Soft Tissue Pain: Clinical Features of Fibromyalgia

July 21, 2002

The most common symptom of fibromyalgia is chronic pain. The pain often

begins in the neck and shoulder, but becomes more generalized. Most patients

state that it hurts all over and many patients have difficulty locating one

certain area of pain. The pain experienced by patients is often described as

burning or gnawing pain. Many patients also report fatigue. They state that

the fatigue is noticeable when they wake in the morning, but is also noticed

throughout the day. Seemingly minor activities aggravate the pain and

fatigue. Patients report that they do not feel rested even after 8-10 hours

of sleep. Many patients also have said that they sleep lightly and have

difficulty going back to sleep.

A majority of patients with fibromyalgia often complain of headaches. These

vary from mild tension headaches to sever migraines. Other common symptoms

include intolerance to the cold, dizziness, trouble concentrating, dry eyes

and mouth, palpitations, and sensitivity to foods. Anxiety and depression

have also been reported. Many patients report muscle weakness and muscle

fatigue, but after extensive examination and testing there is no significant

weakness. Numbness and tingling, especially in the extremities are present

in approximately 75% of patients, but neurologic examination does not

indicate significant abnormalities.

Medications are used in the management of fibromyalgia. Although there is no

evidence of tissue inflammation, non-steroidal anti-inflammatory drugs

(NSAIDs) may be more effective than simple analgesics. Tricyclic

antidepressants also are used and produce desired effects. A key aspect of

treating the patient with fibromyalgia is education. The patient should be

taught about the condition in order to more clearly understand diagnosis and

treatment. Many patients with fibromyalgia have found that relaxation

techniques may be helpful.

Patients with fibromyalgia need to be followed regularly until they have

achieved some improvement in their symptoms. Even with all the treatment, it

is rare that one with fibromyalgia go into a state of remission. The

continuation of the study of fibromyalgia will lead to a better

understanding of the condition and better understanding in methods of

treatment.

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