Fibromyalgia is a disorder that causes chronic pain in the muscles and tendons all over the body. The cause of fibromyalgia is unknown; however, researchers hypothesize there is a disruption in the perception of pain. The disorder affects more women than men and is associated with other chronic symptoms, but is not a life-threatening disorder, according to the University of Maryland Medical Center.
Cause and Symptoms
The cause of fibromyalgia is unknown. The disorder is not a result of a disease process or bodily injury; there are changes that occur to internal chemistry and functional processes, but it is unclear whether these changes are a cause or result of fibromyalgia, notes Cedars-Sinai Hospital. Other theories include changes in the autonomic nervous system that change the body's reaction to stress; sleep issues that disrupt muscle healing; brain chemistry changes that hinder mood and pain perception; genetics; and injury or infection, according to the University of Maryland Medical Center.
Fibromyalgia is primarily characterized by pain, stiffness and aching of the muscles and tendons, in all four quadrants of the body. Other symptoms include fatigue, weakness, disturbed sleep, headaches, brain fog, irritable bowel syndrome, depression, dizziness and numbness and tingling of the hands and feet. Patients will also exhibit painful, tender points in the spine, shoulders, neck and hips, according to Cedars-Sinai Hospital.
Tender Point Test
Historically, the American College of Rheumatologists recommended the tender point test to verify a diagnosis of fibromyalgia. The test involves applying light pressure with the thumbs to 18 specific points on the body. Regions include just below the base of the skull, just under the jaw on the neck, on top of the shoulders, between the shoulder blades, in front of the elbow, in the back of the hips where the low back meets the buttocks, the side of the upper leg near the hips and the inside of the knee. If pain is felt at 11 of 18 tender points, fibromyalgia is confirmed. As of 2010, however, the tender point test is no longer used in diagnosis, according to Rush University Medical Center News Blog.
Old Diagnostic Criteria
In 1990, the American College of Rheumatologists published a set of diagnostic criteria for fibromyalgia. A diagnosis was based upon severe pain experienced in all four quadrants of the body, pain in at least 11 of 18 tender points, extreme fatigue, brain fog and the inability to perform activities of daily living, according to Rush University Medical Center News Blog.
New Diagnostic Criteria
In 2010, the American College of Rheumatologists published their revised list of diagnostic criteria for fibromyalgia, one they predict will increase the number of patients being diagnosed. The criteria, instead of focusing upon the tender point test, recommends rating the severity of widespread pain in all four quadrants, in addition to the severity of other symptoms such as fatigue, sleep issues, brain fog and difficulty completing activities of daily living. The new criteria no longer requires the presence of tender points.
Diagnostic Improvements
The American College of Rheumatologists believe the new diagnostic criteria is an improvement from the old recommendations. Basing a diagnosis on the presence of tender points was an unreliable test, since the severity or presence of tender points fluctuates and the severity of symptoms can improve with treatment, but the presence of tender points remain. The old criteria also was gender-biased. Men do not present with as many tender points as women; therefore, many men missed a proper diagnosis. With the new criteria, it is predicted that the number of diagnosed patients will rise. More patients will receive focused treatment and potential improvement in their symptoms, notes Rush University Medical Center.
References
- University of Maryland Medical Center: Fibromyalgia
- Cedars-Sinai Hospital: Fibromyalgia Syndrome
- Rush University Medical Center News Blog: New Diagnostic Criteria for Fibromyalgia May Result in More Diagnosed Cases
- Rush University Medical Center: New Criteria Proposed for Diagnosing Fibromyalgia Suggests No Longer Focusing on Tender Points
