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Fibromyalgia is a common health problem that causes widespread pain and tenderness (sensitive to touch). The pain and tenderness tend to come and go, and move about the body. Most often, people with this chronic (long-term) illness are fatigued (very tired) and have sleep problems. It can be hard to diagnose fibromyalgia.

FAST FACTS
Fibromyalgia affects two to four percent of people, mostly women.

Doctors diagnose fibromyalgia based on all the patient's relevant symptoms (what you feel), no longer just on the number of tender points.

There is no test to detect this disease, but you may need lab tests or X-rays to rule out other health problems.

Though there is no cure, medications can relieve symptoms.

Patients also may feel better with proper self-care, such as exercise and getting enough sleep.

WHAT IS FIBROMYALGIA?
Fibromyalgia is a chronic health problem that causes pain all over the body and other symptoms. Other symptoms that patients most often have are:

Tenderness to touch or pressure affecting joints and muscles

Fatigue

Sleep problems (waking up unrefreshed)

Problems with memory or thinking clearly

Some patients also may have:

Depression or anxiety

Migraine or tension headaches

Digestive problems: irritable bowel syndrome (commonly called IBS) or gastroesophageal reflux disease (often referred to as GERD)

Irritable or overactive bladder

Pelvic pain

Temporomandibular disorder—often called TMJ (a set of symptoms including face or jaw pain, jaw clicking and ringing in the ears)

Symptoms of fibromyalgia and its related problems can vary in intensity, and will wax and wane over time. Stress often worsens the symptoms.

WHAT CAUSES FIBROMYALGIA?
The causes of fibromyalgia are unclear. They may be different in different people. Fibromyalgia may run in families. There likely are certain genes that can make people more prone to getting fibromyalgia and the other health problems that can occur with it. Genes alone, though, do not cause fibromyalgia.

There is most often some triggering factor that sets off fibromyalgia. It may be spine problems, arthritis, injury, or other type of physical stress. Emotional stress also may trigger this illness. The result is a change in the way the body "talks" with the spinal cord and brain. Levels of brain chemicals and proteins may change. For the person with fibromyalgia, it is as though the "volume control" is turned up too high in the brain's pain processing centers.

WHO GETS FIBROMYALGIA?
Fibromyalgia is most common in women, though it can occur in men. It most often starts in middle adulthood, but can occur in the teen years and in old age. Younger children can also develop widespread body pain and fatigue.

You are at higher risk for fibromyalgia if you have a rheumatic disease (health problem that affects the joints, muscles and bones). These include osteoarthritis, lupus, rheumatoid arthritis, or ankylosing spondylitis.

HOW IS FIBROMYALGIA DIAGNOSED?
A doctor will suspect fibromyalgia based on your symptoms. Doctors used to require that you have tenderness to pressure or tender points at a specific number of certain spots before saying you have fibromyalgia. This is no longer the case. Your doctor may still look for tender points, but they are not required to make the diagnosis (see the Box). A physical exam can be helpful to detect tenderness and to exclude other causes of muscle pain.

There are no diagnostic tests (such as X-rays or blood tests) for this problem. Yet, you may need tests to rule out another health problem that can be confused with fibromyalgia.

Because widespread pain is the main feature of fibromyalgia, health care providers will ask you to describe your pain. This may help tell the difference between fibromyalgia and other diseases with similar symptoms. For instance, hypothyroidism (underactive thyroid gland) and polymyalgia rheumatica sometimes mimic fibromyalgia. Yet, certain blood tests can tell if you have either of these problems. Sometimes, fibromyalgia is confused with rheumatoid arthritis or lupus. But, again, there is a difference in the symptoms, physical findings and blood tests that will help your health care provider detect these health problems. Unlike fibromyalgia, these rheumatic diseases cause inflammation in the joints and tissues.

Criteria Needed for a Fibromyalgia Diagnosis

1. Pain and symptoms over the past week, based on the total of:

Number of painful areas out of 18 parts of the body (see image)

Plus level of severity of these symptoms:

Fatigue

Waking unrefreshed

Cognitive (memory or thought) problems

Plus number of other general physical symptoms:

2. Symptoms lasting at least three months at a similar level

3. No other health problem that would explain the pain and other symptoms

Source: American College of Rheumatology, 2010 — with Boris Boruchov and Moniker Taken.