Topic Overview
What is fibromyalgia?
Fibromyalgia is widespread
pain in the muscles and soft tissues above and below the waist and on both
sides of the body. Fibromyalgia is a syndrome—a set of symptoms that happen
together but do not have a known cause. In this syndrome, the nervous system
(nerves, spinal cord, and brain) is not able to control what it feels, so
ordinary feelings from your muscles, joints, and soft tissues are experienced
as pain. People with fibromyalgia feel pain and/or tenderness even when there
is no injury or inflammation.
Fibromyalgia does not harm your
muscles, joints, or organs. And there are many things you can do to control it.
When it is not controlled, you may not have any energy. Or you may feel
depressed or have trouble sleeping. These and other symptoms can be bad enough
to cause problems with your work and home life. With treatment, most people
with fibromyalgia are able to continue working and participating in daily
activities. Some people change their work duties and lifestyle if their
symptoms are severe.
What causes fibromyalgia?
Experts have theories
about what may cause fibromyalgia. But there is not enough evidence to support
any single cause. Some think that people with fibromyalgia may have nerve cells
that are too sensitive. Others think that chemicals in the brain
(neurotransmitters) may be out of balance. Or it may be related to problems
with the deep phase of sleep.
What are the symptoms?
The main symptom of
fibromyalgia is pain in the muscles, soft tissues, back, or neck. Also certain
spots on the body hurt when you press directly on them. Experts call these
tender points. But you may also hear them called trigger points.
Fibromyalgia also causes sleep problems and tiredness.
Less
common symptoms include headaches, morning stiffness, trouble concentrating,
and
irritable bowel syndrome. As with many conditions that
cause
chronic pain, it is common for people with
fibromyalgia to have
anxiety and
depression. These can make you feel worse.
Fibromyalgia is a long-lasting (chronic) condition with no cure. Symptoms
tend to come and go. You may have times when you hurt more, followed by times
when symptoms happen less often, hurt less, or are absent (remissions).
Some people find that their symptoms are worse in cold and damp weather,
during times of stress, or when they try to do too much.
How is fibromyalgia diagnosed?
Doctors can find
out if you have fibromyalgia based on two things. One is widespread pain, which
means the pain is on both sides of your body above and below the waist. The
other is tenderness in at least 11 of 18 points when they are pressed. Your
doctor will also take steps to be sure you don't have other conditions that
cause pain, such as
rheumatoid arthritis,
polymyalgia rheumatica,
systemic lupus erythematosus, or other
autoimmune diseases.
How is it treated?
You may be able to control your
symptoms with regular exercise and by finding better ways to handle stress.
Good sleep habits are very important too. If you have trouble sleeping,
changes to your routine, schedule, and sleep surroundings can help. Counseling
can help you cope with long-term (chronic) pain.
If your symptoms
are troublesome, your doctor can prescribe medicines that help you feel
better.
Symptoms of depression, such as a loss of interest in
things you usually enjoy or changes in eating and sleeping habits, can often be
successfully treated if you tell your doctor about them.
Some
people with fibromyalgia also find
complementary therapies helpful. These include
tai chi, acupuncture, massage, behavioral therapy, and relaxation techniques.
Frequently Asked Questions
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Learning about fibromyalgia:
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Being diagnosed:
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Getting treatment:
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Living with fibromyalgia:
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Cause
Fibromyalgia
is
considered to be a syndrome—a set of symptoms that occur together but do not
have a known cause. There are theories as to what may cause it, but there is
not enough evidence to support any single theory. People—especially women—who
have a family member with fibromyalgia are more likely to develop it
themselves. It has been recognized as a medical disorder only since the
1980s.
Some theories suggest that fibromyalgia may be linked
to:
- Oversensitive nerve cells in the spinal cord
and brain. Oversensitivity may be due to changes in chemicals in the brain or
spinal cord that regulate pain. As a result, the person senses pain more
easily, and widespread muscle pain occurs.
- An imbalance in the
brain chemicals that control mood, which results in a lowered tolerance for
pain and may also cause an unrestful sleep cycle and fatigue. When this
happens, a person becomes less physically active, and the muscles and tissues
become more sensitive and painful and more easily irritated.
- An
imbalance of hormones such as cortisol and growth hormone. Their release is
controlled by the
pituitary gland and the
hypothalamus. Imbalances of these hormones can result
in fatigue, mood changes, concentration and memory difficulties, a lowered
tolerance for pain, and other symptoms.
