Fibromyalgia and Myofascial Pain
FIBROMYALGIA is a chronic pain disorder characterized by widespread musculoskeletal aches, pain and stiffness, soft tissue tenderness, general fatigue and sleep disturbances. The etiology of fibromyalgia is unclear. It is estimated that approximately 3-6% of the U.S. population has fibromyalgia. While about 80% of those diagnosed are women, fibromyalgia may be seen with any gender, age, or ethnicity.
The most common sites of pain include the neck, back, shoulders, pelvic girdle and hands, but any body part can be involved. The pain is severe, widespread and chronic. Often, fibromyalgia pain has been described as deep muscular aching, throbbing, twitching, stabbing, and shooting, and it often consumes the patient’s life. Neurological complaints such as numbness, tingling, and burning often coexist and add to the discomfort of the patient.
Genetics play a role in fibromyalgia, with strong patterns of familial aggregation. Mode of inheritance is unknown but likely polygenic. Polymorphisms of genes in the serotonergic, dopaminergic, and catecholaminergic systems may play a role in etiology (Smith, 2010).
Fibromyalgia adversely impacts function and activities of daily living. Chronic pain appears to have major impact on mental health and social functioning (Carmona, 2001).
Fibromyalgia affects sleep quality. Analysis of EEG indicates that the patients with fibromyalgia take longer to fall alseep, have frequent arousals, show extended stage 1 sleep, and demonstrate little slow wave sleep, indicative of vigilant arousal state during sleep (Bigatti, 2008).
Figure 19 According to the American College of Rheumatology criteria, pain in 11 or more of the above 18 predetermined tender points are seen in fibromyalgia (Wolfe, 1990). |