Fibromyalgia: Defining characteristics of fibromyalgia

Introduction to fibromyalgia symptoms, diagnosis and treatment

Fibromyalgia is a fairly common—although difficult to understand—syndrome. It is characterized by scattered musculoskeletal pain (involving the muscles and bone structure), tenderness in specific areas, generalized fatigue and a feeling of being tired after sleeping ^1-6.

Fibromyalgia is most common in relatively young, otherwise healthy-appearing individuals, and occurs much more often in women than in men. It is estimated that fibromyalgia affects up to six million people in the US (10). In fact, fibromyalgia is the third most common diagnosis made in rheumatology clinics, after rheumatoid arthritis and osteoarthritis (in Wolfe et al, 1983, 14.6% of patients were diagnosed with fibromyalgia).

Fibromyalgia is difficult to identify

The condition is especially enigmatic and difficult to identify. Routine physical examination and diagnostic studies are seemingly unrevealing. Yet the frequency and consistency in which fibromyalgia is encountered in clinical practice has given a new interest to an old but elusive complex.

Studies on fibromyalgia

The natural history of fibromyalgia has yet to be definitively described. While it is not degenerative or life threatening, it can be life altering. As demonstrated by the following research, it is apparent that fibromyalgia is a chronic condition, with potential for significant periods or remission.

• One study found that the average time from onset to diagnosis was 5 to 8 years, showing that the condition is chronic ¹⁶.

• A 3-year study of 39 fibromyalgia patients showed that the most common response from year to year was "no change" in their condition ²⁰.

• In another study of 81 fibromyalgia patients, it was found that the condition lasted for an average of nearly 13 years. Additionally, remissions of at least two months were reported in 23% and repeat remissions in 6%. The average remission was 34 months long, with a median of 12 months and a maximum of 20 years. ¹

More information about fibromyalgia

While many aspects of fibromyalgia are not yet clear, there has been a reasonable amount of progress in defining and understanding the syndrome. To help provide a better understanding of fibromyalgia, this article includes:

• An overview of the conceptual evolution of fibromyalgia

• A profile of fibromyalgia patients

• An overview of symptoms and modulating factors

By: Thomas K. Van Sistine, MD

January 20, 2000