Understanding Fibromyalgia - the Basics

What Is Fibromyalgia?

Fibromyalgia is a non-life-threatening, chronic disorder of the muscles and related soft tissue, including ligaments and tendons.  Its main symptoms are muscle pain, fatigue, sleep disturbances, and tender points at certain parts of the body.  Many people describe fibromyalgia as feeling like a persistent flu.

Some health care providers may use these terms to refer to fibromyalgia:  fibromyositis, fibrositis, periarticular fibrositis, muscular rheumatism, chronic muscle pain syndrome, musculoskeletal pain syndrome, or tension myalgia.  However, "fibromyalgia," which means "pain of the muscles and other fibrous tissue," is the accepted term and has replaced some of the others.  Terms ending in "-itis," which means "inflammation," are now considered incorrect because inflammation does not play a significant role in fibromyalgia.

Key Characteristics

Muscle pain, either throughout the body or only at certain points, is the primary symptom.  It may range from mild discomfort to pain severe enough to limit work, social activities, and everyday tasks.  Pain commonly occurs in the neck, shoulders, chest, rib cage, lower back and thighs and may feel like a burning, gnawing, throbbing, stabbing, or aching sensation and may develop gradually. It usually seems worse when a person is trying to relax and is less noticeable during activity.

A related, key aspect of fibromyalgia is the presence of "tender points," muscles and tendons that are tender when pressed.  Typically, tender points are located in the neck, back, knee, shoulder, elbow, and hip.

People with fibromyalgia also feel moderately to severely fatigued and have sleep problems, including insomnia.  This may result from restless legs and arms, which may disrupt their sleep, or they may suffer from sleep apnea or grind their teeth while they sleep.

Tender Points

According to the American Academy of Rheumatology, for a diagnosis of fibromyalgia, you must have unusual tenderness at a minimum of 11 of the 18 "tender points" associated with the condition.  Some health care providers diagnose fibromyalgia in patients who have fewer tender points but who otherwise have severe, widespread (meaning upper and lower body occurring on both right and left sides) pain symptoms that are present for at least three months.

The standard tender points are located in the muscle or other soft tissue on both sides and the front and back of the body.  Those who have fibromyalgia may have unusual tenderness at any of several other points on the body as well.

Who Is Affected

Experts estimate that 3 million to 6 million Americans have fibromyalgia.  Of these, 80% are women.  One of the main risk factors is being a woman between the age of 20 and 50.  Another risk factor is having a rheumatic disease, such as rheumatoid arthritis, lupus or Sjogren's syndrome.  Fibromyalgia also seems to run in families, so a gene may be at least partly responsible for the condition.  Most people with fibromyalgia begin to notice symptoms between the ages of 20 and 40, but children and older adults may also develop the condition.  Women with fibromyalgia typically feel pain throughout their body, while men are more likely to have facial pain or pain and stiffness in a certain part of the body as a result of a work- or recreation-related muscle strain.