- A disturbance in the deep
phase of sleep. Some chemicals, such as growth hormone, are secreted by the
body during this phase of sleep. If sleep is disrupted, the body produces less
of the hormone. Disturbed sleep may be both a cause and an effect of the pain
of fibromyalgia.
Many people connect the beginning of their fibromyalgia
symptoms to a certain event. These events can include an illness such as the
flu, an injury or surgery, or emotional trauma and stress.1 An event of this type combined with other factors, such as
increased sensitivity to pain and an ongoing sleep disturbance, may lead to
fibromyalgia syndrome in some people.
Symptoms
The range and severity of symptoms caused
by
fibromyalgia vary from person to person. Widespread,
chronic pain—often described as deep or burning—is the most common symptom.
Pain is considered to be widespread if it is above and below your waist and on
the right and left sides of your body. Fibromyalgia pain is more common in the
trunk, neck, low back, hips, and shoulders. And it is
rare in the hands and feet. It usually develops gradually and can interfere
with even simple daily activities.
Other symptoms that can occur
along with pain include:1
- Fatigue that interferes with work and daily
activities.
- Sleep problems (difficulty falling or staying asleep,
waking up feeling tired).
- Morning stiffness lasting less than an
hour.
- Headaches.
- Constipation or diarrhea related to
irritable bowel syndrome.
- Memory problems
and difficulty concentrating.
- Anxiety or depression.
Fibromyalgia can sometimes feel like the
flu. You may experience body aches, tiredness, and
intestinal problems. The pain in your joints and muscles may be especially
bothersome at night, waking you from sleep, or in the morning, when you may
feel very stiff and sore. You may have trouble concentrating because of
fatigue. Symptoms can last from days to months or years.
People
with fibromyalgia have periods when their symptoms become worse and periods
when they have milder or no symptoms. Flare-ups of fatigue and muscle and joint
aches are common, especially following physical or emotional stress. Many
people with fibromyalgia report that cold or damp weather, poor sleep, fatigue,
stress, or overexertion makes their pain worse.
Because symptoms
of fibromyalgia are similar to so many other disorders, your doctor may try to
rule out
other conditions with similar symptoms before he or she can properly diagnose
fibromyalgia. In some cases, you may have another condition in addition to
fibromyalgia.
What Happens
For most people,
fibromyalgia seems to involve a cycle of muscle pain,
increased sensitivity to pain, and inactivity that may be made worse by sleep
problems and fatigue.
- Increasing pain causes a person to be less
physically active.
- Muscles that are not exercised regularly are
more likely to be irritated during activity. It is also possible that people
with fibromyalgia are more sensitive to pain or have muscles that are more
easily irritated.
- The irritated muscles are painful. Some doctors
think that the muscles of people with fibromyalgia remain sore because they do
not repair themselves as well as the muscles of people who do not have this
condition.
- Muscle pain, sometimes occurring together with disrupted
sleep and daytime fatigue, leads to less and less activity.
Although fibromyalgia is a long-lasting (chronic) condition
with no cure, it can be controlled and does not damage the muscles, joints, or
internal organs. People usually can manage symptoms with home treatment,
especially exercise. Treatment with medicines may be helpful when sleep
problems, severe pain, or depression develop. Unfortunately, a few people may
not respond to any treatment measures.
Most people with
fibromyalgia adjust to their symptoms and are able to continue working and
participating in daily activities. But some may have to
change their work duties and lifestyle if their symptoms are
severe.
What Increases Your Risk
Certain factors may increase
your risk for developing
fibromyalgia. Being female greatly increases your
chance of developing this syndrome. It is possible that having a rheumatic
disorder (such as
rheumatoid arthritis), an infectious disease (such as
Lyme disease or
mononucleosis), a psychiatric condition (such as major
depression), or a traumatic event (such as a car
accident) may increase your chance of developing fibromyalgia. There is some
evidence that having a family history of fibromyalgia may increase your
risk.
If you already have fibromyalgia, you may be more likely to
have recurring symptoms or persistent pain if you are a woman and you
have:2
- Frequent episodes of emotional or physical
stress.
- Had symptoms for many years.
- Insomnia or a
sleep disorder.
- Depression or an
anxiety disorder.
- Belly pain, headaches,
or problems with urination.
