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Fibromyalgia (FMS)

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Overview
Causes
Diagnosis
Treatments
Complications
Related
Autoimmune/Scleroderma
Autoimmune Thyroid Disease and FMS
Cardiac
Gastrointestinal
Interstitial Cystitis
Lupus
PMS
Sjögren's
Sleep Disorders/RLS
Scleroderma
TMJ
CFS/FMS?
Disability
Research
Psychosocial
Medical: Pain
Support
Personal Stories

Overview: What is Fibromyalgia (FMS)?

Fibromyalgia KaleidoscopeFibromyalgia (FMS) causes chronic pain, fatigue, disturbed sleep and a myriad of other symptoms. It can occur by itself or along with other forms of arthritis, including scleroderma. Although it is never fatal, it is usually difficult to manage and can cause significant disability and disruption of quality of life.

What is Fibromyalgia? Fibromyalgia is a long-term (chronic) condition that causes widespread pain in the muscles, tendons and ligaments. Arthritis Research UK. (Also see Autoimmune Diseases)

Illness perceptions and burden of disease in fibromyalgia. Long–term prospective studies should be conducted to improve the understanding of the course of illness and to determine whether early diagnosis and intervention can reduce the severity and duration of symptoms. PubMed, Expert Rev Pharmacoecon Outcomes Res, 12/07/2016.

Causes

Daily Fluctuations of Progesterone and Testosterone are Associated with Fibromyalgia Pain Severity. These results suggest that progesterone and testosterone play a protective role in fibromyalgia pain severity and other hormones may serve to both increase and decrease fibromyalgia pain severity. PubMed, J Pain, 12/14/2017.

Effects of Vitamin D Therapy on Quality of Life in Patients with Fibromyalgia. Vitamin D deficiency seems to be linked to the pathogenesis of fibromyalgia and Vitamin D supplementation may improve the quality of life in patients with fibromyalgia. PubMed, Eurasian J Med, 2017 Jun;49(2):113-117. (Also see Vitamin D Deficiency)

Sympathetic nervous system dysfunction in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis. Sympathetic dysfunction could be the common underlying pathogenesis that brings on these overlapping clinical features. PubMed, J Clin Rheumatol. (Also see Chronic Fatigue Syndrome, Irritable Bowel Syndrome and Interstitial Cystitis)

Diagnosis

Fibromyalgia symptoms or not? Understand the fibromyalgia diagnosis process. Fibromyalgia symptoms include widespread body pain, fatigue, poor sleep and mood problems. And because fibromyalgia symptoms can occur alone or along with other diseases, it can take time to tease out which symptom is caused by what problem. Mayo Clinic.

Is it necessary to strictly diagnose fibromyalgia syndrome (FMS) in patients with chronic widespread pain (CWP)? Future research should be directed toward classification of CWP to provide guidance to clinicians in selecting effective therapies. PubMed, Clin Rheumatol, 05/26/2015.

Treatments

Overview
Alternative Therapies
Cognitive Therapy
Exercise
Low Level Laser
Medications
Peripheral Nerve Stimulation
Transcranial Stimulation

Complications

Fibromyalgia Complications Fibromyalgia symptoms may come and go, but the pain syndrome can disrupt your life and is often associated with other diseases. Healthline.

Autoimmune, Arthritis or Rheumatic

Autoimmune Diseases. Fibromyalgia may occur by itself or along with any other autoimmune, arthritis or rheumatic disorder, including scleroderma. ISN.

Patients with fibromyalgia (FM) rarely fulfil classification criteria for axial spondyloarthritis (axSpA). FM patients only rarely fulfil classification criteria for axSpA but some axSpA patients also fulfil FM criteria and assessment instruments evaluated in axSpA are not disease–specific. Rheumatology, 09/08/2017.

