Fibromyalgia patients experience widespread muscle tenderness and nagging muscle pain that is apparently unrelated to injury or other diseases. In the 20th century, many doctors told their patients that chronic pain was "all in their heads." While the doctors did not know it at the time, they were actually correct. During the past 10 years, research, functional brain imaging, and genetic tests show that altered pain-processing mechanisms in the brain cause fibromyalgia.
Factors
Many people recognize the approximate date of onset of their chronic pain and can identify potential triggers. Some individuals develop fibromyalgia after exposure to a viral infection, vaccine, or drugs. In addition, hormonal changes, physical injury, and emotional stress have also been associated with the onset of fibromyalgia. The diagnosis of fibromyalgia is difficult because there is no single definitive diagnostic test for the condition. Blood tests are either normal or used to exclude the existence of other medical conditions.
Complaints
Most patients experience chronic pain along with many different and apparently unrelated symptoms that can be confused with other diagnoses such as systemic lupus erythematosus, rheumatoid arthritis, or ankylosing spondylitis. In addition, many fibromyalgia patients suffer from other concurrent conditions including chronic fatigue, irritable bowel or irritable bladder syndrome, or temporomandibular disorder.
Chronic Pain
Published in 1990, the American College of Rheumatology (ACR) guidelines for the diagnosis of fibromyalgia are still used 2010. According to the ACR, fibromyalgia should be considered if a patient reports unexplained pain at multiple sites for at least 3 months. Unexplained pain might include chronic headaches or other chronic pain in the chest, abdomen or pelvis.
Tender Points
The ACR guidelines for the diagnosis of fibromyalgia also require that the patient must exhibit tenderness or pain in at least 11 of 18 "tender points" on the body to confirm the diagnosis. These specific tender points are located on either side of the back of the head, neck or upper back, the chest, arms or on either side of the lower back or hips, and near the knees. Therefore, diagnosis of fibromyalgia is warranted if a patient exhibits widespread, chronic pain that conforms to the ACR guidelines.
