Fibromyalgia - Risk Factors

Some doctors believe that fibromyalgia is simply an extreme variant of chronic fatigue syndrome. There is some physical evidence, however, that the two disorders are distinct, with treatments that are specific to each.

text continues below

Myofascial Pain Syndrome. Myofascial pain syndrome can be confused with fibromyalgia and may also accompany it. Unlike fibromyalgia, myofascial pain tends to occur in trigger points, as opposed to tender points, and typically there is no widespread, generalized pain. Trigger-point pain occurs in tight muscles, and when the doctor presses on these points, the patient may experience a muscle twitch. And unlike tender points, trigger points are often small lumps, about the size of a pencil eraser.

Major Depression. The link between psychological disorders and fibromyalgia is very strong and problematic. Certain studies report that between 50 - 70% of fibromyalgia patients have a lifetime history of depression. Only between 18 - 36% of fibromyalgia patients, however, have concurrent major depression, a severe form of depression. It should be noted that some researchers have observed that people who have both psychological disorders and fibromyalgia are more likely to seek medical help than patients who simply have symptoms of fibromyalgia. Such findings may bias study results and favor a higher-than-actual association between depression and fibromyalgia.

Depression most likely does not cause fibromyalgia, but it may increase susceptibility. Depressed feelings in people with fibromyalgia can certainly be normal responses to the pain and fatigue caused by this syndrome. Such emotions, however, are situational and temporary, and are not considered to be a depression disorder. Unlike ordinary periods of sadness, an episode of major depression disorder can last many months. Symptoms of major depression include the following:

A depressed mood every day
Significant weight gain or loss (of 10% or more of an individual's typical body weight)
Insomnia or excessive sleeping
Restlessness or a sense of being slowed down
Low energy every day
Worthless or inappropriately guilty feelings
An inability to concentrate or to make decisions
Suicidal thoughts

Major depression is likely to be the responsible condition in the presence of several of these symptoms plus the absence of physical symptoms (particularly the tender points typical of fibromyalgia).

Chronic Headache. Chronic primary headaches such as migraines are common in fibromyalgia patients. Some experts believe that migraine headaches and fibromyalgia may even share common defects in the systems that regulate certain neurotransmitters (chemical messengers in the brain), including serotonin and epinephrine (commonly called adrenaline). Low levels of magnesium have also been noted in patients with both fibromyalgia and migraines. In fact, chronic migraine sufferers who fail to benefit from usual therapies may also have fibromyalgia.

Symptoms of a migraine attack may include heightened sensitivity to light and sound, nausea, vision problems (auras), difficulty of speech, and intense pain predominating on one side of the head.