Dear Alice,

What is "fibromyalgia"? Heck, I'm not even sure of the spelling, but that's it phonetically, anyway. Thanks.

Dear Reader,

That's okay if you're not sure how to spell it — medical professionals aren't even completely sure about what causes fibromyalgia. By the way, you were close with the spelling!

Generally speaking, fibromyalgia, formerly thought of as an imaginary or psychosomatic condition, is in fact a chronic illness more often diagnosed in women in their mid-thirties to late-fifties, although it also affects men and children. The American College of Rheumatology (ACR) estimates that the condition affects between two to four percent of the population.

Fibromyalgia causes fatigue, pain in the muscles and ligaments (not the joints), and a number of tender spots on the body, where even a small bit of pressure causes pain. This pain is commonly seen in the neck, upper and lower back, hips, elbows, and knees. Beyond these symptoms, fibromyalgia shows itself in a number of other ways, which may include:

  • stiffness, especially in the morning
  • problems sleeping
  • increased sensitivity to pain
  • headaches, including migraines
  • facial pain
  • irritable bowel syndrome
  • chest pain
  • painful menstrual periods
  • skin numbness (paresthesias)
  • allergic symptoms
  • frequent and/or urgent urination
  • problems with concentrating and/or memory (commonly referred to as "fibro fog")

While this list of symptoms may seem overwhelming, several types of treatments have been recommended. Antidepressants, Anti-seizure medications, and even over-the-counter medications may help relieve symptoms associated with the condition. Alternative therapies like massage, Tai Chi, and acupuncture may also provide both stress and pain relief for people with fibromyalgia. 

In addition to physical symptoms, fibromyalgia patients are also prone to psychological troubles including depression, anxiety, and post-traumatic stress disorder. These mental health issues and the social burden of fibromyalgia can exacerbate patients' physical pain and complicate their relationships at home and at work. People with fibromyalgia may feel guilty about complaining about their condition or fear that loved ones won't believe they are in pain. Fibromyalgia treatment programs that promote social support and emotional coping ability can help patients' manage the physical and emotional challenges of their condition.

The exact cause(s) of fibromyalgia is unknown, but researchers believe a number of factors may contribute to the illness. Currently, one leading theory known as "central sensitization" holds that people with fibromyalgia have a lower pain threshold due to increased sensitivity to pain signals in the brain. This sensitivity may be linked to elevated levels of Substance P, a chemical found in spinal fluid that communicates pain signals with the brain. A second theory involves chemical changes in the brain resulting in low levels of serotonin, a chemical (neurotransmitter) linked to pain, sleep, and depression. Other possible causes or triggers include lack of deep sleep, injury/trauma that affects the central nervous system, certain infections, problems with the sympathetic nervous system, changes in muscle metabolism, hormonal changes, and/or physical or psychological stress.  

If you have been diagnosed with or believe that you have fibromyalgia, seek treatment from a health care provider familiar with fibromyalgia. Students at Columbia can make an appointment with a health care provider who can help direct you to a specialist in fibromyalgia by contacting Medical Services (Morningside) or the Student Health Service (CUMC).

Here's to some clarity on a commonly misunderstood condition.

Alice!
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