CHRONIC pain, stiffness, fatigue, and cognitive dysfunction characterize fibromyalgia syndrome. The pain originates from discrete areas, called tender points, located over muscles, tendons, ligaments, bursa and joints.

"Fibromyalgia has been called the invisible condition because you can’t look at someone and tell if he or she has fibromyalgia" ¹. Many people have been led to believe that the pain they are experiencing is "all in their heads." But advancements in technology and pain research have proven this notion wrong.

Fibromyalgia symptoms may feel like arthritis because soreness often occurs around joints, but it is referred to by doctors as a form of rheumatism (pain and stiffness) because fibromyalgia doesn't cause joint deformities that are hallmarks of arthritis.

The patient's pain fluctuates and is "often aggravated by various physical, environmental, and emotional factors" 2. People with fibromyalgia describe the pain as stabbing, shooting, throbbing, burning and deep muscular aching. They often experience more pain and stiffness in the morning and in muscle groups that are used repetitively 3. Next to pain, fatigue is the most common complaint for fibromyalgia patients 4. The medical definition of fatigue is "a physical state of discomfort and decreased efficiency from prolonged or excessive exertion, causing loss of power and capacity to respond to stimulation" 5. This definition implies that fatigue is a normal consequence of excessive physical activity. But this definition does not appropriately describe the fatigue experienced by fibromyalgia patients.

Fibromyalgia fatigue is a physical and mental low energy state that results from simple activities or for no reason whatsoever. There are multiple explanations why people with fibromyalgia experience this type of fatigue ⁶:

• poor sleep,
• low adenosine triphosphate (ATP)—the body's energy molecule,
• autonomic nervous system dysfunction,
• low concentration of serotonin—a brain hormone,
• constant pain,
• depression,
• problems with other chronic conditions associated with fibromyalgia,
• problems with hormones regulating the body's metabolism,
• poor use of oxygen in the muscles, and
• constant muscle movement to decrease pain.

In addition to pain, fatigue, and cognitive problems, fibromyalgia is commonly associated with these symptoms and conditions ⁹:

• allergies,
• anxiety disorder and panic attacks,
• chest pain,
• depression,
• dizziness,
• dysmenorrhea history,
• fatigue,
• headaches (tension, migraine or both),
• irritable bowel syndrome (diarrhea, constipation, stomach cramps)
• irritable bladder (constant urge to urinate),
• mitral valve prolapse (bulging of a heart valve during heartbeat),
• morning stiffness,
• paresthesias,
• Raynaud's phenomenon,
• restless legs (nighttime leg cramps and restlessness),
• sicca symptoms,
• sleep disturbances,
• TMJ dysfunction (jaw pain),
• tenderness in at least 11 tender points, and
• widespread pain.

Other common symptoms include numbness, tingling, swelling in extremities, dry eyes and mouth, and sensitivities to bright light, odor, noise, food, and medications ¹⁰. Each of these conditions may be severe enough to require separate treatment. The conditions, by themselves, do not indicate a person has fibromyalgia syndrome ¹¹.

Fibromyalgia is the third most commonly diagnosed rheumatic disorder (after osteoarthritis and rheumatoid arthritis), affecting 2—5% of the general population ¹². Women are more frequently diagnosed with fibromyalgia then men. Children can also have fibromyalgia. The median age of onset for fibromyalgia is from 29 to 37 years ¹³.

Currently, there is no cure for fibromyalgia. The severity of symptoms differs from person to person. Symptoms may persist for many years. Although studies indicate fibromyalgia syndrome does not cause crippling or lead to premature death, many patients and their families will experience a reduced quality of life and dysfunction as an outcome of fibromyalgia ¹⁴.

2. MJ Pellegrino, The Fibromyalgia Survivor, (Columbus, Ohio: Anadem Publishing, 1995), 1.

3. Fibromyalgia Network, "Fibromyalgia Basics: Symptoms, Treatments and Research," <http://www.fmnetnews.com/pages/basics.html> (4 May 1999).

4. Pellegrino, Fibromyalgia Supporter.

5. Pellegrino, Fibromyalgia Supporter, 17.

6. Pellegrino, Fibromyalgia Supporter, 18—19.

7. Pellegrino, Fibromyalgia Supporter.

8. Pellegrino, Fibromyalgia Supporter, 21.

9. Pellegrino, Fibromyalgia Supporter.

F Wolfe, HA Smythe, MB Yunus, RM Bennett, C Bombardier, DL Goldenberg, P Tugwell, SM Campbell, M Abeles, P Clark, et al., "The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia: Report of the Multicenter Criteria Committee," Arthritis and Rheumatism 33, February (1990): 160-172.

10. Fibromyalgia Network, "Fibromyalgia Basics."

11. Pellegrino, Fibromyalgia Supporter.

12. Pellegrino, The Fibromyalgia Survivor.

13. M Boissevain, G McCain, "Toward an Integrated Understanding of Fibromyalgia Syndrome. I. Medical and Pathophysiological Aspects," Pain 45, no. 3 (1991): 227-238.

14. RM Bennett, "Principles of Treating Fibromyalgia," <http://www.myalgia.com/off/overview.htm> (10 February 1998).