Fibromyalgia in Behçet's disease: a narrative review. PVD is a rare complication of BD and management of immunosuppressive agents may improve the prognosis and should be recommended. PubMed, Br J Pain, 2017 May;11(2):97-101. (Also see Behçet's Disease)

The problem in differentiation between psoriatic–related polyenthesitis and fibromyalgia (FMS). The unmet needs in the differentiation between FM and enthesitis in psoriatic disease patients are highlighted and critically evaluated in this article. PubMed, Rheumatology (Oxford), 04/05/2017. (Also see Psoriasis and Psoriatic Arthritis)

Undifferentiated connective tissue disease (UCTD), fibromyalgia and the environmental factors. Environmental factors are gaining increasing attention since the description of Autoimmune/Inflammatory Syndrome Induced by Adjuvants (ASIA), a syndrome that includes symptoms typically seen in patients with fibromyalgia and UCTD. PubMed, Curr Opin Rheumatol, 03/31/2017. (Also see Undifferentiated Connective Tissue Disease)

Autoimmune Thyroid Disease and Fibromyalgia

Hypothyroidism and Fibromyalgia — What's the Connection? It's significant that a significant number of the estimated 27 million people with hypothyroidism end up also being diagnosed with fibromyalgia as both conditions share many similar symptoms. VeryWell, 07/13/2017. (Also see Autoimmune Thyroid Disease)

Cardiac Autonomic Dysfunction

Comparison of heart rate variability (HRV) and classic autonomic testing for detection of cardiac autonomic dysfunction (CAD) in patients with fibromyalgia. HRV does not improve detection of CAD in FM patients over classic autonomic testing. PubMed, Int J Rheum Dis, 04/29/2016.

Gastrointestinal

Bidirectional association between fibromyalgia (FM) and gastroesophageal reflux disease (GERD): two population–based retrospective cohort analysis. The present study suggests a bidirectional relationship between FM and GERD and there is a greater risk of developing GERD for patients with FM than developing FM for patients with GERD. PubMed, Pain, 2017 Oct;158(10):1971-1978. (Also see Reflux (Heartburn) and GERD)

Association between fibromyalgia syndrome (FMS) and peptic ulcer disease (PUD) development. FMS patients exhibit a higher risk of PUD than that of patients without FMS. PubMed, PLoS One, 2017 Apr 6;12(4):e0175370.

Interstitial Cystitis (Bladder) and Fibromyalgia

Interstitial Cystitis and Fibromyalgia. A subset of interstitial cystitis (IC) patients also have fibromyalgia (FM), a chronic pain disorder with a multitude of symptoms. Interstitial Cystitis Association.

Lupus and Fibromyalgia

Lupus. It is common for people with lupus (and other autoimmune diseases) to be initially diagnosed with fibromyalgia. ISN.

Overview
Antibodies
Causes
Diagnosis
Lupus in Overlap
Media Stories
Pediatric Lupus
Personal Stories
Research
Support
Symptoms
Treatments

Irritable bowel syndrome (IBS)-type symptoms in female patients with mild systemic lupus erythematosus (SLE): frequency, related factors and quality of life. IBS-type symptoms are highly prevalent among women with SLE and are associated with fibromyalgia (FM) and depression. SLE+IBS patients had worse quality of life (HRQOL) vs Non-IBS SLE, independently of FM status. Treating IBS symptoms may improve HRQOL in women with SLE. PubMed, Neurogastroenterol Motil. (Also see Systemic Lupus Erythematosus and Depression)

Migraine and Fibromyalgia

Frequency of Migraine Headaches in Patients With Fibromyalgia. Migraine headaches are common in patients with fibromyalgia and these conditions can significantly increase a patient’s cumulative disease burden. PubMed, Headache, 05/21/2015.

Premenstrual Syndrome

Premenstrual syndrome (PMS) and fibromyalgia (FMS) may be related; in fact, PMS is listed as a symptom of fibromyalgia. However, a person can have PMS without having FMS.

