QR:  What is fibromyalgia?

What is fibromyalgia?

So I have been allotted months of futility, and nights of misery have been assigned to me. When I lie down I think, “How long before I get up?” The night drags on, and I toss and turn until dawn. (NIV Bible, Job 7:3-4)

And now my life ebbs away; days of suffering grip me. Night pierces my bones; my gnawing pains never rest. (NIV Bible, Job 30:16-17)

The primary symptom of fibromyalgia or fibromyalgia syndrome is chronic and widespread pain. Currently, in 2015, it is commonly accepted that fibromyalgia has been described in literature for centuries from Biblical times onwards (Wallace and Hallegua, 2001; White and Harth, 2001; FitzGibbons, 2007). However, the concept of fibromyalgia has been developed and described under many terms, such as fibrositis, fibromyalgia syndrome, rheumatoid illnesses, widespread pain or musculoskeletal pain (White and Harth, 2001; Hagen et al., 2005; Linares et al., 2007).

In 2010 Wolfe et al. revised the original criteria for the diagnosis of fibromyalgia. Not all patients responded to the relevant amount of tender points, but were clearly suffering from widespread and chronic pain and not all physicians knew how to ascertain the relevant tender points. Also, by 2010 it had been acknowledged that fibromyalgia could produce another set of symptoms such as fatigue and cognitive dysfunctions. The American College of Rheumatology set of criteria from 2010 means that even in the absence of reactions to 11 tender points fibromyalgia could still be diagnosed if the score relating to somatic symptoms is greater than five or nine, depending on the ultimate value of the widespread pain index. This influential publication regarding the revision of criteria for the diagnosis of fibromyalgia led to the understanding that it is a heterogeneous condition (Häuser et al., 2015) with a wide range of complex symptoms that include pain, fatigue, sleep dysfunctions, cognitive problems, increased sensitivity to temperature, light and sound, increased sensitivity to painful and non-noxious stimuli, central sensitisation and psychological disorders (White and Harth, 2001; FitzGibbons, 2007; Linares et al., 2007; Wolfe and Walitt, 2013).

Yunus (1994, 2008, 2009) considers fibromyalgia to be part of a family of illnesses that are all connected with central sensitisation. In his original publication he collects this group of illnesses as “dysfunctional spectrum syndrome” (Yunus, 1994, p.12), but later on changes this terminology to “central sensitivity syndrome” (Yunus, 2008; Yunus, 2009). The common factors for illnesses that belong to this syndrome are central sensitisation on the one hand and mutual associations on the other. According to Yunus (2009) the central sensitivity syndrome list is not exhaustive and other illnesses may well be added, but encompasses:

Irritable bowel syndrome [IBS] Fibromyalgia syndrome [FMS] Myofascial pain syndrome [MPS] Regional soft tissue pain syndrome [RSTPS] Chronic fatigue syndrome [CFS] Tension-type headache [TTH] Migraine Temporomandibular disorders [TMD] Restless legs syndrome [RLS] Periodic limb movement in sleep [PLMS] Female urethral syndrome [FUS] Interstitial cystitis [IC] Primary dysmenorrheal [PD] Premenstrual syndrome [PMS] Vulvodynia/vulvar vestibulitis syndrome [VVS] (Yunus, 2009, p.401)



List of references:

FitzGibbons, J. (2007). Be a myth-buster. American Nurse Today, 2(9), 40-45.

Hagen, K., Zwart, J., Svebak, S., Bovim, G., & Stovner, L. J. (2005). Low socioeconomic status is associated with chronic musculoskeletal complaints among 46,901 adults in Norway. Scandinavian Journal of Public Health, 33, 268-275.

Linares, M. d. C. U., Ruiz-Pérez, I., Pérez, M. J. B., Labry-Lima, A., Hernández-Torres, E., & Plazaola-Castaño, . (2008). Analysis of the impact of fibromyalgia on quality of life: Associated factors. Clinical Rheumatology, 27, 613-619.

Häuser, W., Walitt, B., Klose, P., & Fitzcharles, M. (2015). Cannabinoids for fibromyalgia. Cochrane Database of Systematic Reviews, 5, Art. No.: CD011694.

Wallace, D. J., & Hallegua, D. S. (2001). Quality-of-life, legal-financial, and disability issues in fibromyalgia. Current Pain and Headache Reports, 5, 313-319.

White, K., & Harth, M. (2001). Classification, epidemiology, and natural history of fibromyalgia. Current Pain and Headache Reports, 5, 320-329.

Wolfe, F., & Walitt, B. (2013). Culture, science and the changing nature of fibromyalgia. Nature Reviews Rheumatology, 9, 751-755.

Yunus, M. (1994). Fibromyalgia syndrome: clinical features and spectrum. Journal of Musculoskeletal Pain, 2 (3), 5-18.

Yunus, M. (2008). Central sensitivity syndromes. Seminars in Arthritis and Rheumatism, 37, 339-352.

Yunus, M. (2009). Central sensitivity syndromes. Journal of Musculoskeletal Pain, 17(4), 400-408.



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