When To Call a Doctor
Call your doctor if you have
had the following symptoms for more than 6 weeks without an obvious cause. They
may be signs of
fibromyalgia, especially if they have developed
gradually.
- Widespread muscle tenderness and pain,
particularly on both sides of the body and both above and below the
waist
- Disturbed sleep (tossing, turning, waking up frequently
during the night) and waking up feeling tired and unrested
- Muscle
and joint stiffness that doesn't get better when you move around
If you have fibromyalgia, be alert to symptoms of
depression, such as a loss of interest in things you
usually enjoy or changes in eating and sleeping habits. These can often be
successfully treated if you tell your doctor about them.
Watchful Waiting
Watchful waiting means taking a wait-and-see
approach. It is normal to have sore muscles when you overexert yourself. This
pain usually will go away after a few days. If you think you are injured and
the muscle or joint pain does not go away in a few days (no more than a week),
talk with your doctor.
Who To See
Not every doctor will be comfortable diagnosing or
treating the symptoms of fibromyalgia, because it still is not a well-defined
disorder. Be sure to seek a doctor who is sensitive to your chronic pain,
fatigue, and other symptoms associated with fibromyalgia. Health
professionals with the most experience with fibromyalgia include:
Other health professionals who may be able to help you
manage your fibromyalgia include:
Pain management programs can be helpful, too. These
typically include a team of doctors, counselors, nurses, and pharmacists who
can help you develop a strategy for pain management. Your personal program may
include medicines, complementary therapies, diet, exercise, and counseling.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
There are no specific tests that can
confirm a diagnosis of
fibromyalgia. It often is diagnosed when other
disorders with similar symptoms of chronic pain have been ruled out with
lab tests. Your doctor will also ask questions about your
medical history and do a
physical exam.
The formal criteria used
to diagnose fibromyalgia include:
- Widespread pain that has been present for at
least 3 months. Pain is considered to be widespread if it is above and below
your waist and on the right and left sides of your body.
- Pain and
tenderness at 11 or more of 18 specific spots, usually occurring only when the
areas are pressed. Experts call these
tender points. But you may also hear them called trigger points. (Some people
may have fewer than 11 tender points but still may have fibromyalgia.)
Other symptoms typical of fibromyalgia include stiffness,
fatigue, headaches, painful menstrual periods, and sleep difficulties. These
may get worse with increased stress, anxiety, or exertion or with changes in the
weather.
A person may not meet these criteria but may still
have fibromyalgia. That is why diagnosis can be so difficult.
Treatment Overview
Currently, there is no cure for
fibromyalgia. But there are many steps you can take to
understand your condition and manage your symptoms. Treatment is focused on
managing pain, fatigue, depression, and other symptoms common in fibromyalgia
in an attempt to break the cycle of increased sensitivity to pain and decreased
physical activity. Every person may respond to a different combination of
treatments.
Treatment may include:
Home treatment is also a vital part of managing
fibromyalgia. Your efforts to get regular exercise, improve your sleep habits,
and reduce stress are as important to your treatment as any medicine your
doctor may prescribe.
Initial treatment
If you have just been diagnosed
with
fibromyalgia, your initial treatment goals might
include:
- Starting a program of regular physical
exercise. Getting consistent exercise, especially
cardiovascular exercise, is one of the best ways to manage fibromyalgia. Pool
exercise has been found to be particularly effective for many people.3 It's important to progress your exercise program slowly so
you don't get sore muscles that cause you to want to stop exercising. Working
with a physical therapist familiar with fibromyalgia may be helpful.1
- Identifying sleep problems, if you have them,
and learning about
ways to get more restful sleep.
- Relieving
pain and stiffness with medicines and heat.
- Identifying "triggers"
that seem to make your symptoms worse and learning to avoid or manage them. A
trigger can be anything you've noticed that increases your symptoms. Triggers
may relate to the weather, particular activities, stressful events, or lack of
sleep.
- Starting a program of
cognitive-behavioral therapy to help you learn to
relax, reduce stress, and manage your pain. This can help decrease pain and
fatigue. And it can improve your mood and help you function.3
With some guidance and instruction, you will be able to
start working on most of these goals at home. You may have a team of health
professionals to help you. The team may include your
family medicine doctor, a
rheumatologist or
endocrinologist, a
physical therapist, and a
psychologist.