Sjögren's Syndrome

Prevalence and clinical impact of fibromyalgia (FM) in patients with primary Sjögren's syndrome (pSS). The study showed that FM was prevalent in pSS and FM was associated with higher EULAR Sjögren's Syndrome Patient Reported Index and more severe depression. PubMed, Clin Exp Rheumatol, 08/27/2015. (Also see Symptoms and Complications of Sjögren's Syndrome)

Sleep Disorders

The association between pain and sleep in fibromyalgia. Future studies should also consider mood disorders and emotional dysfunction, as comorbid conditions could occur with both pain and sleep disorder in fibromyalgia. PubMed, Saudi Med J, 2017 May;38(5):465-475. (Also see Depression)

Decrease of Serum IGF-1 Level is Not Associated With Obstructive Sleep Apnea in Fibromyalgia (FMS) Patients. In FMS patients, serum IGF-1 levels may decrease due to age and PSQI; however, this may not be related to the severity of obstructive sleep apnea. Archives of Rheumatology, 02/10/2017. (Also see Sleep Apnea and Associated Diseases)

The role of sleep in pain and fibromyalgia. Mechanistically, sleep deprivation impairs descending pain-inhibition pathways that are important in controlling and coping with pain. PubMed, Nat Rev Rheumatol, 04/28/2015.

Obesity and sleepiness in women with fibromyalgia (FM). There is an important association between sleepiness and FM, suggesting that the occurrence of obesity may be involved with sleepiness in these patients. PubMed, Rheumatol Int, 2015 Feb;35(2):281-7.

Scleroderma and Fibromyalgia

About half of people with fibromyalgia have Raynaud's. Occasionally Raynaud's is secondary to connective tissue diseases, such as scleroderma. (Also see What is Scleroderma? and Raynaud's)

Temporomandibular Joint Disorder and Fibromyalgia

Features of temporomandibular disorders in fibromyalgia syndrome. Facial pain was reported by 85% of the fibromyalgia group, and 77.5% were diagnosed with myofascial temporomandibular disorders TMD. ProHealth. Cranio.

Relationship Between (CFS) and Fibromyalgia (FMS)

Fibromyalgia and Chronic Fatigue Information on the relationships between the rheumatological condition known as fibromyalgia, fibrositis, or FMS, chronic fatigue syndrome, CFS, myalgic encephalitis, ME, hypometabolism and thyroid disease, including hypothyroidism. VeryWell.

Disability Information for Fibromyalgia

CFS/FMS Objective Medical Evidence Requirements for Disability Adjudication Regarding Social Security Disability in the U.S. Susan M. Daniels, Ph. D.

Research

The relationship between body mass index and pain, disease activity, depression and anxiety in women with fibromyalgia (FMS). Obese female FMS patients had higher levels of pain, tender point count, disease activity and depression. PubMed, PeerJ, 2018 May 28;6:e4917.

The impact of thyroid autoimmunity on arterial stiffness in postmenopausal patients with fibromyalgia (FB). Age, functional status and presence of thyroidperoxidase autoantibody were significantly associated with increased arterial stiffness in postmenopausal FM patients. PubMed, Int J Rheum Dis, Int J Rheum Dis, 2017 Dec;20(12):1978-1986.

Bone mineral density (BMD) is decreased in fibromyalgia syndrome (FMS): a systematic review and meta–analysis. In this meta–analysis, we observe that BMD at lumbar spine is decreased in FMS compared with normal individuals. PubMed, Rheumatol Int, 12/05/2016. (Also see Osteoporosis)

Isokinetic Assessment of the Wrist Muscles in Females With Fibromyalgia (FMS). Patients with FMS had decreased muscle strength compared to healthy controls. Archives of Rheumatology, 04/09/2016.

Perceived function and physical performance are associated with pain and fatigue in women with fibromyalgia. Pain and fatigue are significantly associated with and explain more than one–third of the variance in perceived function and physical performance in women with fibromyalgia. PubMed, Arthritis Res Ther, 2016 Mar 16;18:68.

Perceived dyscognition reported by patients with fibromyalgia. Study results provide further evidence that perceived dyscognition in fibromyalgia is influenced by various comorbid symptoms. PubMed, Clin Exp Rheumatol, 02/26/2016.

A randomised, double–blinded study comparing giving etoricoxib vs. placebo to female patients with fibromyalgia. Although being mildly underpowered this study clearly has shown that etoricoxib did not improve pain scores and did not lead to any beneficial mental or physical effects. PubMed, Int J Clin Pract, 01/13/2016.

