A chronic condition characterized by pain all over the body. An estimated 5 million Americans over the age of 18 have fibromyalgia, and 80% to 90% of people affected by fibromyalgia are women. The exact cause of fibromyalgia is currently unknown, though it often runs in families, and researchers believe it may be linked to traumatic events, such as car accidents and illnesses. Recently, research has focused on the role that special nerves in the hands may play in fibromyalgia.

Because many of the symptoms associated with fibromyalgia (including pain, fatigue, and increased sensitivity to noise and light) are common to many medical conditions and/or difficult to measure, fibromyalgia can be difficult to diagnose. One laboratory test for fibromyalgia does exist, though it is still fairly new and quite expensive. Doctors have tended to rely on symptoms and a thorough examination to diagnose a person with fibromyalgia. Newly revised guidelines from the American College of Rheumatology for diagnosing fibromyalgia prompt doctors to ask about commonly reported fibromyalgia symptoms such as fatigue, cognitive problems, widespread pain, and pain at 19 specific points on the body, including the hips, shoulders, neck, and either side of the jaw.

People with fibromyalgia often also experience sleep disturbances; numbness or tingling in the arms, legs, hands, feet, or face; and headaches. Stress and inadequate sleep tend to make the symptoms worse. Many people with fibromyalgia also experience anxiety and depression.

Although fibromyalgia may be a chronic, lifelong condition, it generally does not become debilitating, and proper treatment often can at least partially relieve the symptoms. Some steps to lessen fibromyalgia symptoms include performing regular aerobic exercise, especially low-impact exercise such as swimming; getting adequate sleep; and using relaxation techniques and other forms of stress management. The Food and Drug Administration has approved three medicines specifically for the treatment of fibromyalgia: two antidepressants called duloxetine (brand name Cymbalta) and milnacipran (Savella), as well as an anticonvulsant called pregabalin (Lyrica).

Your doctor may also prescribe other drugs to treat your fibromyalgia symptoms “off label,” including tricyclic antidepressants, such as amitriptyline and doxepin, and other antidepressants called selective serotonin reuptake inhibitors, such as fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). (Duloxetine and milnacipran are both examples of a kind of antidepressant called a selective serotonin/norepinephrine reuptake inhibitor.)


Robert S. Dinsmoor is a medical writer and editor based in Massachusetts.

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