Fibromyalgia Syndrome

What is Fibromyalgia Syndrome?

FMS (fibromyalgia syndrome) is a widespread musculoskeletal pain and fatigue condition for which the cause is unknown. People of both genders and ages can get fibromyalgia, but more women than men are afflicted. Many of the symptoms overlap with myofascial pain syndrome (MPS) and chronic fatigue syndrome (CFS).

Symptoms and Associated Syndromes

Pain - Symptoms include pain in the fibrous tissues in the body, the muscles, ligaments, and tendons. When they are experiencing a flare-up of their pain, some patients with fibromyalgia ache all over, muscles may feel like they have been pulled or overworked, and may burn or twitch. Pain with classic FMS follows a specific pattern, with painful areas clustered between the shoulders, buttocks, and neck. Pain with MPS and CFS is in a less predictable pattern.

Fatigue - This symptom can be mild in some patients and yet incapacitating in others. The fatigue has been described as “foggy brain” in which patients feel totally drained of energy and unable to concentrate. Those people with fibromyalgia say they feel as though their arms and legs are heavy and swollen. Their bodies take longer to recover from exercise than people without FMS or CFS.

Poor Sleep - Most fibromyalgia syndrome patients can fall asleep without much trouble, but their deep level sleep is constantly interrupted by bursts of alertness. Patients feel they spend the night with one foot in sleep and the other one out of it. The sleep pattern for clinically depressed patients is significantly different from that found in FMS or CFS.

Other common symptoms - Painful menstrual periods (dysmenorrhea), chest pain, morning stiffness, cognitive or memory impairment, numbness and tingling sensations, muscle twitching, irritable bladder, irritable bowel, the feeling of swollen extremities, skin sensitivities, dry eyes and mouth, frequent changes in eye prescription, dizziness, and impaired coordination can occur.

Possible Causes

The causes of FMS, CFS, and MPS remain elusive, but there are many triggering events thought to precipitate onset. A few examples are infection, motor vehicle crash, or other severely stressful event. These triggering events probably don't cause FMS, but rather, they may awaken an underlying physiological abnormality that is already present in the form of genetic predisposition. Some theories suggest an imbalance of serotonin and substance P to be the culprit. Other theories suggest soft tissue/myofascial shortening to be the cause. It has been suggested that a low-oxygen state in the tissues is to blame. More research is needed in this area.

Treatment Techniques

Holistic physical therapists employ many strategies to help patients struggling with these pain syndromes, to bring them back into balance. Initially, the patient is assisted in oxygenating the tissues using diaphragmatic breathing, rather than overstressing the shoulders and neck to breathe, along with relaxation techniques. Many patients can benefit from extending their posture from the typical protective “pain posture” with the shoulders rotated in and the head forward. Myofascial Release, Craniosacral Therapy, and other manual therapy techniques are often helpful. Body mechanics techniques are taught, to avoid stressing already overworked trigger points. A gentle and safe exercise program is introduced, one that is individually tailored to each patient, featuring stretching, strengthening, and gradual aerobic conditioning.

Further Information

• Fibromyalgia Network
• The American Fibromyalgia Syndrome Association
• The National Fibromyalgia Association