Fibromyalgia – Symptoms, Causes, Targets, Course

What is Fibromyalgia?

The Latin word ‘fibra’ meaning fiber, Greek word ‘myo’ meaning muscle and ‘algos’ meaning pain combine, to name the medical ailment, fibromyalgia.

Chronic pain in the muscle (lasting three months or more) is referred to as Fibromyalgia. It is often accompanied with tenderness of the muscle, fatigue, disturbed sleep and memory lapses. It is also referred to as Fibromyalgia syndrome because the pain is often associated with several other symptoms including dysfunction of the cognitive and motor abilities of the afflicted.

Some medical specialists do not recognise this as a disease because the medical condition is not amenable to lab tests and imaging tests to confirm diagnosis. Yet another school of thought believe it to be a central nervous system disorder which is amenable to research and manifestation as clinical symptoms.

Symptoms of Fibromyalgia:

Chronic pain in the affected muscle apart there are a few other symptoms which typify the presence of Fibromyalgia. Muscle spasms, extreme fatigue, headaches, disturbed sleep ( restless leg syndrome, sleep apnoea, sleep but do not feel rested), stiffness in the joint close to the muscle, pelvic pain, discomfort while swallowing, bowel dysfunction, bladder dysfunction, temporomandibular joint disorder, eye pain, blurring of vision and fluctuation in vision clarity, sensitivity to light and temperature, discomfort in breathing, numbness ( not necessarily in the affected area), tingling, arthritis, lowering of cognitive abilities, lowering of motor abilities and anxiety related problems.

Not all the fibromyalgia symptoms appear in all the afflicted persons. Even the symptoms that do manifest, wax and wane, and do not remain forever.

Causes of Fibromyalgia:

The exact cause and effect of fibromyalgia are not known. The presumed causes are hereditary disposition, physical, mental or emotional stress, lack of sleep, low level of central dopamine (and norepinephrine), abnormal serotonin metabolism, deficiency in human growth hormone secretion, psychological factors, toxins making the nerves less/more sensitive, some infections, allergies, lack of emotional support, perfectionism, arduous work, inactivity, side effects of medications, change in weather conditions and chemical exposures.

Targets of Fibromyalgia:

Fibromyalgia affects 2-4% of the population, mostly in the age group of 20-50. Women are more likely afflicted compared to men with the women versus men ratio being 9:1. Those already afflicted with rheumatoid arthritis, lupus and ankylosing spondylitis are more likely to suffer fibromyalgia pain in the initial stages before developing inflammation.

Fibromyalgia is more likely to attack certain locations in the body known as fibromyalgia tender points – back of head, between shoulder blades, top of shoulders, front sides of neck, upper chest, outer elbows, upper hips, sides of hips and inner knees.
There are about 18 fibromyalgia trigger points of which at least 11 should be painful to the afflicted when 39 Newton force is exerted on the location.

Course of Fibromyalgia:
The afflicted are known to produce more of a substance P in their spinal fluid which gives increased pain signals to the brain. They have a low threshold for pain due to highly sensitized brain signals of pain.

Stress leads to disturbance in the neurotransmission of dopamine which has a lead role to play in how a person perceives pain and how immune he is to pain. Nerve stimulation of certain cells in the brain could help control the release or otherwise of pain transmitters.

Fibromyalgia is not a degenerative or fatal problem. But the pain, disturbed sleep and accompanied anxiety interferes with the performance of domestic work and office work, and maintaining family or office relationships.