Ongoing treatment
Exercise, sleep, and stress
reduction can be extremely helpful in controlling your symptoms. Symptoms of
fibromyalgia come and go repeatedly, so it is
important to keep doing home treatment over the long term.
Prescription medicines can help certain symptoms, including
pain and sleep problems. Talk with your doctor if you think the medicines you
are taking do not help. There may be other choices. Remember that your
need for medicine may change over time.
Another important part of
ongoing treatment for fibromyalgia is, when possible, avoiding or limiting your
exposure to "triggers" or "stressors" that make your symptoms worse. Cold or
damp weather, poor sleep, fatigue, physical or emotional stress, and
overexertion seem to be common stressors for people with fibromyalgia. It may
not be possible to avoid these things completely. But you can learn ways to
reduce stress, practice better sleep habits, and avoid overexerting
yourself.
Watch for signs of
depression or
anxiety. They are common in people with fibromyalgia
and can make problems with sleep and feelings of pain even worse. These can often be successfully treated as long as you
recognize them and discuss them with your doctor.
Many people with
fibromyalgia have other joint or muscle diseases (such as
rheumatoid arthritis or
lupus) that need to be treated too. Make sure you
tell your doctor about new symptoms or problems that get worse.
Treatment if the condition gets worse
Fibromyalgia
is
not a progressive disease and causes no permanent physical damage. But the
symptoms can be debilitating. And there may be periods of time when you
feel worse than usual.
If new symptoms develop or if existing
symptoms get worse, talk to your doctor. He or she may need
to reassess your treatment. Your doctor may need to adjust your medicines or
prescribe different ones. Or perhaps you are exercising too much or not enough.
It's also possible that new symptoms or symptoms that are worse could be
related to something other than fibromyalgia. Your doctor can evaluate this
possibility if you let him or her know that you are having
problems.
What To Think About
Exercise seems to help
most people with fibromyalgia, but no one particular treatment stands out as the
most effective. The kind of treatment you need or want may be based on:
- How bad your symptoms are.
- Whether the condition is disrupting your daily
life.
- What kinds of changes in your life you are willing and able
to make.
Because the symptoms of fibromyalgia can come and go, you
may find it difficult to judge whether a particular treatment is really
working. Different people may respond differently to each type of treatment. It
can take time. And you may have to try several different treatments to find an
approach that works for you.
Prevention
Currently,
fibromyalgia can be neither prevented nor cured. But
prompt treatment of your symptoms may help reduce the length of a
flare-up.
Home Treatment
Although
fibromyalgia is a chronic condition, there is much you
can do to relieve and control your symptoms. Home treatment is the most
important part of treating fibromyalgia. There are many things you can
do:
-
Exercise regularly. Of all the
treatments for fibromyalgia, cardiovascular (aerobic) exercise may have the
most benefit in reducing pain and other symptoms and in improving your overall
condition. Work with a physical therapist or other professional who has
expertise with fibromyalgia to build an exercise program that works for you. And then stay with it.
-
Improve sleep. Sleep disturbances seem
to both cause and result from some of the other symptoms of fibromyalgia, such
as pain. Learn good sleep habits. And try to get enough sleep each
night.
-
Relieve pain. Heat therapy, massage, gentle exercise,
and short-term use of nonprescription pain relievers may be
helpful.
-
Reduce stress.
-
Learn about fibromyalgia. The more you know about fibromyalgia, the more control you
will have over your symptoms. People who feel more in control also tend to be
more active and report less pain and other symptoms.4
- Learn ways to manage your
memory problems. Feeling as though you are not
thinking clearly—sometimes called "fibro fog"—increases stress and can make
memory problems worse. Simple things like writing yourself notes can help you
feel more in control.5
- Adopt a
good-health attitude, along with these other healthy
habits. It's hard to stay positive when you don't feel well. But a good
attitude helps you focus less on your challenges and feel more healthy.
The best results occur when you take an active, committed
role in your own treatment. You may need to adjust your lifestyle to fit home
treatment, especially regular exercise, into your daily routine. It may take time
to find an approach that works for you. Try to be patient. And keep in mind
that consistent home treatment usually can help relieve or control symptoms of
fibromyalgia.
Medications
Medicines do not cure
fibromyalgia. But some medicines may help improve
fibromyalgia symptoms, especially muscle pain and frequent waking during the
night. Not all people with fibromyalgia will need, want, or benefit from
medicines. But people with more severe pain, sleep problems, or
depression that disturbs their daily life may find
medicines helpful.
