Fibromyalgia, also known as fibromyalgia syndrome (FMS), is a chronic condition characterized by pain in the body's soft tissues such as the muscles, tendons, and ligaments, along with fatigue, sleep problems, and other symptoms. About 5 million people in the United States suffer from fibromyalgia. FMS can affect males and females of any age, but it is most common among women of childbearing age.

What are the Symptoms of Fibromyalgia?
Fibromyalgia symptoms, which may persist or come and go in cycles, vary a great deal among individuals. They include:

• Pain – FMS pain may range from intense stabbing, throbbing, or burning sensations to a generalized achy, flu-like feeling, either throughout the body or only in a specific region such as the neck or shoulder. People with fibromyalgia may also experience other pain syndromes such as tension headaches, migraines, or jaw pain (TMJ, short for temporomandibular joint syndrome).
• Fatigue – People with FMS may suffer from a debilitating lack of energy that prevents them from engaging in normal daily activities including work. However, fatigue may be considerably milder among others.
• Sleep disturbances – Having trouble sleeping may keep people with fibromyalgia from getting a restful and restorative night's sleep and may contribute to their fatigue. One explanation may be that some FMS patients have increased brain arousal when the deepest sleep cycle normally occurs, according to research studies.
• Heightened sensitivity – People with FMS may have chemical sensitivities to certain foods, medications, and odors as well as hypersensitivity to noise and bright lights.
• Digestive problems – FMS may be accompanied by symptoms of irritable bowel syndrome (IBS), such as bloating, constipation, and diarrhea.

What Causes Fibromyalgia?
While the cause (or causes) of fibromyalgia is still unknown, research suggests that the following factors may play a role:

• Traumatic physical or psychological events, such as an automobile accident or neck injury.
• A viral or bacterial infection or an autoimmune disease such as lupus or rheumatoid arthritis.
• Abnormalities in brain chemicals such as serotonin, a neurotransmitter (a substance that carries messages between nerve cells) that plays a role in regulating mood.

What Are the Treatments for Fibromyalgia?
While there is currently no scientifically proven cure for fibromyalgia, the following approaches may be recommended by your health care provider for managing your symptoms.

Prescription Medications:

• Lyrica, which has been used to relieve nerve pain associated with shingles and diabetes, has been approved by the FDA for use with fibromyalgia patients. Studies have shown that Lyrica may reduce fibromyalgia symptoms such as pain, insomnia, and general dysfunction.
• Antidepressants – Different classes of antidepressant drugs, which may be given in lower dosages for FMS than when used in treating depression, include:
  Tricyclic antidepressants, including amitriptyline (Elavil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), trazodone (Desyrel), and nortriptyline (Pamelor)
  Selective Serotonin-Reuptake Inhibitors (SSRIs), including fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), and citalopram (Celexa).
• Opioids, (Oxycontin, Percocet) which can have both sedative and addictive effects, are sometimes used for relief of severe pain.
• Sleep medications (Ambien, Lunesta) may be used to target the insomnia and fatigue many people with fibromyalgia may experience.

Over-the-Counter Medications:

Over-the-counter drugs such as acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, naproxen (Alleve), and ibuprofen (Advil).

A Note About Medications:

• Before taking any medication, discuss dosages and potential adverse effects with your health care provider.
• Take all medication as directed.
• Because some medications may interact with one another, and because some medications may interact with herbs and dietary supplements, inform your health care provider of all supplements, herbs, and medications that you are taking or are considering.
• Consult your health care provider before stopping your medication or changing its dosage.
• In March, 2004, the Food and Drug Administration (FDA) issued a Public Health Advisory regarding the potential risks to adults and children of taking certain antidepressants. These risks include increased depression and suicidal thoughts, especially among children and adolescents. Please discuss potential risks of these medications with your or your child's health care provider.

Can Lifestyle Changes Help Manage Fibromyalgia?
Lifestyle modifications may help improve fibromyalgia symptoms. They include:

• Exercise – Low-impact aerobics, stretching, and other physical activity.
• Yoga – stretching, breathing, and relaxing yogic techniques.
• Stress management – Relaxation/meditation practices, guided imagery, and cognitive-behavioral approaches can help develop new methods for coping with symptoms.
• Diet/Nutrition - It has been suggested that a diet rich in fruits, vegetables, and omega-3 essential fatty acids may help strengthen the body's natural ability to heal. However, no specific diet has yet been proven to improve fibromyalgia symptoms.
• Supplements – A number of natural substances have been proposed for treating FMS based on preliminary evidence. They include: SAMe (short for S-adenosylmethionine), used to treat depression and osteoarthritis; 5-HPT, used for depression and sleep disorders; malic acid (produced by the body and found in apples; magnesium, one of the body's essential nutrients; D-Ribose, a naturally occurring carbohydrate; and blue-green algae.

What About Alternative Therapies?
A number of complementary and alternative approaches are being used and studied for people with fibromyalgia. They include:

• Traditional Chinese Medicine – acupuncture and qigong (energy exercises designed to facilitate the flow of the qi, or vital energy)
• Biofeedback, to retrain the body's responses to stimuli that may cause pain and distress
• Magnetic therapies, such as placing magnets in mattresses to improve sleep
• Manual therapies, such as massage and chiropractic.