



Patients with fibromyalgia complain of chronic widespread pain, fatigue and stiffness. They usually report sleep disturbances that involve repeated awakenings and greater fatigue on rising in the morning than on retiring at night. There may also be a component of depression, migraine headaches, irritable bowel problems, tempomandibular joint pain and dizziness when rising from a seated position.

The results of laboratory tests usually are completely normal. The diagnosis of fibromyalgia is aided by a physical examination that reveals multiple symmetric tender points. In contrast to normal tenderness, the tenderness of fibromyalgia is characterized by an exaggerated emotional response, withdrawal of the tender part and worsening of pain after examination.

Fibromyalgia is believed to be a multifactorial disturbance in which environmental and/or stress deteriorates sleep. This disturbed sleep results in pain amplification, depression and fatigue. It in turn leads to more stress plus physical and cardiovascular deconditioning.

Fibromyalgia can present alone or in combination with other autoimmune diseases, cancers, trauma or infections.

The treatment of fibromyalgia includes stress reduction and a structured aerobic exercise program including stretching and flexibility exercises. Also, sleep patterns need to be improved so patients can wake with less fatigue and less pain.