Antidepressants are often used to treat symptoms of
fibromyalgia. This does not mean that the condition is "all in your head."
Antidepressants may help by improving sleep and mood or by blocking pain
signals. Many people with fibromyalgia seem to benefit from the use of these
medicines.
Fibromyalgia symptoms in different people respond to
different medicines. Your doctor may try more than one medicine before finding
one that works best for you. You may also find that a medicine that has been
helping your symptoms seems to become less effective over time.
Talk with your doctor if you are not getting relief. He or
she may try a different medicine or make suggestions for helping find new ways to modify your activity, sleep, and stress.
Medication Choices
Often medicines may be combined (such as fluoxetine and
amitriptyline) for the most effective treatment of symptoms of pain and sleep
disruptions.
Certain types of antidepressants may be used to
improve sleep, relieve pain and fatigue, and, in some cases, treat depression. These
improvements in symptoms may allow you to feel better and to be more active. Antidepressants used
for fibromyalgia include:6
-
Tricyclic antidepressants, such as amitriptyline or
cyclobenzaprine (Flexeril). Cyclobenzaprine is usually
thought of as a muscle relaxant, rather than an antidepressant, but it is the
same type of drug as a tricyclic antidepressant.
-
Selective serotonin reuptake inhibitors (SSRIs), such
as fluoxetine (Prozac) or paroxetine (Paxil).
-
Serotonin and norepinephrine reuptake inhibitors
(SNRIs)—also called mixed (or dual) reuptake inhibitors—such as duloxetine
(Cymbalta), milnacipran (Savella), or venlafaxine
(Effexor).
- Atypical antidepressants, meaning drugs that don't fit
well into the general categories of antidepressant medicines. Bupropion
(Wellbutrin) is an example of an atypical antidepressant that is used for
fibromyalgia.
A seizure medicine (anticonvulsant) called pregabalin
(Lyrica) is used to treat fibromyalgia. Pregabalin may help reduce pain,
sleep problems, and fatigue.7
Other
medicines are being studied and used for treating fibromyalgia,
including:
- Another seizure medicine (anticonvulsant)
called gabapentin (Neurontin).8
- Pain medicines such as tramadol (Ultram), sometimes combined
with acetaminophen.3, 9
- A medicine called sodium oxylate (Xyrem) that is used for sleep disorders such as narcolepsy.10
Nonprescription pain relievers, such as acetaminophen
(for example, Tylenol) or
nonsteroidal anti-inflammatory drugs (NSAIDS, such as
ibuprofen or aspirin) usually are not very helpful in treating day-to-day
symptoms of fibromyalgia. But they may be useful in reducing severe pain caused
by a flare-up of symptoms. You should check with your doctor if you need to
keep taking these medicines, because they may harm your stomach, kidneys,
or in rare cases, your liver. Your doctor may want to monitor you if you take
acetaminophen or NSAIDs daily.
What To Think About
In general, medicines are only
a part of the long-term treatment of fibromyalgia. They may help break the
cycle of pain and sleep problems when symptoms flare up. But medicines usually are
part of a larger treatment plan that focuses on exercise and other types of
treatment.
Narcotic pain relievers and sleep aids that can lead to
addiction are rarely used to treat fibromyalgia. They can be helpful
to some people who have severe symptoms. But you can become dependent on them over
time, and the treatment can become worse than the fibromyalgia symptoms.
Other Treatment
A variety of other treatments
have been used for conditions that cause chronic pain. Most of these
complementary or alternative therapies are not proven treatments for
fibromyalgia. But they may be helpful when symptoms
flare up, and they may improve quality of life. Safe complementary therapies
such as acupuncture or massage, for instance, may help relieve stress, ease
muscle tension, and help you feel better and healthier.
Other Treatment Choices
Most people with fibromyalgia try some type of
alternative therapy.11 Some of these have been shown to
be effective for many people. But for other therapies, such as tender point
injections, there is no evidence that they help. Treatments that have been
shown to help people who have fibromyalgia include:3
A small study found that tai chi may help people who have fibromyalgia. In this study, people who took part in a tai chi class felt better. They had less pain, slept better, and were able to exercise more and be more active.12
Other treatments that have been used to treat
fibromyalgia include:
What To Think About
You may find one or more
complementary or alternative therapies to be helpful in relieving some of your
symptoms. Keep in mind that there is only limited information about the
effectiveness of these treatments (and others you may have heard about) for
treating fibromyalgia.
