Fibromyalgia Is Common, Painful Problem for Millions of Women
Dec. 6, 1999 (New York) -- Fibromyalgia is a chronic, painful condition that
affects an estimated 3.7 million people in the U.S., most of whom are women.
However, no single treatment has been established, leaving doctors and their
patients with little choice but to mix and match a variety of drug and nondrug
approaches. In an article in the December issue of the journal Archives of
Internal Medicine, a Pennsylvania researcher concludes that physicians must
empower patients to look to alternative treatments to achieve the best pain
Doctors do not know the exact causes of fibromyalgia. However, there is a
common pattern of symptoms that occur in about 75% of all fibromyalgia
sufferers. These symptoms include fatigue, disrupted sleep, stiffness on waking
in the morning, and the presence of multiple tender spots in the neck, lower
back, arms and legs. Many patients with fibromyalgia also have other medical
conditions such as irritable bowel syndrome, Lyme disease, arthritis, and
tension headaches. Muscle abnormalities also have been observed, but some
research has concluded that rather than being a feature of fibromyalgia, these
abnormalities may be the result of not using certain muscles because of chronic
"The diagnosis of fibromyalgia is based on a constellation of signs and
symptoms, and there is really no one laboratory or radiographic test that tells
you that someone does or does not have fibromyalgia," Lawrence J.
Leventhal, MD, author of the article, tells WebMD. "It's a diagnosis of
exclusion, so physicians have to rule out other conditions that can mimic
fibromyalgia. As a result, it is an underdiagnosed entity." Leventhal is a
rheumatologist at Graduate Hospital in Philadelphia.
Fibromyalgia is also difficult to treat, with only about 50% of patients who
are treated reporting adequate relief of their symptoms. Contributing greatly
to the difficulty of treatment is the lack of a specific drug or treatment that
works best. Drugs that have been studied include pain killers, antidepressants,
and anti-inflammatories. The most widely prescribed drug for fibromyalgia is
Elavil (amitriptyline), an antidepressant taken at night that has consistently
been found to relieve symptoms in 25-30% of patients. Another antidepressant,
Effexor (venlafaxine), also has shown some success in improving symptoms. Less
effective is the newer antidepressant Prozac (fluoxetine), which initially
showed some success but was ineffective in larger studies. The anti-anxiety
drug Xanax (alprazolam) is also used in some fibromyalgia patients, as is
lidocaine (medication applied to the skin to kill sensation), growth hormone,
and other drugs.
Nearly all of the medications used to treat fibromyalgia have side effects
and none are 100% effective. "Unfortunately at this point in time there is
no one drug available or on the horizon that by itself is a panacea for
fibromyalgia," Leventhal says.