This paper provides a concise clinical overview of fibromyalgia, a chronic pain condition with no known cause or cure. It examines current research on possible genetic and neurological contributors to the disease, the population most commonly affected, and the wide range of physical and psychological symptoms patients experience. The paper also reviews evidence-based treatment recommendations — emphasizing the combined use of pharmacological and non-pharmacological interventions — and discusses prognosis when care is individualized. Community resources available to patients are also identified. The paper draws on Canadian clinical guidelines, peer-reviewed research, and Mayo Clinic reference material.
Fibromyalgia is a rather mysterious condition with no known cause and no known cure. The symptoms of fibromyalgia consist primarily of muscle and joint pain and heightened sensitivity to pain, experienced globally throughout the body. Secondary symptoms, which are also common in sufferers, include chronic fatigue, cognitive and memory dysfunction, sleep disorders, and mood disorders. Women are far more likely to suffer from fibromyalgia than men, and age of onset is generally between 30 and 50 years. A combination of pharmacological and non-pharmacological interventions is recommended, with the latter taking precedence over the former in evidence-based practice. Prognosis is relatively good when the right combination of lifestyle changes and treatment options is employed.
The cause of fibromyalgia remains a mystery. Recent research reveals the possibility of a genetic marker for pain sensitivity in fibromyalgia patients, in that "haplotypes of the COMT gene and genotypes of the Val158Met polymorphism play a key role on pain sensitivity" in patients with the disease (Martinez-Jauand et al., 2013, p. 16). Fibromyalgia does appear to be familial (Mayo Clinic, 2015); however, genetic research on the disease is still in its infancy.
Fibromyalgia has no biological or physical markers, but may be related to brain chemistry and the way the brain processes sensory input or stimuli. Persons with other rheumatic conditions are also more likely to have fibromyalgia, as are persons with lupus (Mayo Clinic, 2015). Traumatic events, surgery, and stress can trigger symptoms, but symptoms may also develop gradually over time (Mayo Clinic, 2015).
About seven times more women than men suffer from fibromyalgia (Mayo Clinic, 2015). Age of onset is variable, but symptoms most commonly emerge between the ages of 30 and 50. It is estimated that more than two percent of the population suffers from the disease (Fitzcharles et al., 2013).
The primary complaint is the "fluctuating and diffuse" musculoskeletal pain that characterizes the disease (Fitzcharles et al., 2013, p. 119). Pain may be felt in deep muscle tissue, joints, the neck, or the back, and it usually moves and shifts periodically. Muscle stiffness, sensitivity to pain stimuli, headaches, temporomandibular joint (TMJ) disorders, and irritable bowel syndrome are also common physiological symptoms of fibromyalgia.
Mood swings, irritability, sleep disorders, memory problems, anxiety, and depression are among the most common psychological symptoms associated with the condition. There are no targeted tests or diagnostic tools specifically for fibromyalgia, although blood tests can be used to rule out other conditions. Because symptoms are generalized and shared in common with other diseases, fibromyalgia may be difficult to detect in some patients. Physicians previously used tenderness points on the body as a type of assessment, but now tend to ask whether a patient has had widespread pain for three months or more with no known medical cause (Mayo Clinic, 2015).
"Combined pharmacological and non-pharmacological interventions"
"Outlook and support organizations for patients"
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