FMS: Psychological and Sociological Research

Paresthesia frequency in fibromyalgia and its effects on personality traits. These results suggest that psychological distress associated with high harm avoidance and low self–directedness scores are more prominent in fibromyalgia patients and especially of those who have paresthesia. PubMed, Int J Rheum Dis, 2018 Jul;21(7):1343-1349.

The effect of depressive symptoms on cognition in patients with fibromyalgia (FM). FM patients show a cluster of cognitive impairment in the attentional and executive domains; some of the symptoms could be explained by depression, while others seem to depend on fibromyalgia. PubMed, PLoS One, 2018 Jul 5;13(7):e0200057. (Also see Depression)

Fear of Falling in Women with Fibromyalgia (FM) and Its Relation with Number of Falls and Balance Performance. FM has an impact on fear of falling, balance performance, and number of falls. Perceived balance problems seem to be more closely associated with fear of falling than objective balance performance. PubMed, Biomed Res Int, 2015;2015:589014.

Affective Modulation of Brain and Autonomic Responses in Patients With Fibromyalgia. Patients with fibromyalgia rated all environments as more negative and arousing than did healthy controls. PubMed, Psychosom Med, 2015 Sep;77(7):721-32.

Medical Research: Pain

Pulsed electromagnetic field (PEMF) therapy in the treatment of pain and other symptoms in fibromyalgia: A randomized controlled study. This study demonstrated that low–energy PEMF therapy was not efficient in reducing pain and stiffness or in improving functioning in women with fibromyalgia. PubMed, Bioelectromagnetics, 04/30/2018.

Pain and emotion as predictive factors of interoception in fibromyalgia (FM). Pain–related affect and reactions in FM patients can reduce their interoceptive ability and our results help to better understand the integration between bodily signals and emotional processing in chronic pain. PubMed, J Pain Res, 2018 Apr 19;11:823-835.

Why Tai Chi Works So Well For Pain Relief. In a new study published in the BMJ, researchers report encouraging results involving one way to reduce the painful effects of fibromyalgia: with tai chi, an ancient practice originating in martial arts. Times Healthland, 03/22/2018.

Impaired Pain Modulation in Fibromyalgia Patients in Response to Social Distress Manipulation. These results are in line with previous studies demonstrating altered pain inhibition in FM patients, and suggest that being socially included may increase pain perception in them. PubMed, Clin J Pain, 2017 Jul;33(7):611-619.

Painful After–Sensations (PAS) in Fibromyalgia are Linked to Catastrophizing and Differences in Brain Response in the Medial Temporal Lobe (MTL). These results suggest that the MTL plays a role in PAS in FM patients. PubMed, J Pain, 03/11/2017.

Pain extent is associated with pain intensity but not with widespread pressure or thermal pain sensitivity in women with fibromyalgia (FMS) syndrome. Pain drawings constitute an easy and accurate approach to quantify widespread pain and larger pain extent is associated with pain intensity but not with signs of central sensitization in women with FMS. PubMed, Clin Rheumatol, 02/04/2017.

Evaluation of a self–management patient education program for patients with fibromyalgia syndrome (FMS): study protocol of a cluster randomized controlled trial. The study evaluates the effectiveness of a self–management patient education program for patients with FMS in the context of inpatient rehabilitation. BMC Musculoskeletal Disorders, 02/03/2016.

Pain characteristics in fibromyalgia: understanding the multiple dimensions of pain. The reciprocal effects of mood and fatigue on pain experience could be identified; catastrophizing scores show a high correlation with overall life quality and pain experience. PubMed, Clin Rheumatol, 2015 Apr;34(4):775-83.

Support

The National Fibromyalgia Partnership, Inc. (NFP) is the largest non-profit, membership organization for fibromyalgia (FM) in the United States. It provides medically accurate information on FM to individuals with fibromyalgia and their families, health care professionals, and the general public—both nationwide and in many other countries.

Personal Stories

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