If you have fibromyalgia and are thinking
about trying a complementary therapy, get the facts before you begin. Consider
these questions with your doctor:
-
Is it safe? Talk with your doctor about the
safety and potential side effects of the treatment. Remember that fibromyalgia
does not physically harm you or damage your body. A treatment that could be
harmful may not be worth the risk, especially when its benefits are unproved.
Avoid treatments that may be harmful, such as unusual diets or excessive
vitamin or mineral supplements. (A daily multiple vitamin-mineral supplement is
okay. Try to avoid taking more than 100% of the recommended daily allowance for
any vitamin or mineral unless your doctor prescribes a special
supplement.)
-
Does it work? Because the symptoms of
fibromyalgia can come and go, you may find it hard to judge whether a
certain treatment is really working. Symptoms of fibromyalgia often improve
on their own. Or the treatment may be causing a
placebo effect that is making you feel better. Keep in
mind that when you get better after treatment, the treatment may not be the
reason for the improvement. Also remember that a treatment that works for one
person may not work for you. It may take time. And you may have to try several
different treatments to find an approach that works for you.
-
Will it improve my general health? Even if
complementary therapies are not effective in treating fibromyalgia, many of
them are safe and healthy habits that may improve your general well-being and
may be worth trying.
With a hard-to-treat condition like fibromyalgia,
it can be tempting to jump at the promise of an effective treatment. Be
careful. Avoid products that claim to have a secret ingredient or that claim to
cure fibromyalgia. Avoid those that encourage unhelpful behaviors such as
excessive resting or avoiding activity.
Also make sure you know
how much a treatment is going to cost before you agree to it. An expensive,
unproven treatment that may or may not help you may not be worth the high cost.
Beware of treatment providers or products that require a large financial
investment at the outset or a series of costly treatments.
Other Places To Get Help
Organizations
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American College of Rheumatology
|
| 1800 Century Place |
| Suite 250 |
| Atlanta, GA 30345 |
| Phone: |
(404) 633-3777 |
| Fax: |
(404) 633-1870 |
| Web Address: |
www.rheumatology.org |
| |
|
The American College of Rheumatology (ACR) and the
Association of Rheumatology Health Professionals (ARHP, a division of ACR) are
professional organizations of rheumatologists and associated health
professionals who are dedicated to healing, preventing disability from, and
curing the many types of arthritis and related disabling and sometimes fatal
disorders of the joints, muscles, and bones. Members of the ACR are physicians;
members of the ARHP include research scientists, nurses, physical and
occupational therapists, psychologists, and social workers. Both the ACR and
the ARHP provide professional education for their members.
The ACR
Web site offers patient information fact sheets about rheumatic diseases, about
medicines used to treat rheumatic diseases, and about care
professionals.
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Arthritis Foundation
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| P.O. Box 7669 |
| Atlanta, GA 30309 |
| Phone: |
1-800-283-7800 |
| Web Address: |
www.arthritis.org |
| |
|
The Arthritis Foundation provides grants to help find a
cure, prevention methods, and better treatment options for arthritis. It also
provides a large number of community-based services nationwide to make living
with arthritis easier, including self-help courses; water- and land-based
exercise classes; support groups; home study groups; instructional videotapes;
public forums; free educational brochures and booklets; the national, bimonthly
consumer magazine Arthritis Today; and continuing
education courses and publications for health professionals.
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National Center for Complementary and Alternative
Medicine (NCCAM) Clearinghouse
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| P.O. Box 7923 |
| Gaithersburg, MD 20898 |
| Phone: |
1-888-644-6226
(301) 519-3153 for international calls |
| Fax: |
1-866-464-3616 toll-free |
| TDD: |
1-866-464-3615 toll-free |
| Email: |
info@nccam.nih.gov |
| Web Address: |
www.nccam.nih.gov/health/clearinghouse (or
www.nccaminfo.org/livehelp/ for live help online) |
| |
|
The National Center for Complementary and Alternative Medicine
(NCCAM) at the National Institutes of Health (NIH) explores complementary and
alternative healing practices in the context of rigorous science, trains
complementary and alternative medicine researchers, and gives out authoritative
information. Send all requests for information and questions about NCCAM to the
NCCAM Clearinghouse.
