New Dimensions in Fibromyalgia
is More Than Pain
Fibromyalgia is a
condition characterized by a history of diffuse musculoskeletal pain,
and the finding of tenderness on examination. Epidemiologic studies suggest
that this illness affects approximately 2% of the population, although
the prevalence in females is much higher (3.4% of all females, >7%
in those between the ages of 60-79).
fibromyalgia is defined by its musculoskeletal features, for some time
it has been clear that there are a large number of other systemic and
localized syndromes that occur commonly in individuals with this illness.
There is a significant overlap between fibromyalgia and other systemic
illnesses such as chronic fatigue, somatoform disorders, and other entities
such as the Persian Gulf Syndrome. Examples of closely related localized
or organ-specific conditions include migraine and tension headaches, irritable
bowel syndrome, temporomandibular dysfunction, non-cardiac chest pain,
myofascial pain syndrome, and a variety of genitourinary syndromes. These
illnesses all occur more commonly in females, and can either be triggered
or exacerbated by a variety of stressors, including physical trauma, immune
stimulation, and emotional stress.
There are several lines of evidence to suggest that these chronic pain and
fatigue conditions may share common pathogenic mechanisms, and that instead
of being discrete, separate illnesses, these entities are part of a larger
spectrum. In this regard, there are several promising areas of research
into these conditions, including the hypothesis that there is a strong familial
predisposition to develop these conditions, and that the symptoms are caused
by aberrations of various components of the central nervous system. Accordingly,
there are several types of treatment that have been shown to be effective
for this spectrum of conditions, including low dose of tricyclic compounds,
aerobic exercise, and cognitive behavioral therapy.
at the National Fibromyalgia Research Association's New Dimensions
in Fibromyalgia Symposium, September 14-15, 1997, in Portland,