Article Medically Reviewed By:
Lesley M. Arnold, MD
Professor of Psychiatry Director, Women's Health Research Program University of Cincinnati Cincinnati, OH
Overview
What Is It?
Fibromyalgia is a chronic disorder characterized by widespread pain and reduced pressure pain threshold.
Fibromyalgia is a chronic disorder characterized by widespread pain and reduced pressure pain threshold (tender points). People with fibromyalgia may also experience fatigue, sleep disturbances, stiffness, deep tenderness, soreness and achiness, increased headaches or facial pain, difficulty concentrating, forgetfulness and problems multitasking. Patients with fibromyalgia frequently report functional impairment and diminished quality of life.
The cause of fibromyalgia is unknown, but recent evidence suggests that it is associated with abnormalities in the central nervous system processing of pain. Fibromyalgia patients develop an increased response to painful stimuli and experience pain from non-painful stimuli such as touch. This is thought to reflect enhanced pain processing that is characteristic of central pain sensitization. Patients with fibromyalgia have been found to have elevated levels of substance P in their spinal fluid, a chemical that helps transmit pain signals from the brain. Fibromyalgia patients also have been found to have reduced spinal fluid levels of neurotransmitters such as norepinephrine and serotonin that are involved in the pain inhibitory pathways in the central nervous system. Scientists are investigating how the brain and spinal cord process pain and how substance P and other neurotransmitters fit into the process. Recent studies have found that fibromyalgia runs in families, suggesting a genetic predisposition to the disorder.
Diagnosing fibromyalgia has been controversial because there are no specific laboratory tests to identify the disorder. Until recently, many health care professionals thought fibromyalgia was primarily caused by psychological factors. In recent years, however, health care professionals have come to understand that psychological factors do not necessarily cause fibromyalgia but rather may contribute to an increased risk for disability associated with fibromyalgia. Furthermore, depression and anxiety disorders may share some of the same chemical imbalances that are associated with fibromyalgia. For example, low levels of certain chemicals in the brain, including serotonin and norepinephrine, are linked not only to depression, but also to pain and fatigue.
It is estimated that at least 2 percent of the U.S. adult population has fibromyalgia. This condition occurs more commonly in women of childbearing age (as many as 80 to 90 percent of those diagnosed with fibromyalgia are women), but children, postmenopausal women, the elderly and men can also be affected. Because diagnosis can be difficult, it may take several years to correctly diagnose. Fortunately, with increased awareness of the diso...
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