What are the ten most important attributes of fibromyalgia (FM)? Let’s take a look!

1. FM definition: It’s characterized by widespread muscular pain and tenderness (in all four of the body’s quadrants) that’s NOT caused by inflammation or joint damage.
2. FM can be primary or secondary: Secondary FM is caused by something else (often after trauma) in association with another disorder like rheumatoid arthritis (RA), irritable bowel syndrome (IBS), lupus, chronic fatigue syndrome, and more. Primary FM has no known association with another condition.
3. FM is OFTEN chronic: Because FM is diagnosed by EXCLUDING other conditions, it’s often left undiagnosed for years! To further complicate this, when a person has a diagnosed condition such as Lyme disease, RA, etc., those conditions get all the attention and FM is left undiagnosed. In fact, the National Fibromyalgia Association reports that it takes about an average of five years to get an accurate diagnosis of FM!
4. Sleep & Chronic Fatigue: A reported 90% of FM patients suffer from severe fatigue or a sleep disorder. Non-restorative sleep contributes significantly to fatigue and poor cognitive function, and is a hallmark of FM making it an important problem to address in treatment.
5. FM Symptoms are many: Headache, IBS, memory problems, TMD (jaw pain), pelvic pain, noise-light-temperature sensitivities, restless leg syndrome (RLS), depression, and anxiety are ALL associated issues with FM (more reasons for a delayed diagnosis and treatment challenges)!
6. FM includes both physical and psychological aspects: One study of 307 FM patients followed over an eleven-year time frame found that 33% had severe physical and psychological problems, another 1/3 had mild issues with both, and the last third had only mild physical symptoms.
7. FM is HIGHLY VARIABLE: With the widespread pain, variable disability rates, variable physical and psychological aspects (see #6 above), and symptom/condition variability (see #5 above), a treatment approach to manage FM must be individualized! There is no “recipe” for managing FM!
8. FM Tests: There are none! Diagnosing FM relies on the patient’s history of widespread pain and associated disabilities more than the physical exam, blood tests, and x-rays which are used to help “rule-out” other disorders.
9. FM Treatment: The “best” management strategies for FM include a multi-disciplinary “team” of providers including primary care (medications), chiropractic (manual therapy, nutrition, exercise training), clinical psychology (depression/anxiety management), and other forms of treatment such as massage therapy, acupuncture, and meditation / relaxation therapy. Programs that are individualized work the best! The patient MUST BE an active participant who is willing to do the work!
10. “Stats” about FM: First of all, it’s common! It affects women more than men, and about 2-4% of the population overall. What is left out of the stats is the intensity of symptoms, how well each patient responds to the different management strategies, and the patient’s coping skills with this chronic, sometimes totally disabling condition (see #6 above). Other “facts” about FM include: increased “substance P” (a chemical that increases nerve sensitivity), decreased blood flow to the thalamus (brain), hormone imbalances, low levels of serotonin and tryptophan, and abnormal cytokine function….and more!

REMEMBER as stated in #9, the “team” approach yields the BEST RESULTS!