Fibromyalgia

Fibromyalgia is a disorder classified by the presence of chronic widespread pain and tactile allodynia. Fibromyalgia patients are also typically affected by a number of symptoms other than pain, including debilitating fatigue, abnormal sleep architecture, functional bowel disturbances and a variety of neuropsychiatric problems including cognitive dysfunction, anxiety and depressive symptoms. While the criteria for such an entity has not yet been thoroughly developed, the recognition that fibromyalgia involves more than just pain has led to the frequent use of the term “fibromyalgia syndrome.” It is not contagious, and recent studies suggest that people with fibromyalgia may be genetically predisposed. It affects more females than males, with a ratio of 9:1 by American College of Rheumatology (ACR)criteria. Fibromyalgia is seen in about 2% of the general population. It is most commonly diagnosed in individuals between the ages of 20 and 50, though onset can occur in childhood.

The disorder is not directly life-threatening. The degree of symptoms may vary greatly from day to day with periods of flares (severe worsening of symptoms) or remission; however, the disorder is generally perceived as non-progressive.

The validity of fibromyalgia as a unique clinical entity is a matter of some contention among researchers in the field. For example, it has been proposed that the pathophysiology responsible for the symptoms that are collectively classified as representing “Fibromyalgia” is poorly understood, thereby suggesting that the fibromyalgia phenotype may result from several different disease processes that have global hyperalgesia and allodynia in common, an observation that has led to the proposition that current diagnostic criteria are insufficient to differentiate patient groups from each other. Alternatively, there is evidence for the existence of differing pathophysiological abnormalities within the greater fibromyalgia construct, which may be interpreted to represent evidence for the existence of biologically distinct “sub-types” of the disorder akin to conditions such as epilepsy, schizophrenia and major depressive disorder. In a January 14, 2008 article in the New York Times, the controversy of the reality of the disease and its proposed cures are discussed, while citing that the American College of Rheumatology, the Food and Drug Administration and insurers recognize fibromyalgia as a diagnosable disease.

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