Joint Pain

Fibromyalgia?

FIBROMYALGIA SYNDROME (FMS)
(Article from the Fibromyalgia Network)

For the most part, routine laboratory testing reveals nothing about fibromylagia or chronic fatigue syndrome. However, upon physical examination, the fibromyalgia patient will be sensitive to pressure in certain areas of the body called tender points. To meet the diagnostic criteria, patients must have:
A. Widespread pain in all four quadrants of their body for a minimum of three months

B. At least 11 of the 18 specified tender points
(see diagram)

These 18 sites used for diagnosis cluster around the neck, shoulder, chest, hip, knee and elbow regions. Over 75 other tender points have been found to exist, but are not used for diagnostic purposes.

*The 18 Tender Point Locations for FMS
on "The Three Graces" Masterpiece.

While many chronic pain syndromes display symptoms that overlap with fibromyalgia, the 1990 ACR multi-center criteria study (published in the February 1990 issue of Arthritis and Rheumatism) evaluated a total of 558 patients, of which 265 were classified as controls. These control individuals weren't your typical healthy "normals." They were age and sex matched patients with neck pain syndrome, low back pain, local tendinitis, trauma-related pain syndromes, rheumatoid arthritis, lupus, osteoarthritis of the knee or hand, and other painful disorders. These patients all had some symptoms that mimic FMS, but the trained examiners were not foiled--they hand-picked the FMS patients out of the "chronically ill" melting pot with an accuracy of 88%. FMS is not a wastebasket diagnosis!

Although the above criteria focuses on tender point count, a consensus of 35 FMS experts published a report in 1996 saying that a person does not need to have the required 11 tender points to be diagnosed and treated for FMS. This criteria was created for research purposes and many people may still have FMS with less than 11 of the required tender points as long as they have widespread pain and many of the common symptoms associated with FMS. Commonly associated symptoms include:
• fatigue
• irritable bowel (e.g., diarrhea, constipation, etc.)
• sleep disorder (or sleep that is unrefreshing)
• chronic headaches (tension-type or migraines)
• jaw pain (including TMJ dysfunction)
• cognitive or memory impairment
• post-exertional malaise and muscle pain
• morning stiffness (waking up stiff and achy)
• menstrual cramping
• numbness and tingling sensations
• dizziness or lightheadedness
• skin and chemical sensitivities