|
|
|
National Fibromyalgia Association
|
| 2121 South Towne Centre Place |
| Suite 300 |
| Anaheim, CA 92806 |
| Phone: |
(714) 921-0150
|
| Fax: |
(714) 921-6920 |
| TDD: |
|
| Email: |
|
| Web Address: |
www.fmaware.org |
| |
|
The National Fibromyalgia Association was founded to support people who have fibromyalgia and other chronic pain illnesses. The association has an educational Web site and publishes an international magazine called Fibromyalgia AWARE. The association also helps develop continuing medical education programs and provides a means for fibromyalgia experts to share their research and expertise with patients and health care professionals.
|
|
|
National Institute of Arthritis and Musculoskeletal and
Skin Diseases (NIAMS), National Institutes of Health
|
| 1 AMS Circle |
| Bethesda, MD 20892-3675 |
| Phone: |
1-877-22-NIAMS (1-877-226-4267) toll-free
(301) 495-4484 |
| Fax: |
(301) 718-6366 |
| TDD: |
(301) 565-2966 |
| Email: |
niamsinfo@mail.nih.gov |
| Web Address: |
www.niams.nih.gov |
| |
|
The National Institute of Arthritis and Musculoskeletal
and Skin Diseases (NIAMS) is a governmental institute that serves the public
and health professionals by providing information, locating other information
sources, and participating in a national federal database of health
information. NIAMS supports research into the causes, treatment, and prevention
of arthritis and musculoskeletal and skin diseases and supports the training of
scientists to carry out this research.
The NIAMS Web site provides
health information referrals to the NIAMS Clearinghouse, which has information
packages about diseases.
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National Pain Foundation
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| Web Address: |
www.nationalpainfoundation.org |
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Through information, education, and support, the
National Pain Foundation (NPF) promotes the recovery of persons in pain. The
NPF website provides information and resources in an interactive way that
encourages patients to take an active role in managing their chronic pain. The
My Pain section of the website includes a Personal Inventory section to help
pain patients identify the information they need to manage their pain. The NPF
has information about pain conditions such as arthritis, back and neck pain,
and cancer pain. The NPF addresses the many approaches to pain management, such
as medicines, injections, surgery, acupuncture, biofeedback, chiropractic, and
physical therapy. The NPF also provides support for the special needs of
children in pain and information about psychological factors related to pain.
The website also provides information on clinical trials that are studying
pain management and treatment.
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References
Citations
-
Bradley LA, Alarcon GS (2005). Fibromyalgia section of
Miscellaneous rheumatic diseases. In WJ Koopman, LW Moreland, eds.,
Arthritis and Allied Conditions: A Textbook of Rheumatology, 15th ed., vol. 2, pp. 1869–1910. Philadelphia: Lippincott
Williams and Wilkins.
-
Bennett RM (1999). Emerging concepts in the
neurobiology of chronic pain: Evidence of abnormal sensory processing in
fibromyalgia. Mayo Clinic Proceedings, 74(4):
385–398.
-
Goldenberg DL, et al. (2004). Management of
fibromyalgia syndrome. JAMA, 292(19):
2388–2395.
-
Nielson WR, Jensen MP (2004). Relationship between
changes in coping and treatment outcome in patients with fibromyalgia syndrome.
Pain, 109(3): 233–41.
-
Arthritis Foundation (2007). Clearing the Fog. Available online:
http://ww2.arthritis.org/conditions/diseasecenter/fibromyalgia/fibro_fog.asp.
-
Häuser W, et al. (2009). Treatment of fibromyalgia syndrome with antidepressants. JAMA, 301(2): 198–209.
-
Crofford LJ, et al. (2005). Pregabalin for the
treatment of fibromyalgia syndrome. Arthritis and Rheumatism, 52(4): 1264–1273.
-
Arnold LM, et al. (2007). Gabapentin in the treatment
of fibromyalgia. Arthritis and Rheumatism, 56(4):
1336–1344.
-
Bennett RM, et al. (2002). Tramadol and acetaminophen
combination tablets in the treatment of fibromyalgia pain: A double-blind,
randomized, placebo-controlled study. American Journal of Medicine, 114(7): 537–545.
-
Russell IJ, et al. (2009). Sodium oxybate relieves pain and improves function in fibromyalgia syndrome. Arthritis and Rheumatism, 60(1): 299–309.
