Patients with fibromyalgia experience chronic widespread pain that seems to begin in the muscles, and can be severe enough to disrupt daily activities. Muscles may twitch, burn, or have deep stabbing pain, and may feel like they’ve been overworked or pulled, even without exercise or other causes. Chronic fatigue syndrome often coexists with fibromyalgia, bringing ongoing, overwhelming fatigue that doesn’t improve with rest. Other symptoms include abnormal pain processing, sleep disturbances, difficulty concentrating, problems with memory and cognitive functioning, and sensitivity to light, noise and cold.
For patients with severe symptoms, fibromyalgia and chronic fatigue syndrome can be extremely debilitating and can interfere with the basic activities of daily life, even bringing psychological distress and social isolation.
A Relatively New Diagnosis
Fibromyalgia is not a new syndrome, but it is surprisingly not well recognized in medical practice, even though it is the most common cause of chronic musculoskeletal pain. Fibromyalgia first began to be recognized in 1990, when the American College of Rheumatology (ACR) created a set of diagnostic criteria for the disorder. According to these criteria, patients just have (1) widespread pain for at least three months in three quadrants of the body, and (2) abnormal sensitivity to light pressure in at least 11 of 18 specific tender points. People affected by fibromyalgia may not even realize they have tender points until someone familiar with the condition applies pressure to these points.
Before the ACR diagnostic criteria were released, fibromyalgia was not considered to be a real disorder. Even today, many doctors deny that fibromyalgia is not a legitimate disease. On average, fibromyalgia patients spend three to five years and see an average of five physicians before receiving a diagnosis, and spend $4,800 to $9,300 annually on associated medical costs.
Causes of Fibromyalgia
It can be difficult for a patient to get a diagnosis of fibromyalgia, because many physicians believe there’s no clear cause or treatment. Many doctors treat the problem with NSAID pain relievers, antidepressants, and muscle relaxers. Unfortunately, none of these approaches address the underlying root of the problem. Current research suggests that many triggers can initiate a cascade of events that cause the hypothalamic, pituitary, immune, and coagulation dysfunction common in fibromyalgia. The most common of these is a viral infection, mostly commonly Epstein-Barr, Cytomegalo or HHV6. These viruses are found in 80% of patients with fibromyalgia and chronic fatigue syndrome. A large number of fibromyalgia patients also have low thyroid hormone levels and thyroid receptor resistance that don’t appear on standard blood tests due to pituitary dysfunction. Many have adrenal insufficiency and growth hormone deficiency, and others suffer from a coagulation defect set off by a chronic infection, effectively starving the cells from oxygen and nutrients. Stress also appears to be a contributing factor. Unfortunately, these issues usually are not detected with standard blood tests and require more specific testing.
Treatment Requires Multiple Interventions
Treatment of fibromyalgia requires a multisystem approach. If the patient is found to have one of the commonly found viruses, treatment with anti-viral medication can result in an improvement in symptoms. Thyroid, adrenal and other hormones deficiencies can be treated with medications. Patients may also have nutritional deficiencies, which can be treated with supplements or IV therapy.
Because fibromyalgia may impact multiple systems, the need for multiple interventions is important to restore a patient’s health. An integrated treatment approach is significantly beneficial if a patient is to get their life back. Once the underlying issues are addressed and treated, patients with fibromyalgia can see significant recovery or a complete resolution of their symptoms.