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Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and multiple tender points. "Tender points" refers to tenderness that occurs in precise localized areas, particularly in the neck, spine, shoulders, and hips. People with this syndrome may also experience sleep disturbances, morning stiffness, irritable bowel syndrome, anxiety, and other symptoms.
Although the cause of fibromyalgia is unknown, researchers have several theories about causes or triggers of the disorder. Some scientists believe that the syndrome may be caused by an injury or trauma. This injury may affect the central nervous system. Fibromyalgia may be associated with changes in muscle metabolism, such as decreased blood flow, causing fatigue and decreased strength. Others believe the syndrome may be triggered by an infectious agent such as a virus in susceptible people, but no such agent has been identified.
Fibromyalgia is difficult to diagnose because many of the symptoms mimic those of other disorders. The physician reviews the patient's medical history and makes a diagnosis of fibromyalgia based on a history of chronic widespread pain that persists for more than 3 months. The American College of Rheumatology (ACR) has developed criteria for fibromyalgia that physicians can use in diagnosing the disorder. According to ACR criteria, a person is considered to have fibromyalgia if he or she has widespread pain in combination with tenderness in at least 11 of 18 specific tender point sites.
Signs and symptoms
Fibromyalgia is a chronic illness that can be debilitating for many. Fibromyalgia sufferers can experience a wide range of symptoms with varying intensities and may include:
Memory impairment and concentration
Widespread musculoskeletal aches
Soft tissue tenderness
Pain and stiffness
Irritable bowel and bladder
Headaches and migraines
Skin sensitivities and rashes
Dry eyes and mouth
Poor (brain) cognition
Ringing in the ears (tinnitus)
Restless Leg Syndrome (periodic limb movement disorder)
Raynaud's Syndrome (freezing hands/feet)
Neurological symptoms (muscle weakness, numbness)
18 Points of Tenderness
Painful tender points are located at various places on your body and are a common characteristic of Fibromyalgia Syndrome, which can be part of the diagnostic process. Your health care provider will ask about your pain symptoms and then press on a series of anatomically-defined soft tissue body sites called "tender points." Eleven of the 18 tender point sites must be painful when pressed in order to receive a medical diagnosis of fibromyalgia.
While any body part can be affected, the most common sites of pain include:
Neck and Back
Shoulders and Chest
Hips and Knees
Hands and Elbow Regions
Buttocks and Pelvic Girdle
Tender points are generally superficial areas under the surface of the skin, such as the area over the elbows or shoulders. However, the tender points of these areas are usually very small, about the size of a penny. Tender points also involve localized areas of tenderness and pain around the joints, but do not involve the joint itself.
These 18 tender points will usually be highly sensitive to pressure in people with fibromyalgia as specified by the American College of Rheumatology criteria. The pain can feel like a deep bone ache, pins and needles, or a stabbing or burning pain. Muscles may feel like they have been pulled or overworked. There are times this pain is mild, others when it is so severe that it becomes unbearable. People who do not have fibromyalgia feel less tenderness when pressure is applied to these areas.
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