FM can exist by itself, but is usually accompanied by a primary or secondary chronic medical condition. FM affects 5% of the population with approximately 90% of those diagnosed being women between the ages of 20-50 years. However, men, adolescents and children are also diagnosed with this syndrome.

The symptoms of fibromyalgia can vary considerably from person to person. This condition is referred to as a "syndrome" as it does not fit the criteria for a distinctive disease process. For purposes of this handbook, the term FM also refers to fibromyalgia syndrome.

Unfortunately, it often takes a long time before a person is correctly diagnosed with FM. Average time from onset of symptoms to diagnosis is five years. People with FM often undergo a series of medical investigations and tests over many years before being diagnosed. Often this delay in diagnosis is due to the over-investigation of multiple individual symptoms that the patient presents with in the general physician's office and the failure to determine the collection of symptoms as part of the larger picture of FM.

• The Basic Symptoms
• What causes FM?
• Is this a new condition?
• What are the symptoms of FM?

The Basic Symptoms

Major complaints associated with FM are widespread pain, fatigue and non-restorative sleep. People with FM may have mild, moderate, or severe symptoms and these symptoms may fluctuate through all degrees of severity or stay constant.

Currently there are no diagnostic tests available to prove you have FM. Your diagnosis must be based on your history of symptoms, and the presence of active tender points specifically located on both sides of your body. It is important that an extensive history and a thorough physical exam be performed by a qualified medical practitioner in order to correctly diagnose fibromyalgia.

What causes FM?

Progress is being made to identify a cause for FM and much useful evidence has been gathered from the research to date, but no definitive answers have yet been found.

New research has shown various biochemical anomolies in people with FM. Additional research is also being conducted in many other areas, such as neurotransmitters, brain imaging, immune system functioning and hormones. Medical researchers have just begun to untangle the truths about this life-altering syndrome.

Is this a new condition?

FM is not new - the condition has been around for many years.

In the late 1980's the American College of Rheumatology sponsored a landmark study that identified criteria with which to better study patients with the symptoms of FM. These Criteria for the Classification of Fibromyalgia were published in the peer reviewed medical journal Arthritis and Rheumatism, Vol. 33, No. 2, Feb. 1990, and defines diagnostic criteria as:

1. History of widespread pain in all four body quadrants for a minimum of three months.

2. Pain in 11 of 18 tender points on digital palpation.

Tender points are anatomical locations that have reproducable tenderness upon palpation. Often the person with FM does not feel pain in these locations unless they are stimulated. Other areas can be tender as well.

Some physicians accept a diagnosis of FM with fewer than 11 tender points if a definitive history as well as several associated symptoms are present.

What are the symptoms of FM?

The following list of symptoms associated with FM have been gathered from a variety of peer reviewed medical journals. They are listed in no specific order. The hallmark symptoms of FM are pain, fatigue and non-restorative sleep.

Widespread Pain

Often described as aching, burning, throbbing, gnawing, shooting, tingling. It can be localized, generalized, can feel like muscle spasm and can be scattered throughout. It may be migratory, with pain presenting in one or more areas on one day and other areas on another day.

Fatigue

The fatigue of FM is much more than just being tired. FM sufferers have described it as feeling like all their energy has been drained away. It can be so profound that it interferes with even the simplest daily activities. Sometimes the fatigue can come on suddenly for no apparent reason and can be very debilitating. Short periods of exertion can require long periods of rest to recuperate.

Non-Restorative Sleep

Sleep difficulties can be described as not being able to fall asleep, frequent night awakenings, unrefreshing sleep or waking up feeling like you haven't slept. Many people with FM also report frequent unusual nightmares and symptoms of restless leg syndrome.

Persons with FM may experience some of the following additional symptoms, but please remember that not everyone with FM will experience them all and each case is individual:

Morning Stiffness

Can last for 1/2 - 2 hours. Sometimes relieved by heat, massage, often goes away with activity, worsened by cold environment.

Cognitive and Memory Problems

Many people with FM report lapses in memory and concentration, as well as cognitive dysfunction, spatial disorientation and communication difficulties.

Irritable Bowel Syndrome

Constipation, diarrhea, frequent abdominal pain, abdominal gas and nausea represent a constellation of symptoms frequently found in many FM patients.

Temporomandibular Joint Dysfunction Syndrome

This syndrome, sometimes referred to as simply TMJ, causes tremendous jaw and head pain in some FM patients. Most of the problems associated with this condition are thought to be related to the muscles and ligaments surrounding the joint and not necessarily the joint itself.

Other symptoms

Various symptoms have been associated with FM, such as: headaches (tension or migraine); numb, tingling or burning feelings (especially in hands and feet); feeling spaced out; disequilibrium; muscle weakness; intolerance of bright lights; intolerance of alcohol; depression; anxiety; mood swings; sinus and other allergies; weight change, usually gain; carpal tunnel syndrome; dry eyes and mouth; cold hands and feet; irritable bladder; heart palpitations; mitral valve prolapse; chest muscle pain (non-cardiac); unexplained rashes, sometimes accompanied by severe itching.