gulf War syndrome also overlaps with FMS/CFS.


? Pain — The pain of FMS has no boundaries. People describe the pain as deep muscular aching, throbbing, shooting, and stabbing. Intense burning may also be present. Quite often, the pain and stiffness are worse in the morning.

? Fatigue — This symptom can be mild in some patients and yet incapacitating in others. The fatigue has been described as “brain fatigue” in which patients feel totally drained of energy. Many patients depict this situation by saying that they feel as though their arms and legs are tied to concrete blocks, and they have difficulty concentrating, e.g., brain fog.

? Sleep disorder — Most FMS patients have sleep disorder called the alpha-EEG anomaly. This condition was uncovered in a sleep lab with the aid of a machine which recorded the brain waves of patients during sleep. Most FMS patients can fall asleep without much trouble, but their deep level sleep was constantly interrupted by bursts of awake-like brain activity.

? Irritable Bowel Syndrome  —  Constipation, diarrhea, frequent abdominal pain, abdominal gas, and nausea represent symptoms frequently found in roughly 40 to 70% of FMS patients. Chronic headaches — Recurrent migraine or tension-type headaches are seen in about 50% of FMS patients and can pose a major problem in coping for this patient group.

? Temporomandibular Joint Dysfunction Syndrome — This is sometimes referred to as TMJ or TMD. It causes tremendous jaw-related face and head pain in some FMS patients. However, a 1997 published report indicated that close to 75% of FMS patients have a varying degree of jaw discomfort.

Other common symptoms — Premenstrual syndrome and painful periods, chest pain, morning stiffness, cognitive or memory impairment, numbness and tingling sensations, muscle twitching, irritable bladder, the feeling of swollen extremities, skin sensitivities, dry eyes and mouth, dizziness, and impaired coordination can occur.

Aggravating factors — Changes in weather, cold or drafty environments, hormonal fluctuations,  stress, depression, anxiety and over-exertion can all contribute to symptom flare-ups.

Possible causes

The cause of FMS remains elusive, but there are many triggering events thought to precipitate its onset. A few examples would be an infection (viral or bacterial), an automobile accident or the development of another disorder, such as rheumatoid arthritis, lupus, or hypothyroidism. These triggering events probably don’t cause FMS, but rather, they may awaken an underlying physiological abnormality that is already present.

Common Treatments

Traditional treatments are geared toward improving the quality of sleep and reducing pain. Deep level sleep is crucial for many body functions (such as tissue repair, antibody production, and the regulation of various neurotransmitters, hormones and immune system chemicals). Therefore, the sleep disorders that frequently occur in FMS patients are treated first because they may be a strong contributing factor to the symptoms of this condition. Medications that boost your body’s level of serotonin  (neurotransmitters that modulate sleep, pain, and immune system function) are commonly prescribed in low doses. Ambien, clonazepam, and trazadone are just a few of the medications that may be used to aid sleep.

In addition to medications, most patients will need to use other treatment methods as well, such as trigger point injections with lidocaine, physical therapy, occupational therapy, acupuncture, acupressure, relaxation/biofeedback techniques, osteopathic manipulation, chiropractic care, therapeutic massage, or a gentle exercise program.

What is the prognosis?

Long term follow-up studies on FMS have shown that it is chronic, but the symptoms may wax and wane. The impact that FMS can have on daily living activities, including the ability to work a full-time job, differs among patients. Overall, studies have shown that FMS can be equally as disabling as rheumatoid arthritis.

Updated: 2013-04-03 — 17:16:53