The word “fibromyalgia” is derived from the Latin roots “fibro” (connective tissue), “my” (muscles), “al” (pain), and “gia” (condition of). As a syndrome, fibromyalgia is composed of a specific, often complex, set of signs and symptoms that complicate diagnosis and treatment. Before official recognition as a disorder by the American Medical Association (AMA) in 1987, fibromyalgia was considered a “wastebasket” diagnosis, but lately there has been a “paradigm shift,” and fibromyalgia is being recognized as a true illness and a major cause of disability.
Fibromyalgia is a disorder characterized by chronic widespread musculoskeletal pain with associated fatigue, insomnia, and multiple somatic complaints such as stiffness, headache, and chest pain, with no evidence of disease. It occurs mostly in women but does occur in men. Most of the pain involves several tender points in the body, which are targeted areas where people with fibromyalgia feel an exaggerated sense of physical pain upon the slightest application of pressure. Fibromyalgia is neither degenerative nor progressive, and there is no inflammation. In fact, it used to be called fibrositis, but the name was changed to fibromyalgia when evidence showed no inflammation in the disease process. It is non-articular, meaning it does not involve the joints, and there is no swelling in the joints or tissues. Descriptions of conditions consistent with what we now call fibromyalgia have been found in the medical literature as far back as the early 17th century.
Although there is no cure for fibromyalgia, several treatments can alleviate the multiple symptoms of this complex disorder, thus making it easier for patients to live a near-normal life. Treatments include pharmacological interventions, dietary counseling, alternative medicine, relaxation techniques, and moderate exercise. Many authors recommend combined management of fibromyalgia rather than just one treatment alone.
Fibromyalgia is not a life-threatening, deforming, or progressive disease. Although lack of proper treatment may lead to the illusion of disease progression, this illusion is not supported by scientific evidence. Compensation of sleep deprivation and physical reconditioning should, at least in some patients, lead to reversal of the disease or improvement of function and reduction of pain.
Numerous modalities available can reduce pain and other debilitating symptoms; these include electrotherapy, cryotherapy, and therapeutic heat. The clinician should teach patients how and when to use therapeutic modalities as part of their maintenance program. A multidimensional clinical approach including behavioral therapy, exercise, and pharmacological intervention is essential.