-
Wahner-Roedler DL, et al. (2004). Use of complementary
and alternative medical therapies by patients referred to a fibromyalgia
treatment program at a tertiary care center. Mayo Clinic Proceedings, 80(1): 55–60.
-
Wang C, et al. (2010). A randomized trial of tai chi for fibromyalgia. New England Journal of Medicine, 363(8): 743–754.
Other Works Consulted
- Arnold LM, et al. (2008). Patient perspectives on the impact of fibromyalgia. Patient Education and Counseling, 73(1): 114–120.
- Busch A, et al. (2007). Exercise for treating
fibromyalgia syndrome. Cochrane Database of Systematic Reviews (4).
- Carville SF, et al. (2007). EULAR evidence based recommendations for the management of fibromyalgia syndrome. Annals of the Rheumatic Diseases, 67(4): 536–541.
- Crofford LJ, Appleton BE (2001). Complementary and
alternative therapies for fibromyalgia. Current Rheumatology Reports, 3(2): 147–156.
- Meisler JG (2000). Toward optimal health: The experts
discuss fibromyalgia. Journal of Women's Health and Gender-Based Medicine, 9(10): 1055–1060.
- Richards SCM, Scott DL (2002). Prescribed exercise in
people with fibromyalgia: Parallel group randomised controlled trial.
BMJ, 325(7357): 185.
- Taylor AG, et al. (2003). Fibromyalgia section of
Pain. In JW Spencer, JJ Jacobs, eds., Complementary and Alternative Medicine: An Evidence-Based Approach, pp. 384–395 . St.
Louis: Mosby.
- Wolfe F, Rasker JJ (2009). Fibromyalgia. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology, 8th ed., vol. 1, pp. 555–569. Philadelphia:
Saunders Elsevier.
Credits
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By
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Healthwise Staff |
|
Primary Medical Reviewer
|
Kathleen Romito, MD - Family Medicine |
|
Specialist Medical Reviewer
|
Richa Dhawan, MD - Rheumatology |
|
Last Revised
|
October 13, 2010 |
Bradley LA, Alarcon GS (2005). Fibromyalgia section of
Miscellaneous rheumatic diseases. In WJ Koopman, LW Moreland, eds.,
Arthritis and Allied Conditions: A Textbook of Rheumatology, 15th ed., vol. 2, pp. 1869–1910. Philadelphia: Lippincott
Williams and Wilkins.
Bennett RM (1999). Emerging concepts in the
neurobiology of chronic pain: Evidence of abnormal sensory processing in
fibromyalgia. Mayo Clinic Proceedings, 74(4):
385–398.
Goldenberg DL, et al. (2004). Management of
fibromyalgia syndrome. JAMA, 292(19):
2388–2395.
Nielson WR, Jensen MP (2004). Relationship between
changes in coping and treatment outcome in patients with fibromyalgia syndrome.
Pain, 109(3): 233–41.
Arthritis Foundation (2007). Clearing the Fog. Available online:
http://ww2.arthritis.org/conditions/diseasecenter/fibromyalgia/fibro_fog.asp.
Häuser W, et al. (2009). Treatment of fibromyalgia syndrome with antidepressants. JAMA, 301(2): 198–209.
Crofford LJ, et al. (2005). Pregabalin for the
treatment of fibromyalgia syndrome. Arthritis and Rheumatism, 52(4): 1264–1273.
Arnold LM, et al. (2007). Gabapentin in the treatment
of fibromyalgia. Arthritis and Rheumatism, 56(4):
1336–1344.
Bennett RM, et al. (2002). Tramadol and acetaminophen
combination tablets in the treatment of fibromyalgia pain: A double-blind,
randomized, placebo-controlled study. American Journal of Medicine, 114(7): 537–545.
Russell IJ, et al. (2009). Sodium oxybate relieves pain and improves function in fibromyalgia syndrome. Arthritis and Rheumatism, 60(1): 299–309.
Wahner-Roedler DL, et al. (2004). Use of complementary
and alternative medical therapies by patients referred to a fibromyalgia
treatment program at a tertiary care center. Mayo Clinic Proceedings, 80(1): 55–60.
Wang C, et al. (2010). A randomized trial of tai chi for fibromyalgia. New England Journal of Medicine, 363(8): 743–754.